Medical Malpractice in Pennsylvania: The Certificate of Merit Requirement

The standard is not perfection

Medicine involves risk, and a poor outcome is not by itself negligence. The question is whether the care fell below the standard a reasonably competent practitioner in that field would have provided, and whether that failure caused the harm.

Both parts matter. Substandard care that did not change the outcome does not support a claim, and this is where a great many potential cases end.

The certificate of merit

Pennsylvania requires a certificate of merit in professional liability actions, filed within a set period after the complaint. It states that a licensed professional has supplied a written statement that there is a reasonable probability the care fell outside acceptable standards and caused harm.

Failure to file it as required results in dismissal. It exists to screen out unsupported claims, and it means an expert has to review the records before a case can realistically be brought.

The deadline is more complicated than two years

The general limitation is two years, but the discovery rule matters here more than in most injury cases, because patients frequently do not know that something was done wrong. Where the injury or its cause could not reasonably have been discovered, time may run from when it was or should have been discovered.

There is also a statute of repose setting an outer limit regardless of discovery, with recognized exceptions including for foreign objects. And minors are treated differently.

These interact in ways that are genuinely complicated. Do not conclude from a calendar that you are out of time.

What these cases usually involve

• Failure or delay in diagnosis, particularly cancer, cardiac events and infections, which is the largest category.
• Surgical error, including wrong site surgery and retained foreign objects.
• Medication error, in dose, drug or interaction.
• Birth injury, which has its own timelines and its own expertise.
• Failure to obtain informed consent about material risks.
• Emergency department failures, including premature discharge.

Why we screen carefully

Expert review is expensive and it happens before anyone knows whether there is a case. Bringing a claim that expert review does not support helps nobody, and we will tell you if the records do not show a departure from the standard.

Get the complete records requested early. That is the necessary first step whatever the outcome.