DiGiacinto v. Obelinas
Opinion of the Court
The plaintiff in this personal injury action has filed a de novo appeal of the special discovery master’s ruling under Pa.R.C.P. 4010 requiring him to submit to two physical examinations by different physicians chosen by the defense. The discovery master found that the defense had established “good cause” for separate examinations by distinct medical specialists since plaintiff’s cervical disc injury and bilateral carpal tunnel syndrome allegedly
Cervical disc injuries and carpal tunnel syndrome are not the exclusive domain of distinct medical disciplines and do not necessitate independent assessments by different specialists. The defense may retain either an orthopedic surgeon or a neurosurgeon to perform a single examination of plaintiff and effectively evaluate his cervical disc and carpal tunnel injuries in the process. The fact that plaintiff has received treatment for those injuries from two separate orthopedic surgeons is of no consequence and does not warrant subjecting plaintiff to the burden of two examinations under Rule 4010. Consequently, plaintiff’s de novo appeal will be granted and the defense request to compel plaintiff to submit to two medical examinations by different physicians will be denied.
I. FACTUAL BACKGROUND
On December 10,2007, plaintiff, Thomas F. DiGiacinto (“DiGiacinto”), was involved in a motor vehicle accident with defendant, Ralph C. Obelinas (“Obelinas”), as both parties were travelling in a southerly direction on Route 476, Montgomery County. (Docket entry no.5 at ¶¶ 4-5; Docket entry no.8 at ¶¶ 4-5). At the time of the accident, Obelinas was acting within the course and scope of his employment with defendant, Nivert Metal Supply, Inc. (“Nivert”). (Id. at ¶¶ 2-3). DiGiacinto filed suit against Obelinas and Nivert seeking to recover economic and noneconomic damages for “severe bodily injuries, including, but not limited to, neck and left shoulder injuries” causing “great mental anguish and physical
According to the medical records that have been produced during discovery, DiGiacinto was originally treated by Neal A. Stansbury, M.D., of Valley Sports & Arthritis Surgeons (“VSAS”), for his accident-related orthopedic injuries. Dr. Stansbury initially diagnosed DiGiacinto with “left shoulder strain, aggravation of pre-existing degenerative disc disease and carpal tunnel syndrome.” (Docket entry no. 31 at ¶¶ 7, 12; Docket entry no. 32 at ¶¶ 7,12 & exhibits A, D). Dr. Stansbuiy provided ongoing treatment to DiGiacinto for his left shoulder and bilateral wrist complaints, but referred him to one of his twelve VSAS partners, Amir H. Fayyazi, M.D., for evaluation of his cervical symptoms. (Id). Dr. Stansbury performed a right carpal tunnel release on DiGiacinto in April 2008 and a left carpal tunnel release in June 2008. (Id. at Exhibit D).
Dr. Fayyazi diagnosed DiGiacinto’s cervical injury as “an aggravation of a pre-existing cervical degenerative disc disease” causing “nerve root compression.” (Id. at ¶¶ 9, 11 & exhibit C). On July 31, 2008, Dr. Fayyazi performed an “anterior cervical discectomy and fusion at [the] C3-4” vertebral level “for treatment of C3-4 nerve root compression.” (Id. at p. 3). In addition, DiGiacinto has been diagnosed with accident-related depression for which he has received psychiatric treatment. (Docket entry no. 31 at ¶ 6; Docket entry no. 32 at ¶6).
Defense counsel sought to schedule physical and mental examinations of DiGiacinto pursuant to Pa.R.C.P. 4010, and forwarded a letter to DiGiacinto’s counsel requesting his concurrence with the scheduling of three such examinations: (1) a physical examination by one physician “to address the carpal tunnel issues;”
DiGiacinto filed a de novo appeal of the discovery master’s order directing him to submit to two medical examinations with respect to his cervical, left shoulder and carpal tunnel injuries. (Docket entry no. 33). Noting that Rule 4010(a)(3) empowers a court to order a party to submit to a physical or mental examination “only on
In support of their request for two physical examinations of DiGiacinto under Rule 4010, Obelinas and Nivert argue that “[bjecause [DiGiacinto] required two separate and distinct specialists to address the carpal tunnel and cervical spine issues, [Obelinas and Nivert] should be permitted an equal and fair opportunity to address the same allegations in the same fashion.” (Docket entry no. 36 at p. 8). Obelinas and Nivert assert that they should be allowed to retain separate medical witnesses to address those orthopedic injuries, and reason that “[t]o limit the defendants to one physical injury examination would require the defendants to locate one medical expert who is appropriately qualified in both carpal tunnel surgeries and cervical spine surgeries.” (Id. at p. 10). Following the completion of oral argument on April 7,2014, DiGiacinto’s discovery appeal became ripe for disposition.
II. DISCUSSION
(A) MEDICAL EXAMINATION CRITERIA UNDER Pa.R.C.P. 4010
Pennsylvania Rule of Civil Procedure 4010(a)
DiGiacinto concedes that the defense has demonstrated “good cause” for a physical examination of his neck, left shoulder and carpal tunnel injuries. He further agrees that the requisite cause exists for a separate “mental examination” in conjunction with his depression claim. The parties disagree, however, on the issue of whether DiGiacinto must submit to two physicial examinations under Rule 4010.
(B) MULTIPLE EXAMINATIONS UNDER Pa.R.C.P. 4010
Rule 4010 is silent on the number of medical examinations to which a party may be subjected. See 9
There is a paucity of reported case law addressing requests for multiple examinations under Rule 4010, and most of those decisions concern instances where a second examination of the plaintiff was demanded by the defense after the plaintiff had already undergone an earlier examination. Some trial courts have required plaintiffs to submit to a second examination under Pa.R.C.P. 4010 if a significant period of time has elapsed since the date of the original medical examination.
The Court of Common Pleas of Lackawanna County first addressed the issue of multiple examinations under Rule 4010 in Lodolce, supra, where the defense request for a re-examination was predicated upon the fact that more than two years had passed since the date of the defense expert’s original examination of the plaintiff. Lodolce, 99 Lacka. Jur. at 56. In that case, we noted that courts “may permit an additional examination if subsequent discovery reveals that the plaintiff is alleging a new injury since the date of the initial examination, or deliberately concealed an injury at the time of the first examination.” Id. at 57; see also 9 Goodrich-Amran 2d, supra, at p. 412 (stating that a second examination may be warranted if plaintiff’s discovery responses “disclose a claim for an injury which was not originally asserted and which was not inquired into by the physician at the first examination,” or “where an
After considering the defendants’ purported need for an additional examination by [defense medical witness], and weighing it against [Lodolce’s] right to be protected against unwarranted invasions of his privacy and the inconvenience that [Lodolce] will experience if he is required to submit to another examination of questionable value, we conclude that defendants have not established “good cause” for a supplemental examination under Pa.R.C.P. 4010(a).
Id. at 59.
Other Lackawanna County jurists have applied the foregoing standard articulated in Lodolce when considering defense requests for serial examinations under Rule 4010. DiGiacinto references three reported decisions in which Judge Carmen D. Minora cited the criteria set forth in Lodolce and denied the defense motions seeking additional examinations. See, e.g., Judge v. Solid Waste Service, Inc., 41 Pa. D. & C. 4th 225,234-236 (Lacka. Co. 1999) (quoting Lodolce and refusing request for second examination since there was “no indication that plaintiff has alleged any new injuries or deliberately
In Mehall, “[n] either plaintiff’s complaint nor his amended complaints identified] a foot injury” and merely asserted “lumbar injuries” resulting from his automobile accident on September 10, 2007. Id. at pp. 1-2 & n. 1. By the time of his discovery deposition on April 27, 2010, the only medical records that had been produced by Mehall were the office records of Dr. Mark Micciche, and “[ajccording to Dr. Micciche’s discharge notes, [Mehall] was allowed to return to full work activity shortly after the accident, more particularly on November 28,2007. Id. at p.
In considering the defense request for a supplemental examination to evaluate Mehall’s foot injury claim, Judge Mazzoni quoted Lodolce for the proposition that an additional examination is allowable “if subsequent discovery reveals that the plaintiff is alleging a new injury since the date of the initial examination or deliberately concealed an injury at the time of the first examination.” Id. at p. 3 (quoting Lodolce, 99 Lacka. Jur. at 57). Judge Mazzoni found that a new injury was alleged by Mehall following his original examination on July 21, 2011, and that “[defendants were not aware of this development until after their [Rule 4010 exam] on the lumbar issues and only after [Mehall] tendered Dr. Micciche reports on July 25, 2011.” Id. at p. 4. Judge Mazzoni noted that Mehall’s “failure to seasonably supplement his discovery [h]ad the same ‘net effect’” as a litigant “deliberately concealing] an injury at the time of the first examination.”
Unlike the aforementioned cases where additional medical examinations were ordered, an earlier physical examination of DiGiacinto has not been conducted in this case. Consequently, Obelinas and Nivert do no premise their request for multiple examinations upon the lapse of time since the original examination, see Edelstein, supra, and Sperath, supra, the development of a new injury since the date of the first examination, or the concealment of an injury at the time of the initial examination. See Mehall, supra. Rather, they assert, and the discovery master agreed, that the defense has established “good cause” to have “two separate and distinct specialists” evaluate DiGiacinto’s “alleged cervical spine injuries” and “his general orthopedic issues involving allegations of bilateral carpal tunnel and left shoulder complaints.” (Docket entry no. 32 at pp. 1-2; Docket entry no. 36 at p. 8).
The defense demand for separate examinations by different specialists is based upon the faulty premise that the same medical specialist cannot treat and evaluate a cervical injury and a carpal tunnel condition. Orthopedic surgeons routinely treat carpal tunnel syndrome and perform carpal tunnel surgeries. See Hansen v. Workers’ Compensation Appeal Board (Stout Road Associates), 957 A.2d 372,373-374 (Pa. Cmwlth. 2008) (“An orthopedic surgeon diagnosed bilateral carpal tunnel syndrome” and performed a “carpal tunnel decompression in November 2005.”); Olivetti Corp. v. Workmen’s Compensation Appeal
Orthopedic surgeons also diagnose and treat cervical injuries and degenerative disc disease, and perform discectomies for those injuries. See Kastenbaum v. Workers’ Compensation Appeal Board (Teleflex Marine), 2013 WL 3946315, at *1 (Pa. Cmwlth. 2013); Alltell Pennsylvania, Inc. v. Workers’ Compensation Appeal Board (Kovalik), 2010 WL 9513222, at *1 (Pa. Cmwlth. 2010). Parties defending claims involving degenerative disc disease and discectomies commonly hire orthopedic surgeons to conduct medical examinations on their behalf
Neurosurgeons likewise treat carpal tunnel syndrome and provide surgical care for that ailment. See Sauer v. Workers ’ Compensation Appeal Board (Verizon
A cervical spine injury and carpal tunnel syndrome are not the sole province of discrete medical specialties, and the defense may retain either an orthopedic surgeon or a neurosurgeon to conduct a single examination of DiGiacinto for those injuries and to testify as an expert witness on behalf of the defense. The mere fact that DiGiacinto may ultimately present the testimony of two orthopedic surgeons, Dr. Stansbury and Dr. Fayyazi, does not justify the inconvenience of two physicial examinations
Based upon the foregoing, Obelinas and Nivert have not established “good cause” for requiring DiGiacinto to submit to two physical examinations by separate physicians. Accordingly, DiGiacinto’s de novo appeal will be granted, the special discovery master’s order will be reversed, and the defense motion to compel two medical examinations under Rule 4010 will be denied. An appropriate follows.
ORDER
And now, this 17th day of April, 2014, upon consideration of the de novo discovery appeal of plaintiff, Thomas F. DiGiacinto, pursuant to Lacka. R.C.P. 4000.1, the memoranda of law submitted by the parties, and the oral argument of counsel on April 7,2014, and based upon the reasoning set forth in the foregoing memorandum, it is hereby ordered and decreed that:
1. The de novo discovery appeal filed by plaintiff, Thomas F. DiGiacinto, pursuant to Lackawanna County R.C.R 4000.1 is granted;
2. The special discovery master’s order directing plaintiff, Thomas F. DiGiacinto, to submit to two physical examinations by separate physicians is reversed; and
3. The “motion to compel independent medical examinations” filed by defendants, Ralph C. Obelinas and Nivert Metal Supply, Inc., is denied.
. Pursuant to Lacka. Co. R.C.P. 4000.1, discovery motions must initially be presented to and decided by the court-appointed discovery master whose ruling “may be appealed de novo’” to the court of common pleas within ten days of the master’s decision. Fratzola v. Klepadlo, 26 Pa. D. & C. 5th 533, 537-538 (Lacka. Co. 2012).
. Prior to the adoption of the first version of Rule 4010 on June 1, 1951, one lower court granted a defense request for two medical examinations, and reasoned that “[wjhere the disease is progressive, or the injuries are alleged to be permanent, the defendant ought to have an opportunity to examine again before trial, where two years and six months have elapsed since the first examination.” Narzisi v. Meyer Dairy Corp., 22 Pa. D. & C. 258, 260 (Northampton Co. 1933).
. A Luzerne County orthopedic surgeon, Peter A. Feinstein, M.D., testified on behalf of the employer in Badyrka, and opined that the employee’s cervical injury had resolved and that the “claimant had no restrictions and was able to return to work.” Badyrka, 729 A.2d at 184. Dr. Feinstein frequently testifies on behalf of the defense in civil litigation. See Clifford v. Leonardi, 61 Pa. D. & C. 4th 13, 16-18 (Lacka. Co. 2003) (Dr. Feinstein verified in discovery responses that in a four year period, he conducted 2,449 medical examinations and provided 856 trial depositions for the defense side of litigation). Dr. Feinstein has identified himself in the past as a local pioneer in endoscopic carpal tunnel release surgery. See “New Method Used in Wrist Surgery Procedure,” The Standard-Speaker, Vol. 124 at p. 22 (July 17, 1990). Dr. Feinstein would presumably be available to conduct the defense examination of DiGiacinto in this matter.
. By way of illustration, a motor vehicle accident claimant may submit to a pre-litigation physicial examination at the behest of the claimant’s own first-party benefits insurer which provides medical expense coverage. See Fleming v. CNA Insurance Companies, 409 Pa. Super. 285, 288-289, 597 A.2d 1206, 1207-1208 (1999) (if the language of the insurance policy requires an insured to submit to a physical examination by a physician of the insurer’s choosing, the first-party benefits insurer does not have to establish “good cause” in order to compel the insured to undergo that medical examination). Despite the fact that such a claimant has already been examined by a physician hired by an insurer, [s]he may nevertheless be required to undergo another examination under Rule 4010 after litigation has been commenced. See Kapp v. Oasis Enterprises, Inc., 83 Lacka. Jur. 190, 192 (1982). In that event, the tortfeasor may offer the testimony of the physician who conducted the pre-litigation examination, as well as the physician who performed the subsequent examination under Rule 4010.
Case-law data current through December 31, 2025. Source: CourtListener bulk data.