Both questions before the Pennsylvania Supreme Court survived only because the hospital objected at the charging conference to the verdict slip’s agency framing and to its combination of factual cause with increased risk of harm.
On July 29, 2026, the Pennsylvania Supreme Court granted allocatur (No. 30 EAP 2026) to review Hagans v. Hospital of the University of Pennsylvania, in which the Superior Court affirmed a $182.7 million jury award that, accounting for delay damages, produced a judgment exceeding $207 million. The court will decide (1) whether vicarious liability may be imposed on a hospital without an express jury finding against a specific named agent; and (2) whether the jury may find liability based on either factual causation or increased risk of harm, resolving a direct conflict between Superior Court panels on this important causation question.
Background and Case Posture
The plaintiff sued the Hospital of the University of Pennsylvania (HUP), related corporate entities and several individual providers (collectively, “defendants”) based on the allegedly negligent care they provided during her labor and delivery at HUP in February 2018. She claimed that the defendants should have decided earlier to deliver via C-section, and had they done so, the minor plaintiff would not have been injured. She further alleged that the attending physician had negligently failed to check on her for more than two hours, and thus, she missed significant indications for an earlier C-section. The plaintiff’s experts testified in support of these theories, and the jury awarded $182,737,791, including $101 million in future medical expenses and $80 million for pain and suffering. With delay damages, judgment was entered for over $207 million.
In a precedential opinion filed July 10, 2025 (2025 PA Super 142), the Superior Court affirmed in full. The Superior Court reasoned that because the parties stipulated to agency, the individual providers were named on the verdict slip and the plaintiff proved negligence through expert testimony directed at the team’s collective failures, no separate finding against any individual provider was required—particularly where the defense itself had characterized the providers as a “team” throughout trial. The court further held that even if combining “factual cause” and “increased risk of harm” on the verdict slip was an error, it was harmless because the jury charge correctly stated the law.
The Superior Court’s latter holding conflicts with its finding in Lewis v. Reading Hospital, where it treated the “factual cause or increased risk of harm” formulation as reversible error requiring a new trial. 45 A.3d 257 (Pa. Super. 2025). The Lewis court held that the trial court’s instructions blending factual cause with increased risk of harm were erroneous and improperly eased the plaintiff’s burden of proving liability; “increase risk of harm” is only proper in certain cases and it only applies to proximate causation.
Issues the Pennsylvania Supreme Court Will Decide
Vicarious Liability Without an Individual Finding
The court will first determine whether it is reversible error to impose vicarious liability on a principal where its agents were originally named defendants but later dismissed from the case and the jury was never asked to, and did not, find liability against any individual agent. The Pennsylvania Supreme Court’s resolution of that issue may affect whether plaintiffs may need a verdict against a specific named agent, changing how team-care cases are tried and impacting how providers are named and listed on verdict slips.
Factual Cause Versus Increased Risk of Harm
The court will also assess whether it is a reversible error to include separate questions on the verdict form if the defendants’ negligence was either a “factual cause of harm” to the plaintiff or “increased the risk of harm.” A ruling for HUP would require a specific factual-cause finding in cases of medical negligence rather than the alternative formulation. The court’s determination would likely resolve a direct conflict between the opinion in this case and that in Lewis on the same causation question.
Implications and Recommendations Keyed to Issues on Appeal
Both questions before the Pennsylvania Supreme Court survived only because the hospital objected at the charging conference to the verdict slip’s agency framing and to its combination of factual cause with increased risk of harm. As parties wait for the Pennsylvania Supreme Court’s holding, defendant providers should preserve objections to the verdict slip on the record at the charging conference—both to any “by and through” agency framing and to any causation question that pairs factual cause with increased risk of harm.
In addition, the hospital’s stipulation that each clinician was its agent acting within the scope of employment, paired with a defense narrative describing the clinicians as a single team, is what allowed the case to be presented without individual liability findings. Until the court rules on the vicarious liability issue, the scope of any agency stipulation and the characterization of team-based care warrant particular attention at the outset of a case rather than at the charging conference.
For More Information
If you have any questions about this Alert, please contact Sharon L. Caffrey, Robert M. Palumbos, Anne A. Gruner, J.J. Larkins, any of the attorneys in our Trial Practice Group or the attorney in the firm with whom you are regularly in contact.
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