FREDERICK E. KREPPS AND MARGARET M. KREPPS, Appellants
KHRISTIAN SNYDER, DPM AND CHERRY TREE FOOT AND ANKLE SPECIALISTS, P.C., Appellees
Appeal from the Judgment Entered March 6, 2014, In the Court of Common Pleas of York County, Civil Division, at No. 07-SU-788-Y01.
BEFORE: FORD ELLIOTT, P.J.E., SHOGAN, J., and STABILE, J.
Frederick E. Krepps (individually, " Appellant" ) and Margaret M. Krepps (collectively,
" Appellants" ) appeal from the judgment entered on March 6, 2014. After careful review, we affirm.
Appellants filed a medical malpractice complaint on April 11, 2007, alleging that Khristian Snyder (" Appellee" ), a podiatrist, and his medical practice, Cherry Tree Foot and Ankle Specialists, P.C., (collectively, " Appellees" ) negligently failed to follow appropriate amputation prevention procedures for diabetic patients such as Appellant, eventually resulting in the below-the-knee amputation of Appellant's leg. Lengthy and litigious discovery ensued for four years culminating, in one instance, in imposition of monetary sanctions against Appellees for failure to respond to Appellants' Expert Witness Interrogatories. Trial Court Order, 1/13/12, at unnumbered 1. Additionally, Appellees did not respond to Appellants' Requests for Admissions for almost a year after they were served with the discovery request, well beyond the thirty-day response time set forth in Pa.R.C.P 4014(b).
After discovery closed, on May 14, 2012, Appellants filed a motion for summary judgment requesting the trial court to: 1) define the legal duty owed by Appellee to Appellant; 2) determine the standard of care that applies in this case; and 3) adjudge Appellees liable. In the event that the trial court decided summary judgment was not warranted, Appellants requested that certain facts be deemed admitted and others be classified as established without controversy. Although the trial court decided that, under Rule 4014(b), statements included in Appellants' Requests for Admissions were considered true for purposes of adjudicating the motion, it ultimately denied awarding summary judgment in Appellants' favor because material issues of fact remained outstanding. Summary Judgment Opinion, 9/14/12, at unnumbered 5--6. Prior to trial, Appellees filed a motion in limine to preclude these same admissions from being introduced at trial; the motion was denied as untimely. Trial Court Order, 4/24/2013, at unnumbered 1.
At trial, Appellants' theory of liability was that Appellee was derelict in following appropriate amputation prevention procedures for diabetic patients, specifically, that he failed to perform necessary vascular examinations, failed to order additional vascular studies, failed to properly document Appellant's foot pulses in his medical records, and failed to refer Appellant to a vascular surgeon in a timely manner. Appellants' expert, Dr. Vincent Mandracchia, opined that patients presenting in Appellant's condition -- toe ulcer with no palpable foot pulses--must be referred immediately to a vascular surgeon and that podiatrists should document foot pulses each time a patient is seen. Appellee countered that he timely referred Appellant to a vascular surgeon when it appeared that an ulcer on Appellant's left foot was not healing properly. Appellee's expert, Dr. Michael Downey, disagreed that documentation of foot pulses was required each time a patient is seen when the treating podiatrist is familiar with the patient's history and concluded that Appellee met or exceeded the standard of care for a podiatrist treating patients presenting like Appellant.
When testimony concluded, the trial court denied Appellants' request to read admissions allegedly made by Appellee to the jury. It also denied certain of Appellants' requested jury instructions, but did instruct the jury on the " two schools of thought" charge that is relevant in a malpractice action when competent medical authority is divided on a course of treatment. The jury returned a verdict in favor of Appellees based on its finding that Dr. Snyder was not negligent. Appellants
filed post-trial motions, which the trial court denied on March 4, 2014. This appeal followed the entry of judgment in Appellees' favor.
Appellants present the following questions for appellate review:
I. Did The Trial Court Commit Reversible Error By Refusing To Allow Mr. Krepps To Admit Conclusively Established Judicial Admissions Under Pa.R.C.P. 4014(d) Into Evidence?
II. Did The Trial Court Commit Reversible Error By Instructing The Jury On The Two Schools Of Thought Doctrine?
III. Did The Trial Court Commit Reversible Error By Refusing To Grant Mr. Krepps' Points For Charge?
IV. Did The Trial Court Abuse Its Discretion Or. Commit An Error Of Law When It Denied Mr. Krepps' Motion for Summary Judgment And Establishment Of Averments Deemed Admitted And Facts Without Controversy When It Failed To:
A. Determine If Dr. Snyder Had An Affirmative Duty To Protect Mr. Krepps From Foreseeable Risk Of Amputation?
B. Determine The Standard Of Conduct That Applied To Dr. Snyder's Care Of Mr. Krepps?
C. Failed To Grant Judgment In Favor Of The Plaintiffs And Against The Defendants?
D. Determined That Facts Existed Without Controversy And Were Deemed Established Under Pa.R.C.P. 1035.5?
Appellants' Brief at 6--7.
I. Exclusion of Admissions
On the last day of trial, Appellants attempted to introduce two exhibits: Appellees' statements that were previously deemed admitted under Rule 4014(b) due to Appellees' failure to timely respond to discovery and proposed admissions that Appellees failed to respond to in any manner. Plaintiffs' Exhibits 36a and 36b, respectively. After some preliminary discussion, Appellants limited their original demand and requested that Admissions numbered ten through twenty-four, excepting Admission number sixteen, included in Exhibit 36a be read to the jury. N.T., 8/8/13, at 659. The trial court agreed in principle that the statements should be deemed admitted because of Appellees' failure to timely respond to Appellants' discovery request, but ruled against admissibility, questioning both the timing of the proffer and its evidentiary value in light of the testimony offered at trial. Making the additional observation that Appellants were not prejudiced by Appellees' late response to the Requests for Admissions, the trial court employed the liberal construction precepts of Pa.R.C.P. 126 to negate operation of Rule 4014(b). N.T., 8/8/13, at 663--664.
Despite the trial court's ruling, Appellants continued to advocate that certain admissions should be read to the jury because they were admitted by Appellees in their eventual response to Appellants' Requests for Admissions. The trial court
again denied Appellants' request reiterating that admission of this evidence would be repetitive of trial testimony. N.T., 8/8/13, at 665. Appellants' final plea that Admission thirty-two, relating to the availability of non-invasive tests to assess arterial disease, was likewise rejected by the trial court. Id. at 665--666.
The trial court expanded on its rationale for its evidentiary ruling on Exhibits 36a and 36b in its opinion denying post-trial relief:
First, the Court determined it was not appropriate to read the admissions that were not responded to by Defendants because all those admissions were testified to at trial, it would therefore be repetitious to read those admissions to the jury. Second, while the Court agreed in principle that [Pa.R.Civ.P.] 4014(b) provides that Admissions not timely responded to are deemed admitted, the Court was concerned that this issue was not raised by Plaintiffs until the end of the trial. In addition, there was testimony to the effect that Defendants did not in fact agree with all of the Admissions, and the Court believed that this issue would have been more properly raised during testimony or, preferably, pre-trial, i.e., in discovery; further, there was testimony wherein Defendants did in fact admit to some of the admissions, rendering any potential reading of the Admissions into evidence duplicative. The court also determined Admission responses were provided at a date not sufficiently late to prejudice the Plaintiffs. Finally, relying on [Pa.R.Civ.P.] 126, a rule rarely relied on by this Court but which the Court believes is intended for cases such as this, the Court liberally construed Rule 4014. For the reasons stated above, the Court's decision was not in error.
Trial Court Opinion Denying Post-Trial Relief, 3/4/14, at 9. On appeal, Appellants' overarching argument is that the trial court erred when it applied Rule 126 to exclude from evidence Exhibit 36a's recital of facts deemed admitted under Rule 4014(b).
Interpretation and application of Pennsylvania Rules of Civil Procedure present a question of law. Accordingly, our scope of review is plenary. Keller v. Mey, 2013 PA Super 79, 67 A.3d 1, 5 (Pa. Super. 2013) (citing Gray v. Buonopane, 2012 PA Super 174, 53 A.3d 829, 834 (Pa. Super. 2012)).
Pa.R.C.P. 4014 provides in pertinent part:
(a) A party may serve upon any other party a written request for the admission, for purposes of the pending action only, of the truth of any matters . . . set forth in the request that relate to statements or opinions of fact or of the application of law to fact, including the genuineness, authenticity, correctness, execution, signing, delivering, mailing or receipt of any documents described in the request.
(b) Each matter of which an admission is requested shall be separately set forth. The matter is admitted unless, within ...