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Castille, C.J., Saylor, Eakin, Baer, Todd, Mccaffery, Orie Melvin v. Medical Care Availability and Reduction of Error Fund

April 28, 2011

CASTILLE, C.J., SAYLOR, EAKIN, BAER, TODD, MCCAFFERY, ORIE MELVIN, JJ. STEVEN B. HEIM, AS ASSIGNEE OF ROBERT O.DETWEILER, D.O. AND DETWEILER FAMILY MEDICINE AND ASSOCIATES, P.C., APPELLEES
v.
MEDICAL CARE AVAILABILITY AND REDUCTION OF ERROR FUND, APPELLANT



Appeal from the Order of Commonwealth Court at No. 358 MD 2004

dated 1/21/10 granting summary judgment

ARGUED: December 1, 2010

OPINION

MR. JUSTICE SAYLOR

The outcome of this direct appeal turns on the interplay among the statutory schemes providing healthcare providers with protection from excess liability and insurer insolvency and the doctrine of joint and several liability.

In 1998, Stephen B. Heim commenced a professional liability action against physician Robert O. Detweiler, D.O.; his family medical practice of Detweiler Family Medicine and Associates, P.C.; and employee-physician Stephen J. Carver, D.O. Proceeding individually and as an estate administrator, Mr. Heim alleged that the doctors' negligent services, from 1992 through 1996, caused the death of his wife.

In August 2000, upon trial, Mr. Heim secured a verdict of over $1 million. The jury attributed a substantial percentage of fault to Mrs. Heim and apportioned the remaining liability among the defendant physicians.

With delay damages, a molded verdict of approximately $707,000 was entered against all defendants, for which they bore liability jointly and severally. See Maloney v. Valley Med. Facilities, Inc., 603 Pa. 399, 416, 984 A.2d 478, 489 (2009) ("Joint tortfeasors generally are jointly-and-severally liable for the entire amount of a verdict, albeit that a jury may assign only a portion of fault to each."). Subsequently, the judgment on this verdict was affirmed on the defendants' appeal. See Heim v. Carver, 850 A.2d 19 (Pa. Super.) (table), appeal denied, 581 Pa. 700, 864 A.2d 1205 (2004).

At the time of the events underlying the litigation, Drs. Detweiler and Carver each maintained primary professional liability coverage in the amount of $200,000 per occurrence under a policy issued by a private insurer, as required under the Health Care Services Malpractice Act.*fn1 See 40 P.S. §1303.701(a)(1) (superseded). On account of this primary insurer's subsequent insolvency, however, claims under the policy were assumed by the Pennsylvania Property and Casualty Association ("PPCIGA"), subject, inter alia, to a $300,000 per-claimant limitation. See id. §991.1803(b). By virtue of a monetary payment -- which, coupled with a statutory setoff which is not presently in dispute, amounted to $300,000 -- it has been agreed for purposes of this litigation that PPCIGA satisfied its own responsibility in this regard.*fn2

Significantly, however, the primary insurer's obligation related to the Heim case exceeded this statutory cap by $100,000, which was attributed to Dr. Carver's share of the verdict.*fn3

Also when the cause of action accrued, under the HCSMA, excess liability protection was provided to health care providers through a government-run contingency fund known as the Medical Professional Liability Catastrophe Loss Fund (the "CAT Fund"). See 40 P.S. §1303.701(d) (superseded) (delineating the CAT Fund's general responsibility to pay judgments against qualifying health care providers in excess of the provider's primary coverage, subject to a $1,000,000 per occurrence cap). Under the specific terms of the governing statute, the CAT Fund was responsible to pay the judgment against each of Drs. Detweiler and Carver to the extent the judgment "exceeds its [or his] basic coverage insurance in effect at the time of the occurrence[.]" Id. (emphasis added).*fn4 In 2002, the CAT Fund's statutory liabilities were transferred to the Medical Care Availability and Reduction of Error Fund (the "MCARE Fund" or the "Fund"), per the Medical Care Availability and Reduction of Error Act.*fn5

(. . . continued) 571 Pa. 333, 343-45, 812 A.2d 566, 571-73 (2002) (discussing the concept of a "covered claim" under the PPCIGA scheme).

Relative to the Heim case, the Fund determined that it had no responsibility to redress the $100,000 shortfall in primary insurance benefits occasioned by the primary insurer's insolvency and the manner in which the PPCIGA cap was administered. Thus, consistent with the law of joint and several liability, Mr. Heim elected to commence execution proceedings against assets of Dr. Detweiler and his practice group to recover the unpaid portion of his judgment, including the $100,000 attributed to Dr. Carver, as well as attendant delay damages and post-judgment interest.

Dr. Detweiler and the medical group, for their parts, commenced a declaratory judgment action against the Fund and Mr. Heim in the Commonwealth Court, challenging the Fund's position relative to the $100,000 shortfall. During the course of the declaratory judgment proceedings, Mr. Heim reached a settlement with Dr. Detweiler and the practice and, via an associated assignment of the latter's claims, Mr. Heim assumed the role of the petitioner. Furthermore, he took the position ...


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