Brown v. Philadelphia College of Osteopathic Medicine
2000 Pa. Super. 262, 2000 Pa. Super. LEXIS 2464, 760 A.2d 863 (2000)
Rule of Law:
For a defendant's negligence to be a proximate cause of injury, the harm must be a reasonably foreseeable and direct consequence, not primarily attributable to significant intervening factors or a remote lapse of time, and claims for negligent infliction of emotional distress in Pennsylvania generally require a contemporaneous physical impact.
Facts:
- Yvette Brown delivered her second child at Philadelphia College of Osteopathic Medicine (PCOM) on August 29, 1991.
- Soon after delivery, a PCOM physician erroneously informed Yvette Brown that her daughter had congenital syphilis and that the baby could only have contracted it from Yvette.
- Yvette Brown confronted her husband, Gerald Brown, with the diagnosis, leading Gerald Brown to confess to an ongoing extramarital affair.
- The baby received a series of injections to treat congenital syphilis, and Yvette Brown received one injection to treat syphilis.
- In October 1991, the Browns learned that their daughter, in fact, did not have syphilis.
- In December 1991, Gerald Brown received test results confirming he did not have syphilis.
- In November 1991, Yvette Brown, a police officer, suffered a physical assault from Gerald Brown after he became suspicious during a phone call, and she subsequently discharged her service revolver at his car on a public street.
- As a result of the altercation and discharge of her firearm, Yvette Brown was discharged from the Philadelphia police force for conduct unbecoming an officer.
Procedural Posture:
- In October 1993, Yvette and Gerald Brown filed a lawsuit in the Court of Common Pleas of Philadelphia County (trial court) against PCOM, alleging professional negligence and negligent infliction of emotional distress.
- After a six-day trial in April 1998, a jury found in favor of the Browns against PCOM, awarding $500,000 to Yvette Brown and $10,000 to Gerald Brown.
- PCOM filed post-trial motions, which the Honorable Sandra Mazer Moss denied on August 31, 1999.
- The trial court also granted the Browns' motion for delay damages, bringing the total judgment to $666,983.90.
- Judgment was entered on the verdict on September 27, 1999.
- PCOM appealed this judgment to the Pennsylvania Superior Court (intermediate appellate court); PCOM is the appellant, and Yvette and Gerald Brown are the appellees.
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Issue:
Does an erroneous medical diagnosis constitute the proximate cause of subsequent, remote damages such as marital breakdown, physical violence, loss of employment, and emotional distress, where significant intervening factors and a lack of contemporaneous physical impact are present?
Opinions:
Majority - Todd, J.
No, an erroneous medical diagnosis of syphilis was not the proximate cause of the Browns' alleged damages, including marital breakdown, physical violence, loss of employment, or compensable emotional distress, because significant intervening factors broke the chain of causation and the emotional distress lacked the requisite contemporaneous physical impact under Pennsylvania law. The court acknowledged PCOM's duty and breach, and that its conduct was an 'actual cause' of subsequent events, but determined it was not the 'proximate' or 'legal' cause. Proximate cause is a legal question for the court, requiring a determination of whether it is 'highly extraordinary' that the actor’s conduct brought about the harm. Applying the Restatement (Second) of Torts § 433 factors, the court found: 1) Gerald Brown's extramarital affair and his confession, along with his suspicions of his wife's infidelity, were far greater factors in causing the marital discord and breakdown than the false diagnosis; 2) PCOM's conduct did not create a continuous force or series of forces, as Mr. Brown confessed his adultery before retesting, and the physical altercation occurred after the erroneous diagnosis was known to be false; and 3) the lapse of more than two months between the erroneous diagnosis and the primary physical altercation and marital separation indicated remoteness. Regarding Yvette Brown's loss of income, her independent act of discharging her service revolver at her husband and her subsequent termination by the police department for conduct unbecoming an officer were deemed the proximate causes. The only physical harm proximately resulting from PCOM's negligence was a single, non-damaging injection. For the claim of negligent infliction of emotional distress, the court reaffirmed Pennsylvania's 'physical impact' rule, holding that 'prolonged and aggravated anger and rage' or 'weight gain over a period of years' do not constitute the required contemporaneous physical impact, nor do physical injuries intentionally inflicted by a third party two months after the misdiagnosis.
Analysis:
This case strongly reaffirms the strict application of proximate causation principles and the 'physical impact' rule for negligent infliction of emotional distress in Pennsylvania. It highlights the judiciary's role in limiting liability for unforeseeable and remote consequences, even when a defendant's negligence is an actual cause. The ruling underscores that significant intervening acts by third parties or substantial lapses of time can break the chain of legal causation, preventing recovery for indirect damages, and clarifies what constitutes a 'physical impact' for emotional distress claims.
