Heffelfinger, M. v. Shen, L.

2025 Pa. Super. 153
CourtSuperior Court of Pennsylvania
DecidedJuly 21, 2025
Docket681 MDA 2024
StatusPublished

This text of 2025 Pa. Super. 153 (Heffelfinger, M. v. Shen, L.) is published on Counsel Stack Legal Research, covering Superior Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Heffelfinger, M. v. Shen, L., 2025 Pa. Super. 153 (Pa. Ct. App. 2025).

Opinion

J-A11033-25

2025 PA Super 153

MARY HEFFELFINGER : IN THE SUPERIOR COURT OF : PENNSYLVANIA : v. : : : LINDA SHEN, DDS, SHEN SMILES, : PC AND DRUMS DENTAL LAB, LLC : : No. 681 MDA 2024 Appellants :

Appeal from the Judgment Entered April 30, 2024 In the Court of Common Pleas of Luzerne County Civil Division at No(s): 202008443

BEFORE: MURRAY, J., KING, J., and STEVENS, P.J.E.*

OPINION BY STEVENS, P.J.E.: FILED: JULY 21, 2025

Linda Shen, DDS (“Dr. Shen”), Shen Smiles, PC, and Drums Dental Lab,

LLC, appeal from the April 30, 2024 judgment entered on the jury verdict in

favor of Appellee, Mary Heffelfinger, and jointly against Appellants, in the total

amount of $11,459,513.69. After careful review, we affirm.

The relevant factual history of this case, as gleaned from the certified

record, is as follows: Appellee is a 68 year-old woman who resides in Chester

County, Pennsylvania. Dr. Shen is licensed to practice dentistry in the

Commonwealth of Pennsylvania and is the sole owner of her professional

corporation, Shen Smiles, PC (“Shen Smiles”) in Drums, Pennsylvania.

Appellee had known Dr. Shen for over a decade when she became her patient

____________________________________________

* Former Justice specially assigned to the Superior Court. J-A11033-25

in 2013. On May 13, 2018, Appellee went to Dr. Shen for dental care with a

lesion present on the left side of her tongue. Throughout more than six visits

in 2018, each initiated by Appellee, the lesion continued to grow and worsen.

In each instance, Dr. Shen prescribed palliative treatment but failed to refer

Appellee for specialist care, perform an oral cancer screening or biopsy for

diagnosis of the lesion, nor schedule Appellee for follow-up visits. In

December of 2018, Dr. Shen’s then-assistant, Dora Comstock, looked for the

first time at Appellee’s sore, and was immediately alarmed. When she raised

her concern with Dr. Shen, Dr. Shen responded in a hostile manner and told

Comstock to stay silent. Nevertheless, Comstock instructed Appellee to

immediately go to an oral surgeon. Appellee visited an oral surgeon, Niral

Parikh, DDS, on December 28, 2018, who immediately recognized the lesion

as possible squamous cell carcinoma, and referred Appellee for a biopsy, which

confirmed the cancer diagnosis.

Appellee underwent treatment for squamous cell carcinoma from

January thru June of 2019. The resulting extensive, invasive treatment

caused permanent injury to Appellee. Appellee underwent radiation and

chemotherapy, and required dissection of her neck to remove the left side of

her tongue and several lymph nodes. Said surgery also required a skin and

blood vessel graft, taken from Appellee’s arm, which restored some

functionality to her tongue. Although Appellee was able to achieve remission,

-2- J-A11033-25

she suffered permanent injury including speech deficits, lymphedema,

scarring, and a continued risk of recurrence.

The trial court set forth the early procedural history of this case as

follows:

This matter was commenced by writ of summons dated September 15, 2020. Pre-complaint discovery was conducted, and [Appellee’s] complaint was filed on August 17, 2021. A series of preliminary objections and amended complaints ensured. [Appellee’s] third amended complaint was filed November 9, 2021. Following disposition of [Appellee’s] preliminary objections to [Appellants’] preliminary objections to [Appellee’s] third amended complaint, [Appellee’s] third amended complaint became the operative complaint in this matter. The complaint alleged negligence against all [Appellants], as well as intentional infliction of emotional distress against [Dr. Shen]. The cause of action for intentional infliction of emotional distress was subsequently withdrawn at trial. Punitive damages were sought pursuant to the negligence claim.

Trial court opinion, 8/23/24 at 1-2 (extraneous capitalization omitted).

On February 20, 2024, the parties proceeded to a jury trial before the

Honorable Richard M. Hughes, III. At trial, the jury heard testimony from

eight witnesses, including a number of experts. Appellee presented, inter

alia, the expert testimony of George Just, DDS, DMD, to opine of the standard

of care for general dentistry, as well as the expert testimony of Dr. Wayne

Koch, MD, to opine on the causation of Appellee’s injuries and the alternative

treatment that would have been required with a timely diagnosis. Appellants

-3- J-A11033-25

presented, inter alia, Christopher Bereznak, DMD as an expert in general

dentistry as well as Dr. Shen as a fact witness.

At trial, the parties also contested whether Dr. Shen had in fact seen

Appellee as a patient during the seven-month period between May and

December of 2018. Dr. Shen’s patient ledger did not reflect any appointments

with Appellee during this timeframe, and Dr. Shen failed to maintain any

medical records relative to Appellee. As a result, the trial court admitted

testimony from Appellee’s sister, Catherine Martin, Dr. Shen’s former officer

manager from 2013 to 2019. Martin testified that Dr. Shen regularly took

patients ‘off-the-books’ and received payments in unrecorded cash amounts,

or in-kind services, which would therefore not have been reflected in her

patient’s ledger. Additionally, the trial court admitted testimony that Dr. Shen

herself was responsible for the medical records relevant to the Appellee during

that time frame the records went missing. See notes of testimony, 2/20-

22/24 at 75, 82-84, 174, 183-184.

Following a three-day trial, the jury returned a verdict in favor of

Appellee in the total amount of $11 million. Specifically, the jury found Dr.

Shen negligent and awarded Appellee $3 million in compensatory damages;

the jury also found Dr. Shen’s reckless conduct warranted $8 million in

punitive damages. Jury Verdict Slip, 2/23/24 at 1-3. On February 26, 2024,

Appellee filed a motion for $459,513.69 in delay damages pursuant to

Pennsylvania Rule of Civil Procedure 238. Thereafter, on March 4, 2024,

-4- J-A11033-25

Appellants filed motions for post-trial relief, which were denied by the trial

court on April 11, 2024. On April 23, 2024, the trial court granted Appellee’s

motion for delay damages in the amount of $459,513.69. On April 30, 2024,

judgment was subsequently entered in favor of Appellee, and jointly against

Appellants, in the total amount of $11,459,513.69. This timely appeal

followed on May 9, 2024.1

Appellants raise the following 14 issues for our review:

1. Whether the evidence was sufficient to warrant an award of punitive damages when the evidence showed nothing more than negligence on the part of Appellant Dentist?

2. Whether the [trial] court erred in allowing the jury to decide if punitive damages should be imposed on [Appellant] Dentist?

3. Whether punitive damages may be awarded for misconduct that constitutes ordinary negligence[?]

4. Whether the trial court committed plain error or abused its discretion in [sic]?

5. Whether there is a recognized cause of action for negligent record documentation in Pennsylvania[?]

6. Whether the [trial] court erred in denying [Appellants’] motion in limine, seeking to limit certain irrelevant and prejudicial testimony.

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