Karen E. Minehan

Missy is a member of the Health Care Department where she focuses her practice on the defense of professional medical negligence and premises liability claims, as well as medical licensing matters before licensing boards such as the Pennsylvania Boards of Medicine, Osteopathic Medicine, Nursing, and Psychology. Her individual clients include physicians, nurses, Patient Care Technicians (PCTs), Certified Nurses Aides (CNAs), therapists, mental health professionals, and other health care providers. Missy’s institutional clients include acute and rehabilitation hospitals, long-term and skilled nursing facilities, correctional medicine providers, and outpatient dialysis facilities.

Missy has handled matters encompassing a wide range of medical issues, including retained foreign objects, ob/gyn, wound care, patient falls, and neurological injuries. She has significant jury trial, arbitration, mediation, appellate, and administrative law experience.

After receiving her undergraduate degree from Wellesley College, where she played intercollegiate soccer and spent her junior year in Paris, France and Yaounde, Cameroon, Missy graduated from the University of Pittsburgh School of Law and the Graduate School of Public and International Affairs with a J.D. and a Master's Degree in International Affairs.

Missy's bar admissions include the Supreme Court of Pennsylvania and U.S. District Court for the Western, Middle, and Eastern Districts of Pennsylvania. She is a member of the Pennsylvania Bar Association. She is frequently called upon to lecture on a wide array of topics in the field of health care litigation.

Outside of her professional career, Missy is an active volunteer in her local community. She served as a Girl Scout leader to a troop that advanced from Brownie to Ambassador. She interviewed prospective high school students for admission to Wellesley College as an alumna volunteer and served as the President and Vice President of the Southeastern Pennsylvania Wellesley College Club. She worked as a puppy sitter for the Susquehanna Service Dog. An avid skier, Missy co-founded and continues to lead the Camp Hill Middle and High School Ski & Snowboard Club. In addition, Missy is currently a Member and the Secretary of the Cleve J. Fredricksen Library Board of Trustees.

Honors & Awards

•AV Preeminent by Martindale-Hubbell
•Pennsylvania Super Lawyer Rising Star (2006-2007)

Classes/Seminars Taught

•Mitigating and Responding to a Professional Liability Claim: Documentation, Discovery, and Depositions, Skilled Nursing Development Institute's Administrator Appreciation Event, August 6, 2025
•Arbitration Agreements: Hot Topics and Best Practices, client webinar, March 19, 2025
•Trends, Tips, and Tricks in the Defense of Long-Term Care Facilities, PACHRM/PDI Conference, July 14, 2023
•From Arbitrations to Schedule Zs: Trends, Tips and Tricks to Navigate the Written Discovery Process in Long-Term Care Civil Litigation, Marshall Dennehey Trends in Health Care and Health Law Seminar, May 5, 2022
•Reduce Your Risk: Understanding the Emergency Medical Treatment and Active Labor Act (EMTALA), February 18, 2021
•Pitfalls of Social Media and Nursing, May 8, 2018
•ED Documentation: Are You Writing Enough?, April 2018
•Event Management, Documentation and Disclosure: Trends, Dangers and Best Practices, March 2015
•Understanding Advance Health Care Directives in Pennsylvania, March 2015
•General Liability, Professional Liability and Other Interesting Litigation Issues, February 26, 2015
•The Medical Licensing System in Pennsylvania, 2012
•Expert Retention, Review, and Testimony: From Start to Finish, October 8, 2007
•Defensive Documentation, co-presenter, April 2007
•Medical Records Law in Pennsylvania as it Pertains to Litigation Issues, co-presenter, Lorman Education Services, August 2006
•A Statutory Tour Through the Peer Review Protection Act, MCARE Act and the Patient Quality Improvement Act of 2005, co-presenter, October 2005
•Avoiding Lawsuits and Facing the Ones You Cannot Avoid: Documentation, Event Review, Deposition and Trial Testimony, co-presenter, May 2005
•An Overview of Pennsylvania Law as it Relates to HMA Medical Malpractice, co-presenter, January 2005
•Best Practices for Hospital Investigation of Patient Care, October 2004

Published Works

•“The New and Broadened Law Governing Venue in Pennsylvania Medical Malpractice Cases,” Defense Digest, JDSupra, March 2023
•“The Public Policy Exception to the Enforcement of Foreign Judgments: Necessary or Nemesis?,” 18 Loy. L.A. Int’l & Comp. L. J. 795 (1996)

Results

Defense Award Obtained in a Contested Wound Case

We secured a defense award on behalf of a skilled nursing facility in a hotly contested “wound” case after a two-day arbitration. The 93-year-old plaintiff had been a resident at the nursing facility for over three years without having suffered any pressure injuries, despite a plethora of risk factors. In August 2019, she was transferred emergently to an acute care hospital where she was diagnosed with a myocardial infarction (MI) and cardiogenic shock. The hospital administered five days of a vasopressor, a life-saving medication that can increase the risk of pressure injuries, and recommended that she consult with palliative medicine due to her poor condition and prognosis. Within several weeks of her return to our client’s facility, she was found to have a Stage III left heel wound and a Stage II left buttocks wound. The wounds were treated and resolved within four and five months, respectively. At 99 years of age, she still resides at the facility.

Defense Verdict in Ohio Medical Malpractice Case

We obtained a medical malpractice defense verdict on behalf of a skilled nursing facility in the Cuyahoga County Common Pleas Court in Cleveland, Ohio. The children of an 82-year-old skilled nursing resident brought a lawsuit after their mother developed shingles and associated meningitis and passed away. They claimed the facility had inadequate infection control and failed to identify signs/symptoms of developing changes in their mother’s condition. The defense proved the facility offered the appropriate vaccinations that were required by the state of Ohio and that the standard of care did not require the facility offer or administer the Shingrix vaccine to its residents. They also proved the facility properly monitored the resident’s signs and symptoms; that she did not exhibit any classic signs or symptoms of shingles at the facility; and that the facility timely sent her to the ER for evaluation when her condition changed. In closing arguments after a five-day trial, the plaintiffs asked the jury for $3 million. The jury deliberated for 75 minutes and returned with a defense verdict.

Thought Leadership

Defense Digest

The New and Broadened Law Governing Venue in Pennsylvania Medical Malpractice Cases

March 1, 2023

Key Points:Recent Pennsylvania Supreme Court actions may dramatically broaden the counties in which plaintiffs may file medical malpractice actions.Such actions can now be filed and litigated hundreds of miles from the facility where care was provided, where the witnesses live or work, and even where the plaintiffs themselves live.The Pennsylvania Supreme Court’s amendment of Pennsylvania Rule of Civil Procedure 1006, combined with the Pennsylvania Superior Court’s reduction in the threshold for venue in Hangey v. Husqvarna Professional Products, Inc., 247 A.3d 1136 (Pa. Super. 2021), alloc. granted, 278 A.3d 301 (Pa. 2022), have the potential to dramatically broaden the counties in which plaintiffs may file medical malpractice actions. Gone are the days when medical malpractice actions were venued solely in the county where the cause of action arose. Now, such actions can be filed and litigated hundreds of miles from the facility where care was provided, where the witnesses live or work, and even where the plaintiffs themselves live.By order dated August 25, 2022, the Supreme Court amended Pennsylvania’s venue rule, Pa.R.Civ.P. 1006, by deleting Rule 1006(a.1), which provided that medical malpractice actions must be filed “only in a county in which the cause of action arose.” The effect of deleting Rule 1006(a.1) is to make medical malpractice actions subject to the same venue standards that apply to all other types of civil cases. This significant change became effective on January 1, 2023.What will it mean going forward? It means that medical malpractice cases now may be filed where a defendant may be served, the cause of action arose, or a relevant transaction or occurrence took place. This is crucial because, just as the former medical malpractice venue rule was being rescinded, so, too, were the usual venue rules being relaxed. In the non-medical malpractice context, venue is generally determined by assessing whether a defendant’s contacts with the plaintiff’s chosen venue are of sufficient quantity and quality. Although there was never a hard-and-fast rule, the quantity test traditionally has been satisfied if the defendant does about 1% or more of its business in the plaintiff’s chosen venue. This percentage standard was viewed as fair because it applied equally to large and small businesses.However, in Hangey, the Superior Court en banc (by a vote of 7-2) made it much easier for plaintiffs to obtain venue over businesses in counties other than the county where the cause of action arose. In particular, the Superior Court held that venue could lie over a defendant who does only .005% of its business or $75,000 in total business in a forum. This extremely low volume of business expands the ability of plaintiffs to secure venue in locations with minimal connection to the lawsuit. On May 10, 2022, the Supreme Court accepted review in Hangey and it will hear argument in March of 2023. The Supreme Court could reverse, affirm, or even further dilute the low venue standard adopted by the Superior Court in Hangey. In the meantime, Hangey is currently the law and will also dilute the new venue standard that applies to medical malpractice cases, effective January 1, 2023, as a result of the Supreme Court’s amendment to Rule 1006.The Superior Court continued to pick away at the venue standard in Quigley v. Pottstown Hospital, LLC, 2022 WL 17347500 (Pa. Super. Dec. 1, 2022). In that case, the plaintiff alleged that the deceased, an elderly dementia patient, was sexually assaulted while a patient of Pottstown Hospital in Montgomery County. The trial court transferred the case from Philadelphia County to Montgomery County. The Superior Court reversed the transfer and returned the case to Philadelphia. The Superior Court held that the case should not have been transferred to Montgomery County because Tower Health, the hospital’s parent company and co-defendant, regularly conducted business in Philadelphia County through its unrelated subsidiaries.Specifically, the Superior Court found that Tower Health had the requisite quality and quantity of contacts with Philadelphia County because it: (1) owned multiple Philadelphia properties, an acute-care hospital, two urgent care facilities, and a children’s hospital; (2) was the managing partner of an LLC that owned a Philadelphia children’s hospital; (3) conducted medical billing of its subsidiary hospitals through a Philadelphia post office box; and (4) actively asserted control and authority over its subsidiaries by procuring insurance policies, providing them with general counsel, conducting hospital CEO performance reviews and disciplinary actions, ratifying the hospital’s Board of Directors, and implementing acute care hospital federal mandates. Hence, although the cause of action arose in Montgomery County, and even before the implementation of the new Rule 1006 on January 1, 2023, the Superior Court found venue proper in Philadelphia. This decision attributed the activities of related corporations to Pottstown Hospital in a way that is new to Pennsylvania law, which has traditionally respected corporate formalities and not eroded those formalities by attributing the acts of one corporation to another.Many major health systems, parent companies, and long-term care “home offices” have a presence in Pennsylvania’s pro-plaintiff hotbeds (especially Philadelphia, Allegheny, Lackawanna, and Luzerne Counties). Hence, when we combine the impacts of the venue rule change, Hangey, and Quigley, it seems that Pennsylvania is returning to a time when plaintiffs can file suit in nearly any venue, regardless of whether that venue has any legitimate connection to the facts, litigants, or witnesses.