In a case decided on November 22, 2017, the Supreme Court of Pennsylvania Eastern District (“Pennsylvania Supreme Court”) held that Section 513(d) of MCARE establishes a two-year statute of limitations for Medical Professional Liability cases in the form of wrongful death or survival actions, which accrues at the time of the decedent’s death.

The decedent first became a resident of the defendant nursing home in 2005, after she received acute medical care for a serious head injury following a fall at her home. The decedent had pre-existing pressure ulcers (bedsores) that worsened while she was in the defendant nursing home that was allegedly due to the nursing home staff’s negligent failure to follow a physician’s order to frequently reposition the decedent. From 2005 to 2007, the decedent suffered malnourishment, dehydration, conscious pain from the bedsores, bone infection, and a sepsis systemic infection while residing in the defendant nursing home.

One of the decedent’s sacral pressure ulcers became infected in July 2007 that led to sepsis and ultimately caused the decedent’s death on October 18, 2007.

On August 13, 2009, the estate of the decedent filed a complaint against the defendant nursing home alleging negligence on behalf of the decedent (survival action) and a wrongful death action to compensate the decedent’s survivors. On March 13, 2013, the case was tried before a jury and the jury returned a verdict in favor of the plaintiffs in the amount of $125,000.00 on the wrongful death action and $1,000,000.00 on the survival action. On March 21, 2013, the same jury awarded $875,000.00 in punitive damages.

The trial judge denied the defendants’ post-trial motions, which argued that the survival claims were barred by the two-year statute of limitations for personal injury actions, which began to run at the time of the decedent’s injury in 2005. The defendants argued that a survival action is distinct from a wrongful death action: a survival action is merely a continuation of a cause of action that accrued to the decedent while the decedent was alive, and the statute of limitations begins to run when the decedent is injured. On the other hand, a wrongful death action accrues to the decedent’s heirs when the decedent dies of such an injury: its statute of limitations begins to run at the decedent’s death. The defendants argued that once the statute of limitations expires on the decedent’s cause of action, it cannot form the basis for a survival action following the decedent’s death.

The trial judge determined that the plaintiff’s survival action was timely filed pursuant to Section 513(d) of the Medical Care Availability and Reduction of Error Act (MCARE), 40 P.S. §§ 1303.501-1303.516, which permits plaintiffs to bring survival actions within two years of death. The defendants appealed.

Section 513 of MCARE

Section 513 of MCARE states:

§ 1303.513. Statute of repose

(a) General rule.–Except as provided in subsection (b) or (c), no cause of action asserting a medical professional liability claim may be commenced after seven years from the date of the alleged tort or breach of contract.

(b) Injuries caused by foreign object.–If the injury is or was caused by a foreign object unintentionally left in the individual’s body, the limitation in subsection (a) shall not apply.

(c) Injuries of minors.–No cause of action asserting a medical professional liability claim may be commenced by or on behalf of a minor after seven years from the date of the alleged tort or breach of contract or after the minor attains the age of 20 years, whichever is later.

(d) Death or survival actions.–If the claim is brought under 42 Pa.C.S. § 8301 (relating to death action) or 8302 (relating to survival action), the action must be commenced within two years after the death in the absence of affirmative misrepresentation or fraudulent concealment of the cause of death.

40 P.S. § 1303.513(a)-(d)

Pennsylvania Supreme Court Opinion

The Pennsylvania Supreme Court stated that in interpreting a statute, it must ascertain and effectuate the intention of the General Assembly. Every statute must be construed, if possible, to give effect to all its provisions. To do so, the Pennsylvania Supreme Court stated that it must begin by considering the plain meaning of the statute’s language. If the statute’s plain language is unambiguous, the Pennsylvania Supreme Court must apply it without employing familiar canons of construction and without considering legislative intent (when the words of a statute are clear and free from all ambiguity, the letter of it is not to be disregarded under the pretext of pursuing its spirit). Furthermore, the Statutory Construction Act states that the headings of a statute do not control the meaning of its plain language, but may be considered to aid in construction.

Difference Between Statute Of Limitations And Statute Of Repose

The Pennsylvania Supreme Court stated that it must first determine whether Section 513(d) is a statute of repose for survival and wrongful death actions or a statute of limitations that modifies the accrual date for survival actions. A statute of limitations creates a time limit for suing in a civil case, based on the date when the claim accrued: a claim accrues in a personal injury or property damage action when the injury occurred or was discovered. A statute of repose, on the other hand, puts an outer limit on the right to bring a civil action that is measured not from the date on which the claim accrues but instead from the date of the last culpable act or omission of the defendant.

Statutes of limitations, but not statutes of repose, are subject to equitable tolling, a doctrine that pauses the running of, or tolls, a statute of limitations when a litigant has pursued his rights diligently but some extraordinary circumstance prevents him from bringing a timely action. Statutes of repose generally may not be tolled, even in cases of extraordinary circumstances beyond a plaintiff’s control.

Equitable Tolling

Equitable tolling is applicable to statutes of limitations because their main thrust is to encourage the plaintiff to pursue his rights diligently, and when an extraordinary circumstance prevents him from bringing a timely action, the restriction imposed by the statute of limitations does not further the statute’s purpose. But a statute of repose is a judgment that defendants should be free from liability after the legislatively determined period of time, beyond which the liability will no longer exist and will not be tolled for any reason.

The Pennsylvania Supreme Court stated that a survival action is not an independent cause of action, but a continuation of a cause of action that accrued to the decedent, and the latest time when the statute of limitations runs is at the decedent’s death. A survival action merely permits a personal representative to pursue a cause of action that had already accrued to a victim prior to death.

In the present case, the Pennsylvania Supreme Court held: “Section 513(d) declares that a survival action in a medical professional liability case resulting in death accrues at the time of death, not at the time of decedent’s injury. This conclusion is based on the plain language of Section 513. First, Section 513(a) sets forth a seven-year statute of repose for medical professional liability claims. It provides that ‘no cause of action . . . may be commenced after seven years from the date of the alleged tort or breach of contract’ … The statute of repose in Section 513(a) begins running on the date of the tort or breach of contract, no matter when the cause of action accrues (and may even bar a cause of action before it accrues). However, Section 513(a) does not provide how it relates to Section 513(d). Instead, Section 513(d) stands separately.”

“In contrast to the language of Section 513(a), Section 513(d) states that in a medical professional liability claim for wrongful death or survival, ‘the action must be commenced within two years after the death in the absence of affirmative misrepresentation or fraudulent concealment of the cause of death’ … This language mirrors traditional statute of limitation language, such as the two-year limitation contained in 42 Pa.C.S. § 5524 … Section 513(d) focuses not on the defendant’s conduct, but on the time within which the plaintiff must sue. Unlike Section 513(a), it also contains equitable considerations that may toll the two-year period to commence a suit following death: ‘affirmative misrepresentation or fraudulent concealment of the cause of death’ … The focus on when the plaintiff must commence the action and the enumeration of specific equitable considerations that may toll that time period leads us to conclude that Section 513(d) is a statute of limitations for medical professional liability death cases that sets the date of accrual at the date of decedent’s death.”

“Section 513(d) establishes a specific statute of limitations for survival and wrongful death actions in medical professional liability cases that prevails over the general statute of limitations for personal injuries actions contained in 42 Pa.C.S. § 5524(2) … It is within the legislature’s power to enact a more specific statute of limitations for medical professional liability negligence that results in death, and where the plain language of the statute indicates that it did so, we must give effect to that language … If the General Assembly wanted to set a statute of repose of two years from the date of decedent’s death, it could have provided, similar to Section 513(a), ‘no cause of action for wrongful death or survival may be commenced after two years from the death.’ It did not; instead, it created a statute of limitations for medical professional liability cases resulting in death, which accrues at the time of decedent’s death … Therefore, [the plaintiff’s] survival actions were timely filed within two years of [the decedent’s] death.”

Source Dubose v. Willowcrest Nursing Home, No. 22 EAP 2016.

If you or a loved one suffered injuries (or worse) while a resident of a nursing home in Pennsylvania or in another U.S. state due to nursing home neglect, nursing home negligence, nursing home abuse, or resident on resident abuse, you should promptly contact a local nursing home claim attorney in your U.S. state who may investigate your nursing home claim for you and file a nursing home claim on your behalf, if appropriate.

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