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[U] Blango v. Jeanes Hospital, Inc.

Superior Court of Pennsylvania

October 1, 2013

SHIRLEY E. BLANGO, EXECUTRIX OF THE ESTATE OF JOE NATHAN BLANGO, SR., AND SHIRLEY E. BLANGO, INDIVIDUALLY, Appellant
v.
JEANES HOSPITAL, INC., OPERATING AS JEANES HOSPITAL, TEMPLE UNIVERSITY HEALTH SYSTEMS, INC., HILLCREST CONVALESCENT HOME, INC., CRESTVIEW CONVALESCENT HOME, INC., GERIATRIC & MEDICAL SERVICES, INC., GENESIS & MEDICAL COMPANIES, INC., GENESIS HEALTHCARE HOLDING COMPANY I, INC., GENESIS HEALTHCARE CORPORATION, JER PARTNERS, FORMATION CAPITAL, LLC SHIRLEY BLANGO, EXECUTRIX OF THE ESTATE OF JOE NATHAN BLANGO, SR., AND SHIRLEY E. BLANGO, INDIVIDUALLY, Appellant
v.
JEANES HOSPITAL, INC., OPERATING AS JEANES HOSPITAL, TEMPLE UNIVERSITY HEALTH SYSTEMS, INC., HILLCREST CONVALESCENT HOME, INC., CRESTVIEW CONVALESCENT HOME, INC., GERIATRIC & MEDICAL SERVICES, INC., GENESIS & MEDICAL COMPANIES, INC., GENESIS HEALTHCARE HOLDING COMPANY I, INC., GENESIS HEALTHCARE CORPORATION, JER PARTNERS, FORMATION CAPITAL, LLC SHIRLEY E. BLANGO, EXECUTRIX OF THE ESTATE OF JOE NATHAN BLANGO, SR., AND SHIRLEY E. BLANGO, INDIVIDUALLY
v.
JEANES HOSPITAL, INC., OPERATING AS JEANES HOSPITAL, TEMPLE UNIVERSITY HEALTH SYSTEM, INC., HILLCREST CONVALESCENT HOME, INC., CRESTVIEW CONVALESCENT HOME, INC., GERIATRIC & MEDICAL SERVICES, INC., GERIATRIC & MEDICAL COMPANIES, INC., GENESIS HEALTHCARE CORPORATION, FORMATION CAPITAL, LLC AND JER PARTNERS APPEAL OF: JEANES HOSPITAL, INC., Appellant

NON-PRECEDENTIAL DECISION

Appeal from the Order Dated November 17, 2010, in the Court of Common Pleas of Philadelphia County Civil Division at No. October Term, 2007, No. 004518

BEFORE: FORD ELLIOTT, P.J.E., MUNDY AND FITZGERALD, [*] JJ.

MEMORANDUM

FORD ELLIOTT, P.J.E.

This is an appeal and cross-appeal from the judgment entered November 17, 2010, in favor of Shirley E. Blango and against Hillcrest Center and Jeanes Hospital. Joe Blango died on April 18, 2008, allegedly as a result of negligent care at Hillcrest Center and Jeanes Hospital. His wife, Shirley E. Blango, brought a wrongful death and survival action against the defendants; following a jury trial, the jury found in favor of Mrs. Blango and awarded $1, 000, 000 in compensatory damages, finding Hillcrest and Jeanes Hospital each 50% liable. After a separate hearing on punitive damages, the jury awarded punitive damages against Jeanes Hospital and Hillcrest in the amount of $1, 500, 000 and $3, 500, 000, respectively. On post-trial motions, the trial court remitted the punitive damage awards to $500, 000 and $1, 000, 000. These appeals followed.[1]

The trial court has aptly summarized the facts and procedural history of this matter as follows:

This matter was brought by Plaintiff Shirley Blango as executrix of her late husband Joseph Blango's Estate and in her own right for a wrongful death claim and a survival action based upon Mr. Blango's admission to both facilities during the period of May 21, 2006 and ending on June 13, 2006. A jury trial began in this matter on February 9th, 2010 before the Honorable George W. Overton.
The Plaintiff's daughter Sheila Rutherford testified that her father had generally good health with some problems with arthritis and his weight generally stayed the same throughout his life. She testified that her mother called her on May 21, 2006 and said her father was not moving or speaking and he subsequently was admitted to Jeanes Hospital that same day. She testified that she visited him every day for the five days he initially stayed at Jeanes Hospital. He wouldn't eat his food and was only offered regular food and never any soft food or supplements. The Plaintiff was then transferred to Hillcrest Center for ten days. At Hillcrest the Plaintiff also "never ate" and the center staff would just take back whatever food was brought in for the Plaintiff. Ms. Rutherford testified that she never saw her father turned on his bed while at [H]illcrest and noticed that he had feces in his diaper. Mr. Blango then was brought back to Jeanes Hospital because he became sick on June 5, 2006 and was there for three days. Ms. Rutherford testified that her father became noticeably thinner and the diet he was offered was never altered. Ms. Rutherford stated that she learned of her father's bedsores during his second stay at Jeanes Hospital from her mother. She testified that her father was always on a regular mattress with no additional supports. On June 13th, 2006, Mr. Blango was transferred to Abington Hospital and at that point they learned of an infection in the bedsore in his sacral area (the area at the top of his buttocks). He stayed at Abington Hospital for approximately five to six weeks and the infection lasted for the rest of his life when he was taken care of by his family and homecare nurses.
There were a series of videos admitted that showed the homecare routine for Mr. Blango. His family was trained to reposition Mr. Blango every few hours and there was a wound care home nurse but the bedsore continued for the duration of his life. Eventually, Mr. Blango's kidney had to be removed at Einstein Hospital. Mr. Blango passed away in April of 2008.
Nurse Kathleen Fletcher testified as an expert for the Plaintiff and was accepted as an expert in gerontological nursing. She reviewed the records in the case and found that defendants' care fell below the standard particularly in the areas of transition of care and communication. She testified that over the course of his admissions to both defendant facilities, his weight decreased from 190 pounds to 168 pounds. She testified that there was no documentation about his diet at Jeanes Hospital or Hillcrest Center and that his protein stores had declined in his first visit to Jeanes Hospital. Furthermore, she opined that Jeanes Hospital did not communicate the status of Mr. Blango's skin to Hillcrest Center which she stressed was important because of his skin vulnerability. She testified that Hillcrest noted in their records that when admitted from Jeanes Hospital, he had three beginning pressure ulcers with [one] on each ankle and one on his sacrum. Furthermore, she testified that Hillcrest Center's transfer form fell below the standard of care.
Edna Cox, a registered dietician, was accepted by this court as an expert. She testified that Jeanes Hospital failed to provide even the most minimally acceptable care and there was no nutrition assessment despite severe weight loss. She furthermore testified that it was below the standard of care to not order a report on his Albumen levels. She testified that failure to monitor the intake and output of fluids fell below the standard of care as well. As for Defendant, Hillcrest Center, she testified that they "woefully neglected to provide even the minimally acceptable nutrition services." The meals offered fell below the standard of care and the Center could have offered supplements such as Ensure or boosted the calories in his current food. Ms. Cox also addressed the care plan created by Hillcrest on the 29th of May. She said that plan fell below the standard of care because it was not followed through upon and did not address the pressure sores.
Dr. James Steg testified for the Plaintiff and was accepted by this court as an expert. Dr. Steg testified that Mr. Blango contracted a urinary tract infection during his first stay at Jeanes Hospital and that infection contributed to the development of a pressure ulcer. Dr. Steg made his determination based on an analysis of urine culture results. He also testified that when Mr. Blango was admitted to Abington hospital both e-coli and MRSA infections were found in his sacral wound.
Nurse Mary Lynn King testified on February 26th, 2010. She was accepted by this court, without objection, as an expert in wound care and wound care ostomy. She testified to a reasonable degree of nursing certainty that neither Jeanes Hospital nor Hillcrest Center met their standard of care for the plaintiff. In terms of the first visit to Jeanes Hospital she testified that "the documentation, the assessments, and interventions in this case that were put on his skin or not on his skin were not adequate." Specifically she testified that Jeanes Hospital failed to assess Mr. Blango's risk for skin breakdown by not giving him a "Braden score, " and failed to use preventative measures for bedsores. She also opined that the standard of care was not met for Mr. Blango's visit to Hillcrest as well. Specifically, she cites the fact that there was documentation of turning Mr. Blango on days when he was not in the facility. There was documentation that Mr. Blango was repositioned on June 6th, June 14th and June 15th and he was not at Hillcrest Center on those days. She testified that documentation of services that could not have occurred does not meet the standard of care.
Dr. Richard Berg testified and was accepted by this court as an expert in infectious disease. He testified that the sacral ulcer and wound that Mr. Blango had at the time of discharge from Hillcrest Center to Abington Hospital was the source and cause of the chronic sepsis that he had for the rest of his life. He further testified that the sacral bedsore was infected on June 13, 2006 when Mr. Blango got to Abington Hospital. The culture revealed both e-coli and MRSA in the wound and that eventually reached his kidney and the kidney had to be removed. Furthermore, the original bedsore that Mr. Blango got at Jeanes Hospital and Hillcrest Center increased his risk for developing additional smaller wounds. Dr. Berg testified that Mr. Blango's kidney had not been previously infected and that the chronic sepsis prevented healing of the wounds. Finally, Dr. Berg opined that the costs of care were necessitated by the bedsore.
Plaintiff Shirley Blango testified about the care given to her late husband at Jeanes Hospital and Hillcrest Center. She produced two photographs of her husband's wound and indicated that it was a similar representation to how the wound looked when he was admitted to Abington Hospital. She testified that that wound existed until Mr. Blango's death in April of 2008. She indicated that Mr. Blango had a stroke on May 21, 2006 and was taken to Jeanes Hospital. She testified that he could not feed himself and was unable to eat the solid food that the hospital brought for him. Furthermore, none of the Hospital staff attempted to help Mr. Blango eat. She said she never saw anyone reposition Mr. Blango at Jeanes Hospital and that he was always on his back whenever she saw him.
She also testified about Mr. Blango's care at the Hillcrest Center. Ms. Blango testified that she never saw anybody turn or reposition Mr. Blango at the Hillcrest Center. She also indicated that she never saw anyone feed him or give him a diet other than solid food and that as a consequence, Mr. Blango rarely ate. She also testified that often Mr. Blango would go a long time without his pamper being changed and would be sitting in his own feces and commented to her that "they have me sitting in my own poison." She testified that Mr. Blango never received adequate physical therapy and that therapy consisted of sitting in a room and being told to "hold his head up." She further testified that during and after his second admission to Jeanes Hospital she was never informed of any bedsores on Mr. Blango's body and did not learn of any until he was back at Hillcrest the second time. She stated that she first saw the actual wound at Abington Hospital when he was first admitted and was informed of the danger of this condition.
Ms. Blango testified that Abington Hospital advised her to place Mr. Blango back into a nursing home but she refused. Instead, her entire family was trained in how to take care of Mr. Blango at home. She testified that because of the expenses incurred that she had to get a reverse mortgage on their home. Mr. Blango died at home surrounded by most of his relatives and family.
On March 5th, 2010, the jury reached a verdict where they found both Defendants 50% liable for their negligence. The jury awarded $500, 000 for the survival action, $0 for the wrongful death action and $500, 000 for the loss of consortium. Moreover, the jury found both defendants liable for punitive damages.
On March 17th, 2010, this court reconvened for the punitive damages portion of the trial. Hillcrest Center called one witness, Carol Dougherty, and Jeanes Hospital called the Chief Financial Officer for the Hospital. The jury found Jeanes Hospital liable for $1.5 million dollars in punitive damages and Hillcrest Center liable for $3.5 million dollars in punitive damages. On September 13, 2010, this court heard arguments for both post-trial relief and remittitur. On September 29, 2010, this court denied post-trial relief for both defendants but reduced the punitive damages award for Jeanes Hospital to $500, 000 and for Hillcrest Center to $1, 000, 000.

Trial court opinion, 4/18/11 at 2-8 (citations to the record and emphasis deleted).

Jeanes Hospital has raised the following claims on appeal:

A. Did the trial court err and abuse its discretion in failing to enter a judgment n.o.v. in the hospital's favor as to plaintiff's claims of negligence and corporate negligence or, in the alternative, in failing to award the hospital a new trial based on the weight of the evidence and/or related errors?
B. Did the trial court err and abuse its discretion in failing to enter a judgment n.o.v. in the hospital's favor as to plaintiff's claim for punitive damages, and should plaintiff's request for the reinstatement of the entire punitive damages award be denied?
C. Did the trial court err and abuse its discretion in failing to grant Jeanes Hospital a new trial after wrongly allowing plaintiff's five experts to testify beyond the scope of their reports?
D. Did the trial court err and abuse its discretion in failing to grant Jeanes Hospital a new trial after wrongly allowing plaintiff's videotaped discovery deposition play-back of the testimony of several nurses?

Jeanes Hospital's brief at 4.[2]

Mrs. Blango has raised the following issue for this court's review on appeal, challenging the trial court's grant of remittitur: "Whether the trial court committed reversible error when it remitted the punitive damages award against Jeanes Hospital from $1, 500, 000 to $500, 000[?]" (Blango's brief at 3.)

We find Issues A, C, and D raised by Jeanes Hospital are sufficiently addressed in the trial court's Rule 1925(a) opinion. As Blango observes, Jeanes Hospital attempts to re-state the evidence in a light most favorable to it, when Blango was the prevailing party at trial. This is improper. The evidence adduced at trial, if believed by the jury, was sufficient to make out claims for negligence and corporate negligence.

Turning to Issue B in Jeanes Hospital's statement of questions involved, we find the trial court did not err in denying judgment n.o.v. in the hospital's favor as to Blango's punitive damages claim.

When reviewing the propriety of an order granting or denying judgment notwithstanding the verdict, we must determine whether there is sufficient competent evidence to sustain the verdict. Johnson v. Hyundai Motor America, 698 A.2d 631, 635 (Pa.Super.1997), appeal denied, 551 Pa. 704, 712 A.2d 286 (1998) (citations omitted); Rowinsky v. Sperling, 452 Pa.Super. 215, 681 A.2d 785, 788 (1996), appeal denied, 547 Pa. 738, 690 A.2d 237 (1997) (quoting Samuel Rappaport Family Partnership v. Meridian Bank, 441 Pa.Super. 194, 657 A.2d 17, 20 (1995)). We must view the evidence in the light most favorable to the verdict winner and give the verdict winner the benefit of every reasonable inference arising therefrom while rejecting all unfavorable testimony and inferences. Johnson, supra at 635; Rowinsky, supra at 788. We apply this standard in all cases challenging the grant of a motion for J.N.O.V. Shearer v. Reed, 286 Pa.Super. 188, 428 A.2d 635, 637 (1981).
Pennsylvania law makes clear that a judgment notwithstanding the verdict is proper only in clear cases where the facts are such that no two reasonable minds could disagree that the verdict was improper. Johnson, supra at 635; Rowinsky, supra at 788. Questions of credibility and conflicts in evidence are for the fact-finder to resolve. Commonwealth, Department of Transportation v. Patton, 546 Pa. 562, 568, 686 A.2d 1302, 1305 (1997); Miller v. Brass Rail Tavern, Inc., 702 A.2d 1072, 1076 (Pa.Super.1997) (citation omitted). This Court will not substitute its judgment based upon a cold record for that of the fact-finder where issues of credibility and weight are concerned. Id.

Birth Center v. St. Paul Companies, Inc., 727 A.2d 1144, 1154-1155 (Pa.Super. 1999).

Punitive damages will lie only in cases of outrageous behavior, where defendant's egregious conduct shows either an evil motive or reckless indifference to the rights of others. Punitive damages are appropriate when an individual's actions are of such an outrageous nature as to demonstrate intentional, willful, wanton, or reckless conduct.

J.J. DeLuca Co., Inc. v. Toll Naval Associates, ---Pa.Super. ---, 56 A.3d 402 (2012) (citation omitted).

Outrageous conduct is an "act done with a bad motive or with a reckless indifference to the interests of others." "Reckless indifference to the interests of others", or as it is sometimes referred to, "wanton misconduct", means that "the actor has intentionally done an act of an unreasonable character, in disregard of a risk known to him or so obvious that he must be taken to have been aware of it, and so great as to make it highly probable that harm would follow."

Smith v. Brown, 283 Pa.Super. 116, 423 A.2d 743, 745 (1980) (citations omitted).

[I]n Pennsylvania, a punitive damages claim must be supported by evidence sufficient to establish that (1) a defendant had a subjective appreciation of the risk of harm to which the plaintiff was exposed and that (2) he acted, or failed to act, as the case may be, in conscious disregard of that risk.
Snead v. Soc'y for Prevention of Cruelty to Animals of Pennsylvania, 929 A.2d 1169, 1184-85 (Pa.Super.2007), aff'd, 604 Pa. 166, 985 A.2d 909 (2009) (citing Hutchison ex rel. Hutchison v. Luddy, 896 A.2d 1260, 1266 (Pa.Super.2006)).

Weston v. Northampton Personal Care, Inc., 62 A.3d 947, 961 (Pa.Super. 2013). "The determination of whether a person's actions arise to outrageous conduct lies within the sound discretion of the fact-finder and will not be disturbed by an appellate court so long as that discretion has not been abused." Id., citing J.J. DeLuca Co., supra.

There was evidence that following Mr. Blango's admission to Jeanes Hospital after a minor stroke, he developed pressure sores on his sacrum and the heels of his feet. Mr. Blango was not turned and repositioned on a regular basis. Mr. Blango also acquired a urinary tract infection which went undiagnosed. Dr. Steg testified that the UTI contributed to the development of a pressure ulcer. When Mr. Blango was transferred from Jeanes Hospital to Hillcrest following his first admission, no one from the hospital informed Hillcrest of his skin problems.

During Mr. Blango's second admission to Jeanes Hospital, his sacral wound deteriorated to a Stage II pressure ulcer. Again, there was evidence that the hospital failed to turn and reposition Mr. Blango every two hours as required. Nurse Sowirka testified that the hospital was chronically understaffed. Mrs. Blango testified that nursing staff at the hospital repeatedly ignored her requests to change her husband's diaper, and he was always left on his back. There was no attempt to help Mr. Blango use the bathroom or a bedpan instead of adult diapers. Nurse Fletcher testified that incontinence is a risk factor for skin breakdown, as is nutritional compromise. However, there was a lack of communication between Jeanes Hospital and Hillcrest.

In addition, there was evidence that Jeanes Hospital failed to meet Mr. Blango's nutritional needs, which put him at further risk for bedsores. Mr. Blango lost a great deal of weight during his admissions at Jeanes Hospital. There was testimony that he was kept on a standard diet despite the fact he had difficulty swallowing. The hospital made no attempt to feed him protein shakes or supplements to ensure he received the necessary nutrition. According to his family, hospital staff would simply collect his untouched food tray. There was never a nutritional assessment completed by a dietician during either hospital stay.

The above evidence, if believed by the jury, was sufficient for a finding of reckless indifference. There was testimony that the hospital failed to take basic steps to minimize the risk of bedsores, e.g., turning and repositioning the patient, performing a nutritional assessment, regularly changing his diapers, etc. Importantly, Mr. Blango's skin condition was never communicated to Hillcrest during transfer. Ultimately, of course, Mr. Blango's sacral wound developed into a Stage IV pressure ulcer, resulting in osteomyelitis. While Jeanes Hospital challenges some of the testimony on appeal, e.g., the degree of Mr. Blango's weight loss while hospitalized, our standard of review requires that we view the evidence in the light most favorable to the plaintiff, the verdict winner. The trial court did not err in denying Jeanes Hospital's motion for judgment n.o.v. with regard to imposition of punitive damages.[3]

Next, we turn to Blango's claim that the trial court erred in granting remittitur. As described above, the trial court remitted Jeanes Hospital's punitive damages from $1.5 million to $500, 000.

[W]e recognized in Daley v. John Wanamaker, Inc., 317 Pa.Super. 348, 464 A.2d 355 (1983), that it is largely within the discretion of the trial court to reduce a punitive award which it finds excessive. This is not to suggest that the trial court's authority to reduce an award is without constraints. Indeed, the law is clear that the court may not declare an award excessive simply because it might have awarded a lesser amount sitting in place of the jury. The award must be shocking to the court's sense of justice before remittitur can be deemed appropriate. Id.; See generally Marcone v. Penthouse International, Ltd., 577 F.Supp. 318 (1983), rev'd on other grounds, 754 F.2d 1072, (3rd Cir.1985), certiorari denied, 474 U.S. 864, 106 S.Ct. 182, 88 L.Ed.2d 151.

Sulecki v. Southeast Nat. Bank, 516 A.2d 1217, 1220 (Pa.Super. 1986).

Typically, to consider whether a punitive award shocks one's sense of justice, the court must look to the nature of the conduct engaged in by the defendant, the purpose that punitive damages are intended to achieve, the amount of the award and its likely effect as punishment for the defendant's outrageous conduct as well as the relationship between the punitive and compensatory awards. See Feld v. Merriam, 314 Pa.Super. 414, 434-38, 461 A.2d 225, 235-37 (1983) rev'd other grounds, 506 Pa. 383, 485 A.2d 742 (1984).

Id.

We determine the trial court did not abuse its discretion in remitting punitive damages. We note that it is appropriate to consider the financial status of the defendant. See Kirkbride v. Lisbon Contractors, Inc., 521 Pa. 97, 102, 555 A.2d 800, 803 (1989), citing Restatement (Second) of Torts, Section 908(2) (wealth of the defendant is one factor for the jury to weigh in arriving at an appropriate punitive damage award). Jeanes Hospital's chief financial officer testified that the hospital is a non-profit health care provider and is losing money. Therefore, we find the trial court did not abuse its discretion in granting remittitur.

However, the trial court characterized its reduction in the punitive damage award as reflecting a 2:1 ratio, which was a "more reasonable relationship" to the award of compensatory damages. In its Rule 1925(a) opinion, the trial court remarked,

In Pennsylvania, it has been held that the amount of punitive damages must bear a reasonable relationship to the award of compensatory damages. In this instance, both defendants were found 50% liable for $1, 000, 000 in compensatory damages. Therefore, the initial awards of punitive damages were three times the amount of compensatory damages for Jeanes Hospital and seven times the compensatory damages for Hillcrest Center. The awards were reduced to provide a ratio of 2:1 for Jeanes Hospital and 3:1 for Hillcrest Center. This adjustment was within the court's discretion and provided that the awards reflected a more reasonable relationship.

Trial court opinion, 4/18/11 at 13 (citations omitted).

Obviously, the trial court's characterization of the ratio between punitive and compensatory damages as 2:1 was incorrect; the trial court's remittitur of punitive damages to $500, 000 resulted in a 1:1 ratio. Jeanes Hospital cites State Farm Mutual Automobile Insurance Co. v. Campbell, 538 U.S. 408 (2003) (Campbell I), for the proposition that where, as here, compensatory damages are fairly significant, a 1:1 ratio is appropriate. (Jeanes Hospital's brief at 52-53, citing Campbell I, 538 U.S. at 425 ("When compensatory damages are substantial, then a lesser ratio, perhaps only equal to compensatory damages, can reach the outermost limit of the due process guarantee.").) However, Campbell I followed up the previous sentence by stating, "The precise award in any case, of course, must be based upon the facts and circumstances of the defendant's conduct and the harm to the plaintiff." Id. The court in Campbell I also reiterated that single-digit multipliers, particularly in the 4:1 range, can usually survive constitutional scrutiny:

In [Pacific Mut. Life Ins. Co. v. Haslip, 499 U.S. 1 (1991)], in upholding a punitive damages award, we concluded that an award of more than four times the amount of compensatory damages might be close to the line of constitutional impropriety. We cited that 4-to-1 ratio again in Gore. The Court further referenced a long legislative history, dating back over 700 years and going forward to today, providing for sanctions of double, treble, or quadruple damages to deter and punish. While these ratios are not binding, they are instructive. They demonstrate what should be obvious: Single-digit multipliers are more likely to comport with due process, while still achieving the State's goals of deterrence and retribution, than awards with ratios in range of 500 to 1, or, in this case, of 145 to 1.

Id. at 425 (citations omitted).

Instantly, it seems clear that the trial court intended to reduce punitive damages to a 2:1 ratio, i.e., from $1.5 million to $1 million. Furthermore, as the trial court stated in its opinion, a 2:1 ratio is a reasonable relationship between punitive and compensatory damages in this case and satisfies due process. Therefore, we will reverse the order remitting punitive damages to $500, 000 and remand with instructions to enter a punitive damage award of $1, 000, 000. Judgment is affirmed in all other respects.

Judgment affirmed in part and reversed in part. Jurisdiction relinquished.

Judgment Entered.

CONCURRING AND DISSENTING STATEMENT

MUNDY, J.

I respectfully dissent, in part, from the learned Majority's disposition in this matter. The Majority concluded that remittitur of the jury's $1, 500, 000.00 punitive damage award against Jeanes Hospital was appropriate under the facts of this case, but reasoned that the trial court clearly intended to reduce said award to $1, 000, 000.00 to reflect a "more reasonable relationship" between punitive and compensatory damages. Majority Memorandum at 15-16, citing Trial Court Opinion, 4/18/11, at 13. Thus, the Majority reversed the order remitting punitive damages to $500, 000.00, and remanded this case with instructions to enter a punitive damage award against Jeanes Hospital in the amount of $1, 000, 000.00. In reaching this decision, the Majority reasoned that, "a 2:1 ratio is a reasonable relationship between punitive and compensatory damages in this case and satisfies due process." Majority Memorandum at 18.

My review of the record, however, reveals that the jury's initial award of $1, 500, 000.00 in punitive damages against Jeanes Hospital was appropriate under the facts of this case and bore a reasonable relationship to the compensatory damages in this case. Therefore, remittitur was clearly an abuse of the trial court's discretion. I find this Court's decision in Hollock v. Erie Ins. Exchange, 842 A.2d 409 (Pa. Super. 2004) (en banc), appeal dismissed, 903 A.2d 1185 (Pa. 2006), instructive. In Hollock, an en banc panel of this Court noted as follows.

Under Pennsylvania law the size of a punitive damages award must be reasonably related to the State's interest in punishing and deterring the particular behavior of the defendant and not the product of arbitrariness or unfettered discretion. In accordance with this limitation, [t]he standard under which punitive damages are measured in Pennsylvania requires analysis of the following factors: (1) the character of the act; (2) the nature and extent of the harm; and (3) the wealth of the defendant.

Id. at 419 (internal quotation marks and citations omitted).

The Hollock decision further emphasized that, "the United States Supreme Court has expressly rejected the assertion that a punitive damages award must bear a certain proportionality to the amount of compensatory damages." Id. at 421, citing State Farm Mut. Auto. Ins. Co. v. Campbell, 538 U.S. 408 (2003). Rather, courts in this Commonwealth have urged that review of "the ratio of punitive damages to the harm caused by the Defendant is a tool to ensure that the two bear a reasonable relationship to each other." Willow Inn, Inc. v. Pub. Serv. Mut. Ins. Co., 399 F.3d 224, 233-234 (3d Cir. 2005). "Single-digit multipliers are more likely to comport with due process, while still achieving the State's goals of deterrence and retribution, than awards with ratios in the range of 500 to 1." State Farm, supra at 425 (citations omitted).

Instantly, the jury's initial award of $1, 500, 000.00 punitive damages against Jeanes Hospital approximated a ratio of punitive damages to compensatory damages of 3:1. In reducing said punitive damage award, I believe the trial court failed to conduct a proper analysis of the factors set forth in Hollock, and essentially usurped the function of the jury. Specifically, the trial court's Rule 1925(a) opinion essentially concedes that the jury's punitive damage award was reasonable, but states its reduction of said award was to provide for a "more reasonable relationship" between the award of compensatory and punitive damages. See Trial Court Opinion, 4/18/11, at 13. Thus, under the circumstances of this case, and in light of both Hollock and the "reckless indifference" exercised by Jeanes Hospital in its care of Joe Blango, see Majority Memorandum at 12-14, I discern no abuse of discretion or constitutional infirmity in the initial $1, 500, 000.00 punitive damage award.

Thus, for the foregoing reasons, I cannot agree with the trial court's reduction of the punitive damage award nor can I agree with the Majority's decision to "reverse the order remitting punitive damages to $500, 000 and remand this case with instructions to enter a punitive damage award [against Jeanes Hospital in the amount] of $1, 000, 000." Majority Memorandum at 18. On the contrary, I would reverse the remittitur order in its entirety and reinstate the jury's $1, 500, 000.00 punitive damage award against Jeanes Hospital. In all other respects, I join with the Majority's decision to affirm the November 17, 2010 judgment entered in favor of Appellee.


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