Shenoy, S. v. Glazer, A.

Superior Court of Pennsylvania·Decided February 10, 2026·No. 3120 EDA 2024·Unpublished·Bowes

Opinion

NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT O.P. 65.37

SHALINI SHENOY, INDIVIDUALLY : IN THE SUPERIOR COURT OF AND AS EXECUTRIX OF THE ESTATE : PENNSYLVANIA OF VIJENDRA SHENOY :

:

Appellant :

:

v. :

:

ALAN U. GLAZER, M.D., AKUMIN : A/K/A AKUMIN, INC., AKUMIN : CORP., AKUMIN HOLDINGS CORP., : JEANES RADIOLOGY ASSOCIATES, : LLC, (JEANES RADIOLOGY : ASSOCIATES, P.C.), TRI-STATE : IMAGING CONSULTANTS (TRI-STATE : IMAGING CONSULTANTS, LLC, TRI- : STATE IMAGING GROUP, LP, TRI- : STATE IMAGING PARTNERS, LP, TRI- : STATE IMAGING PR, LLC, TRI STATE : IMAGING PARTNERS GP, LLC, TRI- : STATE IMAGING PA HOLDINGS, LLC, : TRI-STATE IMAGING INVESTMENTS : LP, TRI-STATE IMAGING : INVESTMENTS GP, LLC, TRI-STATE : No. 3120 EDA 2024 IMAGING SOLUTIONS, LLC) :

Appeal from the Judgment Entered October 31, 2024 In the Court of Common Pleas of Montgomery County Civil Division at No(s): 2021-02498

BEFORE: LAZARUS, P.J., BOWES, J., and FORD ELLIOTT, P.J.E.* MEMORANDUM BY BOWES, J.: FILED FEBRUARY 10, 2026 Shalini Shenoy (“Plaintiff”), individually and as executrix of the estate of Vijendra Shenoy (“Decedent”), appeals from the judgment entered against

* Retired Senior Judge assigned to the Superior Court.

her and in favor of Alan U. Glazer, M.D., upon a jury verdict in this action for medical malpractice.1 We affirm.

The underlying facts are as follows. Decedent received a prescription from his oral surgeon for a CT scan “due to complaints of jaw pain and swelling.” Trial Court Opinion, 1/8/25, at 1. Dr. Glazer was the radiologist who read the scan, which consisted of hundreds of images that captured not only Decedent’s mouth and jaw area, but also parts of his head, neck, and upper chest. See N.T. Trial (Vol. IV), 8/8/24, at 34-43.2 While he reported observing a nodule “representing a prominent lymph node” in portions of the

1 Plaintiff also sued various business entities (hereafter “Corporate Defendants”), alleging that they were vicariously liable through respondeat superior for Dr. Glazer’s purported negligence. The jury’s determination that Dr. Glazer was not negligent thus resolved her claims against the Corporate Defendants. See, e.g., Mamalis v. Atlas Van Lines, Inc., 560 A.2d 1380, 1383 (Pa. 1989) (“[T]ermination of the claim against the agent extinguishes the derivative claim against the principal. A claim of vicarious liability is inseparable from the claim against the agent since any cause of action is based on the acts of only one tortfeasor.”).

2 There are irregularities in the identification of the trial transcripts.

From the

parties’ briefs, we have determined that Volume III contains the notes of testimony from August 7, 2024, although it purports to be an additional volume for August 6. Also, the transcript for the August 8, 2024 proceedings is not included in the certified record, but an excerpt of it containing Dr. Glazer’s testimony is included in the reproduced record as Volume V. Meanwhile, the certified record contains notes of testimony from August 12, 2024, also labeled as Volume V. We refer to Volume III as reporting the August 7 proceedings, and deem the August 8 excerpt to be Volume IV, accepting the copy included in the reproduced record since there is no apparent dispute as to its accuracy. See Pa.R.A.P. 1921, Note.

soft-tissue images of Decedent’s chest, Dr. Glazer did not note any lesions there in his September 2017 report. See Trial Court Opinion, 1/8/25, at 1.

In 2019, upon seeking medical attention for chest pain, Decedent was diagnosed with a chondrosarcoma in his chest wall. 3 He sued Dr. Glazer for negligence, alleging that a suspicious 2.4 centimeter lesion had been visible on the 2017 CT scan and Dr. Glazer failed to report it. Decedent passed away while the litigation was pending, and Plaintiff amended the complaint to state survival and wrongful death claims, averring that the delayed diagnosis caused Decedent’s demise.

Plaintiff’s liability expert at trial was Marc Glickstein, M.D. Dr. Glickstein opined that the standard of care for a radiologist is to review every image included in the CT study in various types of windows, i.e. densities. See N.T. Trial (Vol. II), 8/6/24, at 29. While the radiologist should “look at the area that would be of interest for the scan,” which in this instance was the parotid gland that produces saliva for the mouth, he should “also go back and look at all of the images again for other findings that may be present in different parts of the examination that was not the main focus of the study.” Id. Dr.

3 As one of Plaintiff’s witnesses explained at trial, “chondrosarcomas are tumors [that] generally originate from the cartilage and tend to grow in areas that have heavy cartilage or bone.” N.T. Trial, 8/6/24 (Vol. II), at 80. Further, “chondrosarcomas, like most sarcomas, are not really sensitive to chemotherapy and radiation.” Id. Rather, “the only way to treat sarcomas in general and chondrosarcomas specifically for a good, long-term result is to completely remove it. So the earlier it is detected, the more likely you are to be able to remove it.” Id. at 80-81.

Glickstein discerned that Dr. Glazer had done so, as he noted a nodule that was in the chest at the same level as the tumor which was ultimately discovered in 2019. Dr. Glickstein indicated that the “fairly large lesion” was visible on the 2017 images and was “not . . . particularly subtle[.]” Id. at 40. As such, he believed Dr. Glazer should have reported the lesion, and his failure to do so constituted negligence. Id. at 43-44.

On cross-examination, Dr. Glickstein conceded that the failure to appreciate or perceive an abnormality does not necessarily indicate a deviation from the standard of care. Id. at 45. He also acknowledged the existence of: (1) framing bias, which can make a doctor more alert to discern something he otherwise might not appreciate based upon who presented the study to him; and (2) hindsight bias, which may cause a radiologist to note something on imaging that he expects it to be present, knowing the patient’s outcome. Id. at 45-46, 48. Dr. Glickstein recognized that practice parameters promulgated by the American College of Radiology, of which he was a member, suggested than an “expert witness should make every effort to avoid being influenced by hindsight and framing biases.” Id. at 54. In that vein, the practice guidelines provide: “The expert witness should strive to minimize all potential sources of conscious and subconscious bias when reviewing case materials. Images and other relevant material presented in a blinded fashion to the expert in a malpractice lawsuit strengthens the credibility of the opinion rendered by the expert.” Id. at 56.

Dr. Glickstein agreed that one way to avoid these biases is to employ blinding techniques, such as having a lawyer send multiple CT studies rather than the one at issue, or embedding the studies within the expert’s clinical work so he is unaware that he is conducting a legal review. Id. at 49. Yet, while he had done blinded reviews in other cases, in the case sub judice he received Decedent’s file “in a totally unblinded fashion.” Id. at 50. Consequently, he (1) knew that a review of Decedent’s CT images had been requested by an attorney, (2) reviewed the materials with access to information about the case that was unavailable to Dr. Glazer in 2017, and (3) authored a report that “focused on something [he] knew to be present based on . . . information derived after the fact[.]” Id. at 60.

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