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HomeMy WebLinkAbout99-5708 CIVILDONALD NELSON and : JUDY NELSON, his wife,: Plaintiffs Vo IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW ROBERT J. BEAUDRY, JR., D.M.D., and ROBERT: J. BEAUDRY, JR., D.M.D,: P.C., t/d/b/a BEAUDRY ORAL SURGERY Defendant NO. 99-5708 CIVIL TERM IN RE: OPINION PURSUANT TO PA. R.A.P. 1925 BEFORE HOFFER, P.J., HESS and OLER, JJ. OLER, J., March 1, 2002. In this dental malpractice case, Plaintiffs have appealed to the Pennsylvania Superior Court from an order denying their motion for post-trial relief.~ The motion had requested relief in the form of a new trial on the issue of damages) Plaintiffs' action for professional negligence was premised upon a delay of several hours on the part of an oral surgeon in responding to a patient's complaint of bleeding following a tooth extraction. A jury found that the oral surgeon was negligent in not responding more promptly, that his negligence was a substantial factor in causing harm to the patient, that compensatory damages in the amount of $20,000.00 should be awarded to the patient, and that no compensatory damages for loss of consortium should be awarded to the patient's spouse) Delay damages in the amount of $2,321.37 were thereafter added to the verdict) ~ Plaintiffs filed a praecipe for entry of judgment on the jury's verdict prior to filing the notice of appeal from the interlocutory order. See Char/ton v. Toyota Indust. Equil~., 714 A.2d 1043, 1044 n. 1 (Pa. Super. Ct. 1998) (noting that appeal does not lie from order denying post-trial motion but entertaining appeal where judgment entered, notwithstanding appellant's misdesignation of order appealed from). : Plaintiffs' Motion for Post-Trial Relief, paragraph 20. ~ Jury Verdict Slip, November 9, 2001. 4 Order of Court, December 17, 2001. Plaintiffs' motion for post-trial relief sought a new trial on the issue of damages, averring in pertinent part as follows: 5. Plaintiffs believe, and therefore aver, that the jury's compensatory damages award to Donald Nelson is unreasonably low because of a number of significant errors of law committed by the Trial Court that limited the damages claims that could be proven by Plaintiffs, and the evidence that could be introduced by Plaintiffs in support of the damages issues. 6. One such error committed by the Trial Court was Judge Oler's Order on November 5, 2001, upon the Defendants' Third Motion in Limine, precluding Plaintiffs from proving or claiming damages related to the risk of blood-borne diseases from the blood transfusions necessitated by Dr. Beaudry's negligence, or the Plaintiffs' fear thereof. 7. Judge Oler's ruling on Defendants' Third Motion in Limine prohibited Plaintiffs from testifying about this item of damages, or from introducing the deposition testimony of William Pompella, M.D. about the risks accompanying a blood transfusion. 8. Before the ruling on the Motion, Plaintiffs had submitted a Brief opposing the Defendants' Third Motion in Limine for the Court's consideration, which has since been filed with the Prothonotary. [~] 9. The second error of law committed by the trial (sic) occurred during the testimony of Judy Nelson when she was prohibited, upon the objection of the Defendant, from testifying further about a transfer from Holy Spirit Hospital to Dr. Beaudry's office via the family's private vehicle at the insistence of Dr. Beaudry. 10. As Mrs. Nelson had testified before the Defendant's objection, the transfer was extremely uncomfortable for Mr. Nelson as it occurred during his second day of the five-day hospitalization, and was done without the expected comforts of an ambulance--instead, the family was required to transport 5 Although briefs are considered by the court, they are not accepted for filing by the Cumberland County Prothonotary, are not part of the docket record, and may not be used to supplement the record factually. See Commonwealth v. Bowers, 245 Pa. Super. 214, 223, 369 A.2d 370, 375 (1976). 2 the patient in an un-air-conditioned private vehicle that added to Mr. Nelson's pain and suffering claim resulting from the hospitalization required by Dr. Beaudry's negligence. 11. Mrs. Nelson was not permitted to testify fully to this element of Mr. Nelson's pain and suffering claim, and in fact another witness scheduled to testify for the Nelsons, Gaye Nelson (Mr. Nelson's mother), was not called by the Plaintiffs because her expected testimony about the uncomfortable transfer suffered by Don had been preempted by the Court's ruling during Mrs. Nelson's testimony. 12. The third error of law pertaining to Mr. Nelson's damages claim occurred during the testimony of Foster Burkheimer on Wednesday, November 7, 2001. 13. Called as a witness by Plaintiffs, Mr. Burkheimer had visited Mr. Nelson in the hospital following Dr. Beaudry's abandonment, and one of the purposes of his testimony was to elucidate Mr. Nelson's pain and suffering claim by testifying to Mr. Nelson's statements of his then existing mental, emotional and physical condition while in the hospital. 14. Mr. Burkheimer's testimony about Mr. Nelson's statements of his then existing mental, emotional or physical condition was halted by Judge Oler who, without any objection by defense counsel, ordered the witness that he could not testify to such statements as they were, in His Honor's opinion, hearsay. 15. The Court's direction to Mr. Burkheimer was, however, error as such statements are exceptions to the Hearsay Rule under P.R.E. 803(3). 16. Had there been an objection to this testimony by defense counsel, Plaintiffs certainly would have placed the grounds on record for opposing the objection. However, Judge Oler's unsolicited ruling on the admissibility of this witness' testimony terminated any opportunity for Plaintiffs to voice their grounds supporting the admissibility of such testimony. This unprecedented judicial activism on The Honorable Trial Court's part constitutes cause to permit Plaintiffs to specify the inappropriateness of such an instruction to the witness in Post- Trial Motions. 17. The fourth error of law occurred when the jury returned with a question about damages on Friday, November 9, 2001. 3 At that time, the Court charged the jury above and beyond what counsel had agreed to in chambers, and instructed the jury in a manner that was inappropriate and prejudicial to Plaintiffs. 18. Plaintiffs further submit that the jury's award of $0 to Judy Nelson for her loss of consortium claim was against the great weight of the evidence, as her own testimony about her losses was not challenged by Defendant through effective cross-examination or the introduction of independent evidence. 19. Furthermore, the award of $0 to Mrs. Nelson is inconsistent with the jury's verdict awarding compensation to Mr. Nelson. 20. Because the errors of law committed by the Trial Court, and the jury's verdict on the loss of consortium claim, went only to the issue of damages at trial, Plaintiffs respectfully request a new trial limited to the issue of damages.6 Following the submission of briefs by the parties on Plaintiffs' motion for post-trial relief, the matter was argued before a court en banc. The motion was denied by an order of the court en banc dated January 3, 2002. Plaintiffs filed a praecipe for entry of judgment on January 9, 2001.7 On January 31, 2002, Plaintiffs filed a notice of appeal "from the order entered in this matter on the third day of January, 2002.''8 This opinion in support of the court's denial of Plaintiffs' motion for post- trial relief is written pursuant to Pennsylvania Rule of Appellate Procedure 1925(a). STATEMENT OF FACTS On Friday, September 18, 1998,9 Plaintiff Donald Nelson underwent oral surgery in the office of Defendant Robert J. Beaudry, Jr., D.M.D., for the 6 Plaintiffs' Motion for Post-Trial Relief, paragraphs 5-20, filed November 19, 2001. 7 Plaintiffs' Praecipe for Entry of Judgment Pursuant to Pa.R.C.P. 227.4(2) and Pa.R.A.P. 30 l(d), filed January 9, 2002. 8 Plaintiffs' Notice of Appeal, filed January 31, 2002; see supra note 1. 9 N.T. 290, 294, Trial, November 6-9, 2001 (hereinafter N.T. ~ Trial). 4 extraction of twelve teeth,l° The procedure commenced at approximately 10:00 a.m. and lasted about an hour.il No issue of negligence exists in this case as to the performance of the surgery itself. 12 Mr. Nelson was told to expect pain and bleeding following the surgery. He went home at about 1:00 p.m. on the day of the surgery.TM At some point he and his spouse, Plaintiff Judy Nelson, became concerned that the bleeding was not abating as it should.15 According to testimony presented by Plaintiffs, Ms. Nelson, using an emergency number provided to her, telephoned Dr. Beaudry's residence at approximately 9:30 p.m. that evening to express her concerns about the bleeding. Ms. Nelson testified that she reached an answering machine and left a message asking Dr. Beaudry to contact her.16 When her call was not returned by midnight, Ms. Nelson called again and left another message asking whether it would be advisable to take Mr. Nelson to the emergency room. At about 1:00 o'clock in the morning, Plaintiffs went to the emergency room of the Holy Spirit Hospital.la According to the testimony of the emergency room physician who treated Mr. Nelson, after finding that Mr. Nelson had sustained "acute blood loss," intravenous treatment was ordered. 19 Mr. Nelson was also given pain medication and gauze pads for his mouth in an effort to stem the l0 N.T. 122, 146, Trial. Plaintiff's teeth had deterioriated over a period of years due to an absence of dental work. N.T. 168-291, Trial. ~ N.T. 82, Trial. ~2 N.T. 28-29, Trial. ~s N.T. 180-83, 365, Trial. 14 N.T. 14-15, Trial. ~5 N.T. 15-20, Trial. 16 N.T. 18-20, Trial. ~7 N.T. 18-20, Trial. ~8 N.T. 21-22, Trial. 19 Plaintiff's Exhibit 2-A at 20, Trial, November 6-9, Trial). 2001 (hereinafter Plaintiff's Exhibit __, 5 bleeding. When the physician found that the gauze pads failed to stop the bleeding,2° he contacted the on-call oral surgeon for Holy Spirit Hospital for assistance.2~ The surgeon refused to come in because of unidentified conflicts between himself and Dr. Beaudry.~ However, in response to the emergency room physician's request for an opinion on a course of treatment, the surgeon recommended placing "absorbent gauze or foam" into Mr. Nelson's mouth to stem the bleeding.~3 Defendant Beaudry, according to his and his spouse's testimony, was first alerted to Mr. Nelson's situation at about 4:15 a.m. when Dr. Beaudry's wife received a call from Holy Spirit Hospital and woke up Dr. Beaudry, who had been sleeping on a couch on the lower floor of their home.24 Dr. Beaudry got up and proceeded to the emergency room, arriving at approximately 5:00 a.m.25 The bleeding had been substantially stanched by Dr. Paul's treatment, and Dr. Beaudry resolved the matter by the administration of one stitch.26 Mr. Nelson was admitted to the hospital, where he remained for five days.27 Part of his stay was at least arguably attributable to an apparently spurious test result indicating that he was suffering from diabetes.28 While in the hospital, he 20 Plaintiff's Exhibit 2-A at 18, Trial. The physician testified that the bleeding from the right side of the mouth had stopped but that the bleeding from the left side continued. Plaintiff's Exhibit 2- A at 18, Trial. 2~ Plaintiff's Exhibit 2-A at 18-19, Trial. Holy Spirit Hospital had arrangements with several oral surgeons, one of whom was Dr. Beaudry, who agreed to be "on call" for several days every month in case their services were needed in the emergency room. N.T. 191, Trial. Dr. Beaudry was not the on-call oral surgeon for the period in which the events at issue in this case occurred. N.T. 191, Trial. 22 Plaintiff's Exhibit 2-A at 20-22, Trial. 23 Plaintiff's Exhibit 2-A at 21-23, Trial. 24 N.T. 135-36, 341-42, Trial. 25 N.T. 136-37, Trial. 26 N.T. 25, 146-47, Trial. 27 N.T. 25, 49, 151-52, 273-74, Trial. 28 N.T. 281-82, Trial. 6 received two blood transfusions.29 He lost $340.00 in wages while hospitalized,3° and incurred medical expenses of $6,734.33.3~ Ms. Nelson spent most of her time at the hospital with him.32 His recovery from the oral surgery was otherwise uneventful.33 He is presently pleased with the condition of his mouth.34 Plaintiffs initiated a professional negligence action against Defendant Beaudry and his employer on September 17, 1999.35 At trial, the theory pursued by Plaintiffs was that Dr. 36 Beaudry had abandoned his patient following the surgery. Prior to trial, Plaintiffs presented one motion in limine37 and Defendants presented four motions in limine.38 One of Defendants' motions in limine sought, inter alia, to preclude Plaintiffs from introducing evidence as to mental anguish on the part of Mr. Nelson arising out of a fear that he would contract a disease such as Hepatitis C from the units of blood received at the hospital.39 In response to the motion, the court conducted a proceeding prior to trial at which counsel placed their positions on the motion on the record.4° Plaintiffs' counsel indicated that Plaintiffs did not intend to present evidence that Mr. Nelson 29 N.T. 143-50, Trial. 30 N.T. 303-04, Trial. 3~ N.T. 35, Trial. 32 N.T. 25-26, Trial. 33 N.T. 25-26, 49-50, Trial. 34 N.T. 49-50, Trial. 35 Plaintiffs' Complaint, filed September 17, 1999. 36 S~'¢ N.T. 30, 92, Trial. 37 Plaintiff's Motion in Limine To Preclude Evidence of Alcohol and Drug Abuse, filed October 31, 2001. 38 Defendants' First Motion in Limine, filed November 5, 2001; Defendants' Second Motion in Limine, filed November 5, 2001; Defendants' Third Motion in Limine, filed November 5, 2001; Defendants' Fourth Motion in Limine, filed November 5,2001. 39 Defendants' Third Motion in Limine, filed November 5,2001. 40 N.T. 2-19, Pretrial Proceeding, November 5,2001 (hereinafter N.T. __, Pretrial Proceeding). 7 contracted Hepatitis C or another blood-borne disease from the transfusions4~ or that the blood administered was known to have been tainted, but did desire to present evidence of emotional distress resulting from his fear of contracting such a disease.42 At the conclusion of the presentations of counsel, the court entered an order granting Defendants' motion in limine to preclude the introduction of evidence of such fear.43 At trial, during the direct examination of Plaintiff Judy Nelson, she testified at some length about an event which occurred two days prior to his discharge from the hospital.44 The gist of her testimony in this regard was that, at Dr. Beaudry's request, she had transported Mr. Nelson from the hospital to the dental office in her private vehicle for purposes of utilization of a full-mouth x-ray apparatus, that the trip was uncomfortable for Mr. Nelson, that "if [she] had been thinking clear, [she] probably wouldn't have done what [she] did," and that she did not know why an ambulance had not been utilized.45 Defendants' counsel objected to further testimony from this lay witness as to the propriety of the mode of transportation for the office visit, noting inter alia that the report of Plaintiffs' dental expert indicated no such basis for the opinions adverse to Dr. Beaudry expressed in it.46 Plaintiffs' counsel responded that "we would like to point out the unorthodox way that the patient was directed to get to 4~ Plaintiffs' counsel advised that Mr. Nelson did in fact have Hepatitis C, but that Plaintiffs had chosen not to advance any claim that the condition had resulted from the transfusions because they did not wish to delay the trial to pursue the issue. N.T. 7-8, Pretrial Proceeding. It may be noted that the court had granted a motion in limine on behalf of Plaintiffs to preclude Defendants from introducing evidence of a history of drug or alcohol abuse on the part of Mr. Nelson. Order of Court, November 5,2001; see N.T. 3-5, Pretrial Proceeding. 4: N.T. 7-10, Pretrial Proceeding. 43 Order of Court, November 5,2001. 44 N.T. 26-28, Trial. 45 N.T. 26-28, Trial. 46 N.T. 29-30, Trial. Dr. Beaudry's of~ce.''47 In sustaining Defendants' objection, the court advised Plaintiffs' counsel that "[y]ou can certainly bring out the facts that the transportation occurred, as you have done; but I think to the extent that you are going to go forward and attempt to bring out through this witness that there was something unorthodox about that [i.e., the mode of transportation], that would not be permissible.''48 Also during the trial, Plaintiffs presented the testimony of Foster Martin Berkheimer, owner of the mobile home park in which Plaintiffs lived.49 He testified as to Mr. Nelson's good citizenship, his skill at pitching horseshoes, and his satisfaction with his job as a resource coordinator,so Mr. Berkheimer described a visit to Mr. Nelson in the hospital following the oral surgery: He looked very, very weak, and he did not have the normal complexion that he usually had. His eyes were dark and sunk. His jaws looked more like a chipmunk, and he tried to talk to both of us which we thought was unnecessary, but that was Don's response, he wanted us to share in what was going on. At that point it was very hard to really understand what he was trying to say. ! knew he was very uncomfortable. That is about the best ! can explain it. There was a black and blue on the neck and the jaw that ! can recall, maybe it was a small thing, ! don't know what side it was. ! just know from memory that he did not look good, he looked very ill to me. His constitution seemed to be defeated. ! think ! recall trying to figure out what he was trying to say. ! am in here like this, and all I wanted to do was to have some teeth pulled. And I will make that statement that I don't think, but he did say that.s~ 47 N.T. 28, Trial. 48 N.T. 31-32, Trial. 49 N.T. 221-22, Trial. 50 N.T. 221-23, 309, Trial. In his position as resource coordinator, Mr. Nelson testified that his duties included office administration, maintenance of a fleet of company-owned vehicles, and transportation of company documents and personnel. 5~ N.T. 224-25, Trial. 9 Defendants' counsel interposed an objection to statements made to Mr. Berkheimer by Mr. Beaudry on grounds of hearsay,s2 Plaintiffs' counsel responded that she was eliciting a "statement of physical condition, also goes to Don's state of mind.''s3 The direct examination continued as follows: Q Mr. Berkheimer, you were testifying as to what comments Don had made to you while he was in the hospital. Could you go back and start again, please. A Well, simply my recollection of the statement that he was trying to make to me is how could this be that I was just getting some teeth pulled and I end up in this condition,s4 At this point, the court stated as follows: THE COURT: That is a little bit different from a present sense impression. You can relate what comments [Mr. Nelson] might have made about pain, things of that sort, how he felt, but not more general comments about his treatment and so on. Is that satisfactory, Mr. Barnett? MS. BARNETT: Your Honor, Mr. Nelson has a claim for pain and suffering in the hospital. The statements as to his emotional state of mind, as well as his physical state of body are relevant to that claim, and I would ask that his statements in the hospital which are relevant to those issues be admissible, be admitted. THE COURT: But his question as to how he could be in this condition, that is not a sensory impression, that is more historical. So to that extent the objection is sustained. MS. BARNETT: Okay.ss Finally, during its deliberations the jury asked several questions, the final one of which was this: Do we have to reach a dollar amount, and what happens if we can't agree upon it. Will Plaintiff get nothing[?]s6 52 N.T. 226, Trial. 53 N.T. 226, Trial. 54 N.T. 226, Trial. 55 N.T. 226-27, Trial. 56 N.T. 433, Trial. 10 The view of both counsel was that an inability of the jury to reach a verdict on damages (if it found in favor of Plaintiffs on the issues of negligence and causation) should result in a mistrial on all issues,s7 (Obviously, if it found in favor of Defendants on either the issue of negligence or the issue of causation, the jury's inability to agree upon a damage figure should not result in a mistrial.) The question of the jury did not state whether it had reached verdicts on the issues of negligence and causation. Prior to providing a response to the question to the jury, the court reconvened outside the jury's presence, stating as follows: The Court has met in chambers with counsel and understands that each counsel has requested the Court to charge the jury that in the event that it is unable to reach a verdict as to all questions on the verdict slip and each juror feels that the jury is hopelessly deadlocked and that further deliberations would not enable the jury to reach a verdict on all questions, the Court would declare a mistrial and the case could be tried before another jury and counsel have asked that the jury be so instructed. Is that a satisfactory instruction to both counsel? MS. BARNETT: MR. KANTNER: worded, Your Honor? THE COURT: MR. KANTNER: Yes, it is. Is that essentially how it will be I will do my best to repeat that. Our discussion in chambers, my request to the Court making clear whatever means to see fit that this particular jury will not be retrying the case either now or at any time. THE COURT: Yes, if I forget to say that, please come forward and ! will emphasize that. Please bring the jury in.sa When the jury returned, the following instruction was given: s7 N.T. 433-34, Trial. Whether this proposition was correct or not, it was advocated by both counsel and the court instructed the jury accordingly. s8 N.T. 432, Trial. 11 The Court has met in chambers with counsel and counsel have both asked that the Court give this instruction in response to the question, and before I do, I might ask counsel whether counsel are also in agreement that I should give the instruction that we had also discussed about the jurors consulting with each other to reach a verdict? MS. BARNETT: MR. KANTNER: THE COURT: Yes, Your Honor. I agree. All right. The answer to your question which both counsel have agreed that I give is that in order to reach a verdict in the case, the jury must be able, consistent with the instructions which I gave you, to answer all of the questions on the verdict slip. If the jury is unable to answer all of the questions on the verdict slip, that is to render verdicts as to each question, and if each juror feels that the jury is hopelessly deadlocked on at least one of the questions and that further deliberations would not enable the jury to reach a verdict, then the Court would declare a mistrial because the jury is hopelessly deadlocked. In that event, the case could be retried, but, of course, it would be in front of a different jury, you wouldn't have to come back and hear the whole case again. Let me give you a sort of general instruction on reaching verdicts or attempting to. You have the duty to consult with each other and to deliberate with the view to reaching an agreement if it can be done without doing any violence to your individual judgment. Each of you must decide the case for himself or herself, but only after there has been impartial consideration with your fellow jurors. In the course of deliberations, each juror should not hesitate to examine his or her own views and change his or her opinion if convinced it is erroneous; however, no juror should surrender an honest belief as to the weight or effect of the evidence solely because of the opinion of his or her fellow jurors or for the mere purpose of returning a verdict. I had indicated that the jury has to be able to reach a verdict as to each question. Technically, of course, that is not entirely correct, because a jury could reach a verdict of no negligence, and then obviously, you don't have to decide the other two questions. So I don't want to mislead you when I say you have to answer all three questions; but to reach a verdict if 12 damages were to be awarded, you would have to answer all questions, including the damage question. 59 At the conclusion of the instruction, the court inquired of both counsel whether they had any suggestions, objections or corrections to the instruction as given.® Each responded negatively.6~ Following trial, in the brief in support of Plaintiffs' motion for post-trial relief, Plaintiffs' counsel advanced the position that Plaintiffs were entitled to a new trial on the issue of damages because the instruction invited the jury to reconsider verdicts in favor of her clients on the issues of negligence and causation.62 As previously noted, the jury returned a verdict finding that the oral surgeon was negligent, that his negligence was a substantial factor in causing harm to the patient, that compensatory damages in the amount of $20,000.00 should be awarded Mr. Beaudry,63 and that no compensatory damages for loss of consortium should be awarded to Ms. Beaudry.64 Plaintiffs filed a motion for post-trial relief requesting a new trial as to damages. From the en banc court's denial of Plaintiffs' motion, Plaintiffs have filed an appeal to the Superior Court. DISCUSSION Fear of contracting blood-borne disease from tramfusion as element of damages in personal injury action. In the context of recovery of damages for emotional distress resulting from fear of contracting a disease from exposure to another person's blood, the Pennsylvania Superior Court has stated as follows: 59 N.T. 433-34, Trial (emphasis added). 60 N.T. 434-35, Trial. 61 N.T. 435, Trial. 62 Plaintiffs' Brief in Support of Motion for Post-Trial Relief, at 18-20. The brief of Plaintiffs' counsel also argued that "the Court's suggestion to start awarding damages 'at $1.00' was highly prejudicial to Plaintiffs." Id. at 20. Nothing in the court's instruction was remotely susceptible of such a construction. 63 This figure was increased to $2,321.37 by way of delay damages. Order of Court, December 17, 2001. 64 Jury Verdict Slip, November 9, 2001. 13 With respect to establishing a causal nexus, the majority of jurisdictions addressing the issue impose an objective standard for determining proximate cause of emotional distress arising from the fear of contracting AIDS. This objective standard requires proof of actual exposure to HIV. See Brzoska v. Olson, 668 A.2d 1355, 1363 (Del. 1995) (stating that "without actual exposure to HIV, the risk of its transmission is so minute that any fear of contracting AIDS is per se unreasonable."); see also Wendy Allison Reese, Tort Law Actual Exposure or Possible Exposure?: The Aids Phobia Debate Are Courts Opening the Litigation Floodgates or Illustrating Judicial Proscription? 22 Am. J. Trial Advoc. 495, 502 (1998) (collecting cases). Actual exposure requires more than mere presence of an infected specimen. Rather, the existence of a scientifically accepted method of transmission of the virus must coalesce with the presence of an HIV positive specimen. See e.g., Pendergist v. Pendergrass, 961 S.W.2d 919, 926 (Mo. Ct. App. 1998). We find Pennsylvania caselaw is consistent with the latter combined approach. Shumosky v. Lutheran WelJbre Services of Northeastern Pa, Inc., No. 2112 MDA 2000, 2001 WL 11160978, at *4 (Pa. Super. Ct. October 3, 2001) (footnote omitted). This approach is consistent with Pennsylvania's adoption of the "two disease" rule, one implication of which is that fear based upon the risk of developing a second, potential disease is not compensable in litigation arising out of the contraction of the first disease. See Giffear v. Johns-Manville Corp., 429 Pa. Super. 327, 342-43, 632 A.2d 880, 888-89 (1993), aff'd sub nom., Simmons v. Pacor, Inc., 543 Pa. 664, 674 A.2d 232 (1996).65 One obvious consideration involved in this approach is the desirability of avoiding damage verdicts based on speculation.66 A second is the degree to which every personal injury trial in which the plaintiff received a blood transfusion 65 The "two-disease rule" has been extended beyond its initial application to asbestos cases. Klein v. Weisberg, 694 A.2d 644, 645-46 (Pa. Super. Ct. 1997). 66 ~[A]s the Superior Court noted in Giffear, damages for fear of cancer are speculative." Simmons v. Pacor, Inc., 543 Pa. 664, 677, 674 A.2d 232, 238 (1996). 14 would be diverted into an evidentiary contest concerning the risks of contracting diseases therefrom and the reasonableness of the plaintiff's fears of such contraction. In the present case, where Plaintiffs chose to present no evidence that Mr. Nelson knew that he had been exposed to tainted blood, no evidence that the blood he had been exposed to was tainted, and no evidence that he had contracted a disease as a result of exposure to tainted blood, it is believed that the court's pretrial ruling which precluded Plaintiffs from supporting Mr. Nelson's damage claim by reference to his fear of contracting a blood-borne disease from a transfusion at the hospital was proper. Testimony of Ms. Nelson concerning orthodoxy of utilization of private transportation for office visit. The admission of evidence is within the sound discretion of the trial court. Commonwealth v. Allison, 550 Pa. 4, 7-8, 703 A.2d 16, 18 (1997). In general, a lay witness is not permitted to comment upon the propriety of a course of treatment of a health care provider. Lira v. Albert Einstein Medical Center, 384 Pa. Super. 503, 508-10, 559 A.2d 550, 552-53 (1989); Dambacher v. Mallis, 336 Pa. Super. 22, 35-40, 485 A.2d 408, 415-17 (1984). A plaintiff in a professional negligence action is generally not permitted to support the negligence aspect of the claim by lay opinion. Joyce v. Boulevard Physical Therapy & Rehabilitation Center, P.C., 694 A.2d 648, 654-55 (Pa. Super. Ct. 1997); Lira, 384 Pa. Super. at 508-10, 559 A.2d at 552-53. In addition, in general, a party may not present evidence of professional negligence beyond the scope of the report of his or her expert. See Pa. R.C.P. 4003.5(c). In the present case, the court sustained Defendants' objection to Ms. Nelson's testimony concerning the office visit only "to the extent that [Plaintiffs' counsel was] going to go forward and attempt to bring out through [Ms. Nelson] that there was something unorthodox about that [i.e., the mode of transportation 15 selected for the visit].''67 The court's ruling did not, as asserted by Plaintiffs' counsel in the post-trial motion, preclude Ms. Nelson from "testify[ing] fully to this element of Mr. Nelson's pain and suffering claim," nor did it "[preempt] testimony [of Mr. Nelson's mother] about the uncomfortable transfer suffered by Don ....,,68 In so ruling, the court was of the view that the question of the orthodoxy of a mode of transportation from one medical or dental facility to another was a negligence, not a damages, issue. In declining to permit the lay witness to testify as to such orthodoxy, the court was influenced by the rules of evidence regarding lay and expert testimony referred to above, and the fact that Plaintiffs' dental expert had not based his opinion as to professional negligence upon this event. Testimony of Mr. Berkheimer concerning out-of-court statement of Mr. Nelson as to outcome of surgery. The principles of law regarding the admission of evidence and lay and expert testimony recited above are also applicable to the court's ruling on the testimony of Mr. Berkheimer as it related to Mr. Nelson's statement of his expectations of the surgery. In responding to an objection of Defendants' counsel based on hearsay grounds, the court sustained the objection "to the extent" that the witness proposed to repeat an out-of-court statement of Mr. Nelson questioning how his condition could have resulted from what he had expected to be a minor procedure.69 In this regard, it was the court's view that this declaration was more an expression of opinion as to the quality of Dr. Beaudry's performance than a present sense impression or expression of an existing mental, emotional or physical condition. Contrary to the assertions of Plaintiffs' counsel in their post- trial motion, the court did not "halt[]" Mr. Berkheimer's testimony "about Mr. Nelson's statements of his then existing mental, emotional or physical 67 N.T. 31, Trial. 68 Plaintiffs' Motion for Post-Trial Relief, paragraph 11, filed November 19, 69 N.T. 227, Trial. 2001. 16 condition,''7° the ruling was not "unsolicited,''7~ and the court's action, in its view, fell short of being an example of"unprecedented judicial activism.''72 Response by court to jury question as to efJkct of deadlock on damages issue. It is well-settled in Pennsylvania that, in general, an alleged error in an instruction to a jury is waived in the absence of an objection by counsel. See Pa. R.C.P. 227. l(b)(1). It is also well settled that where a trial error is harmless it will not be a ground for a new trial. See In reM. T., 414 Pa. Super. 372, 395, 607 A.2d 271,282 (1992). In the present case, the portion of the instruction in response to the jury's question which Plaintiff's counsel finds offensive was obviously given for purposes of clarification and was intended to avoid a misstatement of law. The question submitted by the jury did not state that it had reached agreement upon any of the verdict slip interrogatories, and the instruction provided in response to the question did not invite the jury to reconsider any such agreement. To the extent that the jury had in fact reached agreement in Plaintiffs' favor on the issues of liability, the instruction did not have the effect of altering the agreement.73 Based upon the foregoing, in the court's view (a) the instruction in question was not "inappropriate," (b) the instruction did not have a "prejudicial" effect upon Plaintiffs, and (c) the issue of the propriety of the instruction was waived by counsel's assent to it. Weight of evidence as to verdict of jury on issue of damages for loss of consortium. The credibility of witnesses and weight to be accorded their testimony is within the province of the jury in its capacity as fact-finder. Nelson v. Hines, 539 Pa. 516, 520, 653 A.2d 634, 636 (1995). In this capacity, the jury is free to "believe all, some, or none of the testimony." Id. at 520, 653 A.2d at 637. 70 Plaintiffs' Motion for Post-Trial Relief, paragraph 14, filed November 19, 2001. 7~ Plaintiffs' Motion for Post-Trial Relief, paragraph 16, filed November 19, 2001. 72 Plaintiffs' Motion for Post-Trial Relief, paragraph 16, filed November 19, 2001. 73 As noted, the jury found in Plaintiffs' favor on the issues of liability. 17 Where a new trial is requested on grounds of the weight of the evidence, the test is whether the jury's verdict was so contrary to the weight of the evidence as to "shock[] the court's conscience." Bonavitacola v. Cluver, 422 Pa. Super. 556, 574, 619 A.2d 1363, 1372 (1993); see Nelson, 539 Pa. at 520, 653 A.2d at 636. More specifically, where a new trial is requested on grounds of an inadequate verdict, relief is appropriate only when the injustice of the verdict "stand[s] forth like a beacon." Musumeci v. Penn's Landing Corp., 433 Pa. Super. 146, 153, 640 A.2d 416, 420 (1994) (quoting Elza v. Chovan, 396 Pa. 112, 118, 152 A.2d 238, 241 (1959)), appeal denied, 539 Pa. 653, 651 A.2d 540 (1994). A trial court's ruling on a motion for a new trial based upon the weight of the evidence is a matter within the sound discretion of the court. Bonavitacola, 422 Pa. Super. at 574, 619 A.2d at 1372. In Nudelman v. Gilbride, 436 Pa. Super. 44, 647 A.2d 233 (1994), the Pennsylvania Superior Court affirmed the refusal of a trial court to award a new trial based upon a jury's award of zero damages to a husband for loss of consortium, where his wife had sustained a fractured toe, damage to the saphenous nerve in her left leg and left knee, and torn cartilage in her left knee, and was hospitalized for three days, following negligence on the part of a defendant which was a proximate cause of her injuries. In so holding, the Superior Court noted that "[d]amages for loss of consortium have no market value, and the amount awarded for loss of consortium is left to the sound judgment and common sense of the jury." Id. at 56, 647 A.2d at 239. In the present case, under the best of circumstances the oral surgery in question could be expected to have affected the lives of Plaintiffs to some extent. The jury's determination that the negligence of Defendant in failing to respond promptly to a call or calls following the surgery, while causing a limited amount of monetary and transient physical harm to Mr. Beaudry, did not result in any appreciable loss of services or companionship to his spouse did not "stand forth like a beacon" as an example of injustice. 18 For the foregoing reasons, Plaintiffs' motion for post-trial relief in the form of a new trial on damages was denied. BY THE COURT, Jan S. Barnett, Esq. 3513 North Front Street Harrisburg, PA 17110 Attorney for Plaintiffs Evan Black, Esq. John R. Kantner, Esq. 240 Grandview Avenue Suite 100 Camp Hill, PA 17011 Attorney for Defendants J. Wesley Oler, Jr., J. 19