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A sharply divided Pennsylvania Supreme Court has ruled that MCARE's statute of repose violates the Pennsylvania Constitution's guarantee of open access to the courts.

The justices ruled 4-3 Thursday in Yanakos v. UPMC, with the court's majority striking down the seven-year limitation on bringing medical malpractice lawsuits as unconstitutional.

Justice Sallie Updyke Mundy wrote the court's majority opinion. She was joined by Justices Debra Todd and Kevin Dougherty. Justice Christine Donohue concurred with the result, and Justice David Wecht filed a dissent that Chief Justice Thomas Saylor and Justice Max Baer joined.

According to Mundy, the defendants in the case needed to show that the General Assembly's enactment of the Medical Care Availability and Reduction of Error (MCARE) Act's statute of repose was "substantially or closely related to an important government interest." However, Mundy said the defendants failed to meet that burden.

"There was no evidence to show the initially proposed four-year statute of repose would provide actuarial certainty, except that it 'seemed like a reasonable resolution' to 'provide some stability and predictability' to insurers," Mundy said, citing the legislative history in first proposing a four-year statute of repose. "There is no evidence in the legislative history as to how the General Assembly arrived at a seven-year statute of repose with exceptions for foreign objects cases and minors. The legislature did not cite any statistics on the number of medical malpractice actions that are commenced after seven years of the occurrence giving rise to the action. There is no indication that such a time period, as opposed to a longer or shorter period, will have any effect on malpractice insurance costs."

Read the majority opinion:

In his dissenting opinion, Wecht said the majority and concurrence "flout the General Assembly's policymaking authority."

"Because existing jurisprudence supplies a different standard, and because it is not this court's role to upend duly enacted legislation simply because we might sometimes deem it imperfect or unwise, I must respectfully dissent," he said.

In 2017, a three-judge panel of the Superior Court ruled that plaintiffs Susan and Christopher Yanakos could not proceed with their lawsuit against UPMC over a liver transplant that occurred 13 years before the suit was filed. The ruling affirmed a decision from an Allegheny County Court of Common Pleas judge who likewise denied the Yanakoses' challenge to the MCARE statute of repose.

According to court records, in September 2003, Susan's son, Christopher Yanakos, volunteered to donate a lobe of his liver to her. Christopher Yanakos underwent various tests, one of which allegedly showed his liver was not properly functioning, court records said. However, according to the Yanakoses, they were unaware of the test results until June 2014, when both Yanakoses were allegedly suffering an advanced liver disease.

The plaintiffs sued UPMC and two doctors, saying that testing from 2003 allegedly showed Christopher Yanakos had the liver disease, which should have disqualified him as a donor. They sued in December 2015 on negligence and lack of informed consent claims.

In arguing that the statute of repose should be deemed unconstitutional, the plaintiffs contended that citizens of Pennsylvania have a right to access the courthouse if they have been injured. Defendants, however, countered that the legislature properly enacted the law, in large part, as a means of keeping insurance and health care costs under control.

Mundy used the intermediate scrutiny standard to evaluate the case—a point of contention between the majority and Donohue—and said that, although the government's interest in controlling the rising costs of medical care and medical malpractice insurance is important, MCARE's statute of repose does not substantially relate to achieving those goals.

Along with citing the lack of evidence about how the statute of repose would affect insurance costs, Mundy further said the law still does not provide a definite date for when no cases could be brought, since the statute allows for certain exceptions.

"Therefore, the seven-year statute of repose, with exceptions for foreign objects cases and minors, is not substantially related to controlling the cost of malpractice insurance rates by providing actuarial predictability to insurers," Mundy said.

The Supreme Court's decision reversed the Superior Court's ruling and remanded the case for further proceedings.

The decision is a win for plaintiffs counsel Patrick Cavanaugh of Del Sole Cavanaugh Stroyd.

Cavanaugh did not return a call seeking comment.

Dickie, McCamey & Chilcote attorney John Conti, who represented UPMC, also did not immediately return a call for comment.