Court affirms judgment for patient left paraplegic after years of unaddressed neurological warning signs; panel finds most of defense's appellate arguments waived for failure to properly preserve them at trial.
PHILADELPHIA — A Pennsylvania Superior Court panel has affirmed a roughly $18.5 million jury verdict in favor of a former University of Pennsylvania Health System employee who became an incomplete paraplegic after her primary care physician allegedly failed for years to act on abnormal neurological findings, according to a non-precedential memorandum opinion filed September 11, 2026.
The panel, in Melendez v. Mo, rejected each of five issues raised on appeal by Dr. Gyi P. Mo and Clinical Care Associates of the University of Pennsylvania Health System, holding that most of the defendants' claims were waived because trial counsel failed to properly preserve them through timely objections, mistrial motions, or adequately briefed post-trial motions. The court also found that, even if the issues had not been waived, none would have entitled the defendants to relief.
According to the court's recitation of the trial record, plaintiff Diane Melendez was a longtime patient of Dr. Mo, who served as her primary care physician beginning in 2011. Melendez began complaining of back pain in 2012, and clinical notes reflected abnormal reflex readings that the court's opinion describes as indicative of a serious neurological condition. At trial, Mo testified that those recorded findings were the product of data-entry mistakes or a software glitch, and that Melendez's reflexes were in fact normal. Mo did not order additional testing or refer Melendez to a neurologist at that time.
Melendez's symptoms progressed over the following years, and in 2016 she was referred to a podiatrist, who in turn referred her to a neurologist. She was ultimately diagnosed with a spinal dural arteriovenous condition — a diagnosis the opinion notes is treatable if caught early. By the time of diagnosis, according to the court, the condition was no longer caught early enough, and Melendez underwent surgery that left her an incomplete paraplegic, unable to walk without a walker and dependent on others for most activities of daily living.
At trial in the Philadelphia County Court of Common Pleas, a jury found in Melendez's favor against Mo, though it also found her 6% contributorily negligent, while a co-defendant podiatrist was found not liable. After the reduction for comparative fault, the verdict totaled approximately $18.49 million, comprising $799,000 for past and future non-economic loss, more than $9.3 million for future economic loss, over $1.1 million for past and future lost earnings, and more than $7.2 million for future medical expenses.
On appeal, Mo and Clinical Care argued that the trial court erred by not entering judgment notwithstanding the verdict, by declining to grant a new trial based on what the trial judge himself had called the “deplorable” conduct of Melendez's trial counsel, by giving a mid-trial cautionary instruction after witnesses referenced documents the court had excluded for a discovery violation, by allowing a verdict the defense called against the weight of the evidence, and by refusing to reduce the size of the award.
The Superior Court rejected the sufficiency-of-the-evidence argument, concluding that Melendez's expert witness, an internal medicine specialist, testified with the reasonable degree of medical certainty required under Pennsylvania law even though he did not use that precise phrase. The panel also found that the defendants had preserved only a narrow slice of that argument for appeal, since they had not challenged the sufficiency of a second expert's causation testimony before or during trial.
On the misconduct claims, the panel agreed that plaintiff's trial counsel had, at times, acted aggressively and referenced Melendez's termination from her hospital job — testimony the defense argued was irrelevant to a medical negligence case and designed to inflame the jury. But the court found the defense had waived the issue by failing to lodge timely objections or promptly move for a mistrial, and noted that defense counsel had also engaged in some of the disputed conduct. The panel further found that the trial court's cautionary instruction regarding late-disclosed evidence was not, as the defense argued, akin to a sanction for spoliation, and that the defense had not shown it was prejudiced by the instruction.
The court likewise rejected the weight-of-the-evidence and remittitur arguments, finding both waived for inadequate briefing and, in any event, unpersuasive given Melendez's catastrophic and permanent injuries, which the panel said justified the size of the award.
President Judge Lazarus, joined by Judge McLaughlin, filed a concurring memorandum agreeing with the outcome but writing separately to address plaintiff's trial counsel's conduct. Lazarus wrote that had the defense properly objected and sought a mistrial at the time, the repeated references to Melendez's termination “provided grounds for a new trial,” and endorsed the trial judge's on-the-record assessment that counsel had tried to inflame the jury. Lazarus catalogued numerous exchanges in which the trial judge admonished plaintiff's counsel for theatrics, argumentative questioning, and disregard of the court's directions, concluding that the attorney's behavior over the course of the three-week trial “imperiled his client's case and reflected poorly on our justice system,” even though it did not, in the end, entitle the defense to a new trial given the procedural posture.
The Superior Court separately noted its frustration with the defendants' appellate brief and reproduced record, which the panel said failed to comply with several appellate procedural rules, including by omitting the post-trial motions and supporting brief that were central to the trial court's waiver findings, and by not identifying where in a record spanning thirty-two volumes of transcripts the disputed issues had been preserved.
The judgment in favor of Melendez was affirmed.
Read the full opinions: Melendez v. Mo — Superior Court Memorandum Opinion (Sept. 11, 2026) and Concurring Memorandum by President Judge Lazarus.
The Trial Attorneys Editorial Staff
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