Doyle v. Keyed, 2025 Pa. Dist. & Cnty. Dec. LEXIS 120 (October 16, 2025) Powell, J.
Opinion by: Mark Powell
On November 20, 2024, Plaintiffs, Julie Doyle and Christopher Doyle, her husband, in their own right and as the Co-Administrators of the Estate of Conor Jack Doyle, Deceased, filed the present wrongful death and survival action against the Defendants asserting medical negligence, institutional negligence, and vicarious liability. More specifically, the Second Amended Complaint alleges that on November 12, 2023, Mrs. Doyle went into active labor and presented to Additional Defendant Laurice Dunning, (hereinafter “Ms. Dunning”), the owner of The Midwives and Associates, Inc. Ms. Dunning provided care to Mrs. Doyle during her pregnancy, and the initial birthing plan was for a home delivery with the assistance of Ms. Dunning. During this time, at approximately 8:30 p.m., Mrs. Doyle experienced a spontaneous rupture of membranes and by 9:00 p.m. she became fully dilated and began pushing. At that time, the fetal head was visible. It, however, became apparent that Mrs. Doyle developed a hematoma on her labia, and she was transported to the Defendant Hospital via ambulance, namely Lehigh Valley Hospital — Pocono.
Upon arrival at the Lehigh Valley Hospital, Defendant Dr. Shadi Kayed, assumed the care of Mrs. Doyle and recorded that Mrs. Doyle had two prior c-sections. Dr. Kayed’s initial fetal assessment noted “active fetal movement, with a fetal heart rate of 130, moderate variability, and normal fetal heart rate accelerations (without evidence of decelerations) — FHT Category 1 at low risk. Dr. Kayed also noted Mrs. Doyle “desires vbac” and his plan was to “try vacuum” and “if no success will consider c/s.”
Dr. Kayed proceeded to attempt a vaginal delivery noting in the Delivery Note as follows:
After the NICU team was present, the Kiwi vacuum was applied to the flexion point. Proper placement was confirmed. With continued maternal expulsive efforts and 4 pulls, no pop off, the head was delivered at 3:20 am, vacuum released, there was tight nuchal cord was released, fetal heart beat was reassuring all the time, there was difficulty delivering the shoulders, so suprapubic pressure and McRoberts maneuvers applied without success, so I had to manually deliver the posterior shoulder, then baby was rotated and manually delivered the anterior shoulder, after that there body dystocia as well, so fundal pressure applied and the baby delivered after 2-3 minutes after delivering the head, umbilical cord clamped and cut and baby handed off immediately to NICU team.
Conor Jack Doyle was delivered at 3:23 a.m. with no heart rate and no spontaneous respirations. Rina Duke, MD, a Neonatologist, unsuccessfully attempted neonatal resuscitation, including positive pressure ventilation, chest compressions, intubation, umbilical catheter insertion, medication (epinephrine), and fluid resuscitation. Efforts were stopped at 4:05 a.m.
Dr. Kayed asserts that he is not an employee of Lehigh Valley Hospital and, therefore, cannot be vicariously liable for any medical staff, as a matter of law. More specifically, Dr. Kayed states “the doctrine of ostensible agency does not extend to an attending physician, who is not an employee of the hospital, but has staff privileges there, for actions of the hospital’s providers, nurses, and/or staff.” To support this argument, Dr. Kayed cites the MCARE Act.
Unquestionably, Section 516 of the MCARE Act regulates when a “hospital may be held vicariously liable for the acts of another health care provider through principles of ostensible agency.” 40 P.S. § 1303.516(a). It, however, has no application to the actual or ostensible agency claims against Dr. Kayed. Polanco v. Lehigh Valley Health Network, Inc., 2024 WL 2874841, at *5 (Lacka. Co. 2024)(Section 516 of the MCARE Act regulates “when a hospital may be held vicariously liable for the acts of another health care provider through principles of ostensible agency.” Section 40 P.S. § 1303.516(a) has no application to the actual or ostensible agency claims against a physician with staff privileges, for the care rendered to a child and the hospital health care providers and staff subject to the physician’s control, direction, and supervision).
Affording Plaintiffs the benefit of “all reasonable inferences deducible” from the factual allegations contained in the Second Amended Complaint, it appears that Dr. Kayed was arguably the supervising physicians for some of the providers, including the “agents, servants, workmen, and employees” who treated Mrs. Doyle in the emergency room and during her labor and delivery, as well as her aftercare.
By seeking to impose vicarious liability upon Dr. Kayed for only those health care providers acting at his direction or under his supervision and control, the averments in the Second Amended Complaint comport with Muller, supra. and its progeny. As a result, Dr. Kayed has not demonstrated that “it is clear and free from doubt” that he may not be found vicariously liable based upon the facts alleged, and his demurrer to the vicarious liability claims against him are Overruled.
1. The Direct Negligence of Defendant LVPG.
Defendants next maintain that medical corporate negligence does not attach to physician practice groups, asserting that “[a] claim for corporate negligence cannot be asserted against a physician’s practice group because it is not a hospital, nor is it a comprehensive medical care provider, such as a nursing home or an HMO,” (Lehigh Valley Defendants’ Memorandum of Law in Support of Preliminary Objections, p. 9)(citing Sutherland v. Monongahela Valley Hosp., 2004 PA Super 245, 856 A.2d 55, 61-62 (Pa. Super. 2004)). First and foremost, the Pennsylvania Supreme Court in Scampone V. Highland Park Care Ctr., LLC, 618 Pa. 363, 57 A.3d 582 (Pa. 2012) rejected efforts like that of the Defendants to limit the duty owed by a medical [*22] corporation under Thompson to just hospitals that coordinate the total healthcare of its patients, in favor of an analysis of the principles outlined in the Restatement (Second) of Torts § 323 and Althaus v. Cohen, 562 Pa. 547, 756 A.2d 1166 (Pa. 2000)).
Because no intervening decision has superseded Scampone, as it stands, the “key” to the test for corporate liability in the medical negligence context “is the relationship between the plaintiff-patient and the corporate defendant” as outlined in Section 323 of the Restatement and the Althaus factors. Scampone, supra.; McClure v. Parvis, 294 F. Supp. 3d 318, 328 (ED. Pa. 2018). An entity, therefore, may owe a non-delegable duty of care to its patient even if the entity does not serve as a “comprehensive health center.” Scampone, 57 A.3d at 606. See also Delavern v. Health Services of Clarion, Inc., 334 A.3d 356, 2025 Pa. Super. Unpub. LEXIS 29 (Pa. Super. 2025).
Here, Defendants not only fail to address Section 323 of the Restatement, but also their argument is completely devoid of a discussion of the Althaus factors or why we should conclude the specific relationship between LVPG and Plaintiffs was such that it owed them no duty. Rather, relying upon Sutherland —a case whose analysis has been rejected by the Pennsylvania Supreme Court—Defendants argue that Plaintiffs’ corporate liability/institutional liability allegations against LVPG fail as a matter of law.
In finding the reasoning of the case upon which Defendants rely has been rejected by the Pennsylvania Supreme Court, see Scampone, 57 A.3d at 606, and with no other analysis offered by the Defendants, we are compelled to Overrule Defendants’ Preliminary Objections premised thereon.
4.Preliminary Objections to Strike Counts VIII, X, and XI as Legally Insufficient to State a Claim for Corporate Negligence Against Defendant Lehigh Valley Hospital.
A claim that a hospital/physician’s group did not have proper protocols in place “implicates the type of systemic negligence that is the hallmark of a corporate negligence claim.” See Bisher v. Lehigh Valley Health Network, Inc., 670 Pa. 501, 265 A.3d 383, 415 n. 18 (Pa. 2021). Moreover, a breakdown in care such that that the Defendant Hospital failed to “oversee all persons who practice medicine within its walls as to patient care, is indicative of the Defendants’ failure to train and oversee persons who practice medicine within the hospital as to patient care. Azaravich v. Wilkes-Barre Hosp. Co., LLC, 2024 PA Super 116, 318 A.3d 876, 888 (Pa. Super. 2024)(A hospital may be found liable under a theory of corporate negligence based upon its failure to properly train or oversee its staff). See also Shiflett V. Lehigh Valley Health Network, Inc., 2017 PA Super 354, 174 A.3d 1066, 1090 (Pa. Super. 2017), rev’d and remanded on other grounds, 655 Pa. 115, 217 A.3d 225 (Pa. 2019); Rauch v. Mike-Mayer, 2001 PA Super 270, 783 A.2d 815, 826-27 (Pa. Super. 2001)(The doctrine of corporate negligence imposes a non-delegable duty on a hospital if it fails to oversee those practicing medicine within its walls as to patient care and fails to formulate, adopt and enforce adequate rules and policies to ensure quality care for the patients). When Plaintiffs’ Second Amended Complaint is read in its entirety, it clearly outlines exactly what conduct the Plaintiffs contend fell below the standard of care and increased the risk of harm to Plaintiffs.
As discussed above, a hospital is directly liable under the doctrine of corporate negligence if it fails to uphold any of the four duties outlined in Thompson, supra., all of which are at issue in the present matter. Accordingly, a jury may find the Defendants failed to adequately perform those duties with respect to obstetrics patients such as Mrs. Doyle and the Decedent, and that those failures were the direct and proximate cause of Mrs. Doyle’s injuries and the Decedent’s death.
Lastly, we note that a Complaint “need not cite evidence but only those facts necessary for the Defendant to prepare a defense.” Unified Sportsmen of Pennsylvania v. Pennsylvania Game Commission, 950 A.2d 1120, 1134 (Pa. Cmwlth. 2008). At the pleadings stage of litigation, the Plaintiff need only aver sufficient facts to enable Defendants to prepare a responsive pleading and defense to Plaintiffs’ claims. Estate of Denmark ex rel. Husrt v. Williams, 2015 PA Super 101, 117 A.3d 300, 306 (Pa. Super. 2015). Even the most cursory review of Plaintiffs’ Second Amended Complaint, as [*31] well as analysis of the well-pleaded facts alleged therein which we must accept as true at this stage of the proceedings, reveals the Plaintiffs have adequately pled a cause of action against Defendant Lehigh Valley Hospital and consequently we Overrule the Preliminary Objections on this issue.
2. Allegations of Carelessness and Punitive Damages Against All Defendants.
Defendants contend that “Plaintiffs have failed to establish any specific acts on the part of Objecting Defendants that rise to the level of willful, wanton, or reckless conduct supporting an award of punitive damages. (Brief in Support of Preliminary Objections, p. 12). A review of Plaintiffs’ Second Amended Complaint, however, reveals Plaintiffs seek punitive damages only against Dr. Kayed.
Thus, claims for punitive damages may withstand preliminary objections asserting factual insufficiency, provided that the complaint generally avers willfulness, wantonness, or recklessness. Hughes v. Wilkes-Barre Hospital Company, 67 Pa. D. & C.5th 377 (Lacka. Co. 2017). Accordingly, accepting as true the allegations of Plaintiffs’ Second Amended Complaint and affording Plaintiffs the benefit of all inferences reasonably deducible from those facts, it is not clear and free from doubt that Plaintiffs may not recover punitive damages with respect to Dr. Kayed based upon the factual averments. Plaintiff sufficiently alleges that prior to Mrs. Doyle’s admission, Dr. Kayed knew or should have known of Mrs. Doyle’s serious medical circumstances and that she was at risk of harm under the conditions created by the complications from her labor and that appropriate care, post-operative treatment, and communication was necessary. Plaintiffs also sufficiently allege that the failure to do so unreasonably increased the risk of harm to Mrs. Doyle and the Decedent and was the direct and proximate result of Plaintiffs’ injuries and Decedent’s death. As such, at this stage of the proceedings, such allegations are sufficient to withstand Preliminary Objections on this issue. Accordingly, Defendant’s Preliminary Objections with respect to Plaintiffs’ claims for Punitive Damages in regard to Dr. Kayed are Overruled and they are Sustained with respect to the other Defendants.
3. Preliminary Objection in the Form of a Demurrer to Strike Plaintiffs’ Claims for Informed Consent at Count XX.
The Defendants next contend that the Plaintiffs cannot set forth a cause of action for breach of informed consent in connection with the delivery of a child because the informed consent doctrine applies only to surgical procedures. Consequently, the Defendants request that Count XX be stricken from the Second Amended Complaint.
Clearly, Pennsylvania Courts contemplate a scenario where a claim for informed consent is applicable to situation very much like that of Mrs. Doyle’s in the present matter. Like Mrs. Gordon, there were two options available to Mrs. Doyle, natural delivery and cesarean section. Her doctor never explored with her the benefits and problems associated with a cesarean section and a vaginal delivery given her history and the problems she was experiencing in the natural delivery process. Mrs. Doyle, just like Mrs. Gordon, essentially argues that she was denied the surgical alternative to natural delivery which would have perhaps prevented the injuries and ultimate death of Plaintiffs’ Decedent. We agree with the Plaintiffs and the reasoning outlined in Gordon, supra. We, therefore, decline at this stage of the proceedings to strike Count XX of the Second Amended Complaint.
4. Negligent Infliction of Emotional Distress — County XIX.
Defendants next assert “Plaintiffs asserted emotional damages of long-term emotional shock and trauma and psychological injury do not meet the physical injuries needed to pursue a claim for Negligent Infliction of Emotional Distress (“NIED”) and such claim is without merit.” We find this argument to be without merit.
A fair reading of the Second Amended Complaint indicates Mr. Doyle was present when the baby was delivered. He observed the delivery and saw what was or was not done in the delivery process and had contemporaneous knowledge that his son had serious and life-threatening problems and witnessed his ultimate death. He also witnessed Mrs. Doyle’s complications, infection, and necessary surgery. More specifically, the Plaintiffs’ Second Amended Complaint avers: 349. Plaintiffs Julie Doyle and Christopher Doyle directly witnessed the above-described negligent acts and/or omissions, including Defendants’ failing to properly deliver Decedent and Decedent’s death, as well as the subsequent hospitalization of Plaintiff Julie Doyle for occult ruptured/perforated uterus and infection.
5. Preliminary Objection to Strike Vague and Unlimited Allegations of Corporate Negligence.
Here, Plaintiffs sufficiently allege that upon Mrs. Doyle’s admission the Lehigh Valley Defendants knew or should have known of her serious medical circumstances and that she was at risk of harm under the conditions created by the complications from her labor and that appropriate care and aftercare treatment and communication was necessary. Plaintiffs also sufficiently allege that the failure to do so was the direct and proximate result of Plaintiffs’ injuries and Decedent’s death.
A Complaint “need not cite evidence but only those facts necessary for the Defendant to prepare a defense.” Unified Sportsmen of Pennsylvania v. Pennsylvania Game Commission, 950 A.2d 1120, 1134 (Pa. Cmwlth. 2008). Indeed, at the pleadings stage of litigation, the Plaintiff need only aver sufficient facts to enable the Defendants to prepare a responsive pleading and defense to Plaintiff’s claims. Estate of Denmark ex rel. Husrt v. Williams, 2015 PA Super 101, 117 A.3d 300, 306 (Pa. Super. 2015). When the present Complaint is examined in its entirety and the well-pleaded facts alleged therein are accepted as true, as we must at this stage of the proceedings, the Plaintiffs have adequately pled a cause of action against the Lehigh Valley Defendants, and those allegations do not lend themselves to supplementation at a later time. Accordingly, Defendants’ Preliminary Objections are Overruled.
The Preliminary Objections of the St. Luke’s Defendants
1. Severance
Our decision to deny severance is further buttressed by the fact that the wrongful death and survival issues related to the death of the Decedent are clearly and easily distinguishable from the issues of the delay in diagnosis of Plaintiff’s uterine rupture and the resulting infections and complications, especially because the Plaintiffs have conceded Count XXI for Wrongful Death and Count XXII for Survival Action, are only asserted against Lehigh Valley Defendants. Accordingly, Defendants’ Preliminary Objection with respect to severance is Overruled.
2. Venue
In light of the Court’s decision with respect to severance, the objections to venue are moot as pursuant to Pa.R.Civ.P. 1006(c), as a Plaintiff may bring an action against an individual Defendant, or more than one Defendant when a Plaintiff asserts joint or joint and several liability. See Pa.R.Civ.P. 1006(c). 8 See also Zappala v. Brandolini Property Management, Inc., 589 Pa. 516, 909 A.2d 1272, 1281 (Pa. 2006).
3. Demurrer to Strike Plaintiffs’ Claim for NIED at Count XIX.
Despite Defendants’ claim that Plaintiffs do not allege physical harm or physical manifestation of the emotional harm as part of their claim, they are incorrect. We find the above allegations satisfy current Pennsylvania law on this issue and are sufficient to survive the challenge of Defendants’ Preliminary Objections on this issue.
4. Direct Corporate Negligence Claims Against St. Luke’s Physician Group, Inc. and St. Luke’s Care, LLC.
Accepting as true the facts of the Second Amended Complaint and all inferences drawn therefrom, we conclude that Plaintiffs have stated sufficient facts to establish that Defendants owed them a duty of care under an Althaus analysis. See Scampone v. Grane Healthcare Company, 2017 PA Super 257, 169 A.3d 600 (Pa. Super. 2017). Whether these facts will survive discovery and a motion for summary judgment, or whether Plaintiffs can meet their burden before a jury and obtain recovery, is for another day and not proper for dismissal on Preliminary Objections. Breslin, supra.
5. (6) Vague and Unlimited Allegations of Agency
It is unreasonable to expect Plaintiffs at the outset of litigation to produce information in the complaint that they do not possess. This is especially true given that the St. Luke Defendants possess the relevant documents as to the staffing of their facility, the list of individuals responsible for the care of Mrs. Doyle, the efforts made to monitor and treat, and the observations the staff of the Defendants made as to Mrs. Doyle’s condition. See generally, Walker v. Scranton Hosp. Co., LLC, 2016 WL 1045751, at *7 (Lacka. Co. 2016). Thus, because the identification of the St. Luke’s Defendants’ potentially culpable agents is a proper subject for discovery, the Defendants’ Preliminary Objections seeking to strike Plaintiffs’ agency allegations are Overruled.
1. Plaintiffs’ Standing to Challenge the Lehigh Defendants’ Amended Joinder Complaint.
Joining Defendants/Lehigh Valley Defendants, assert Plaintiffs lack standing to challenge Defendants Joinder Complaint as their common law claims for indemnification and/or contribution are against Ms. Dunning and The Midwives and Associates, Inc., not the Plaintiffs. Consequently, the Lehigh Valley Defendants assert Plaintiffs have not demonstrated any interest that would establish standing to challenge their claims for indemnification and/or contribution.
Here, both the Lehigh Defendants and the St. Luke’s Defendants seek to strike all allegations of direct negligence, as well as vicarious liability, informed consent, and punitive damages. Accordingly, if sustained the result would be the dismissal of Plaintiffs’ Second Amended Complaint. Thus, the time period to commence the 60-day filing period as to the Plaintiff’s Second Amended Complaint was tolled when the Defendants filed their Preliminary Objections to the Second Amended Complaint, which are presently pending and being addressed in this Opinion and Order. Therefore, Plaintiffs’ argument that they are untimely is without merit, especially because the Plaintiffs have not sufficiently alleged any prejudice.
• This case addresses a variety of procedural matters
• Pleading is sufficient vicarious liability claim for actions of a doctor’s agents
• There may be direct negligence of the hospital for its corporate activities
• Complaint sufficient to state a claim for corporate negligence
• Allegations against carelessness and punitive damages will stand for the sake of the pleading
• Demurrer to informed consent will not be granted
• Claims of emotional distress may go forward
• Vague and unlimited allegations of corporate negligence are sufficient at this stage of the pleading
• The Court also looked at the PO of St. Lukes which were very similar and cover many of the same issues
• Court looks at joinder issue raised by plaintiff among others and refuses to strike that.
