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In 2023, the legal landscape for medical malpractice lawsuits in Pennsylvania changed dramatically. A revision to Rule 1006 of the Pennsylvania Rules of Civil Procedure has redefined where victims of alleged medical negligence can file lawsuits. This amendment represents a fundamental shift in state civil procedure, ending a 20-year restriction that limited these cases to the county where the alleged malpractice occurred.
Now, plaintiffs can choose to file in any county where a defendant regularly conducts business. While proponents argue this expands access to justice, critics fear it could encourage forum shopping and burden certain courts with a flood of new cases. In this comprehensive guide, we’ll explore what the Rule 1006 amendment means, why it was enacted, how it impacts patients and hospitals, and what legal professionals need to know.
Rule 1006 of the Pennsylvania Rules of Civil Procedure governs venue, or the location where a civil case may be filed.
The Original Version of Rule 1006
Prior to the 2023 amendment, medical malpractice cases were an exception to the general venue rules. Plaintiffs could only file in the county where the alleged malpractice occurred. This restriction was introduced in 2003 as part of a broader tort reform movement aimed at curbing forum shopping and reducing court backlogs in plaintiff-friendly jurisdictions like Philadelphia.
The 2023 Rule Change
In August 2022, the Pennsylvania Supreme Court voted to amend Rule 1006. The new rule went into effect on January 1, 2023. Under this reform, plaintiffs can now file medical malpractice suits in any county where any named defendant regularly conducts business, even if the malpractice occurred elsewhere.
Addressing Inequity in the Legal System
Supporters of the change argued that the previous rule unfairly restricted plaintiffs—especially those living in rural areas with limited access to robust legal representation or courts with consistent jury outcomes.
The Civil Procedural Rules Committee found no compelling evidence that the restriction had a meaningful impact on reducing healthcare costs or improving court efficiency. In fact, they determined that it had created an unnecessary burden for patients seeking justice.
Rebalancing Access to Justice
The goal of the amendment was to create parity between malpractice litigants and other civil plaintiffs. Every other type of civil litigant had the right to file in a venue where the defendant conducted business—malpractice plaintiffs were the exception.
By removing that restriction, the court restored broader access to justice and removed what many considered an arbitrary disadvantage.
Definition and Purpose
Forum shopping is the practice of choosing the court jurisdiction where a case is most likely to result in a favorable outcome. Plaintiffs often select courts known for:
Implications of the Reform
The return of forum shopping in Pennsylvania’s medical malpractice arena has drawn criticism from hospitals and healthcare defense attorneys.
Urban venues like Philadelphia County and Allegheny County are widely perceived as plaintiff-friendly, meaning healthcare providers could face lawsuits in courts with higher damages and less local sympathy toward the defendant.
Legal Exposure for Rural Hospitals
Under the previous rule, a rural hospital could only be sued in its home county. Now, if that hospital is part of a larger health system that operates in multiple counties, it could be pulled into a lawsuit in an entirely different jurisdiction.
This could include counties where:
Financial and Operational Concerns
Rural hospitals and their insurers are especially concerned about:
These issues could eventually affect patient care, particularly in underserved communities.
Key Rule Change for Plaintiffs
With the revised Rule 1006 in place, plaintiffs can now file in any county where a defendant regularly conducts business. This allows for more flexibility and strategic decision-making when initiating a lawsuit.
For example, a patient treated at a small hospital in rural Pennsylvania can now sue that hospital in Philadelphia, provided that the hospital or its health system conducts business there.
What Plaintiffs Should Consider
Before choosing a venue, plaintiffs and their attorneys should evaluate:
Venue selection can dramatically affect the outcome and duration of a case, making this a critical step in the litigation process.
For Plaintiffs
Malpractice attorneys representing plaintiffs now have greater tools at their disposal. They can:
This can improve both the settlement leverage and the final outcome for the patient.
For Defense Counsel
Hospitals and their legal teams must now track their venue exposure statewide. A case could be filed in any number of counties, depending on how and where the defendant operates. Defense attorneys must be prepared to:
This can complicate defense planning and increase litigation costs.
Early Signs of Change
Since the reform’s implementation, legal observers have noted an increase in malpractice filings in urban counties. Philadelphia in particular is seeing a resurgence in activity, echoing trends from before the 2003 restriction.
Some law firms have begun developing internal tools and venue maps to guide their clients in strategic filing decisions based on court data and prior verdicts.
Legislative Pushback Likely
If court dockets become overwhelmed or insurance premiums rise dramatically, there may be calls for new legislative limits or reforms. For now, however, the legal community is in a watch-and-wait mode to see how the landscape evolves.
Potential Benefits
Potential Drawbacks
The rule change is still in its early stages, and its long-term impact will depend on how it’s used—and whether it’s challenged.
Can I file a medical malpractice lawsuit in any Pennsylvania county now? Not in every county, but your options are much broader than they were before the 2023 reform. Under the amended Rule 1006, you are allowed to file a medical malpractice lawsuit in any county where a named defendant—such as a hospital, physician, or healthcare system—regularly conducts business. This includes counties where the incident may not have occurred, but where the defendant has a business presence. For example, if a hospital in a rural area is part of a larger health network that operates clinics in Philadelphia, the plaintiff may now be able to file the case in Philadelphia County.
Does the venue change mean it’s easier to win a malpractice case in Pennsylvania? The reform does not directly change the legal burden of proof in medical malpractice cases, but it may influence the environment in which your case is heard. By opening access to venues with more plaintiff-friendly juries, experienced judges, or higher historical award values, it may improve the likelihood of receiving a favorable verdict or settlement. However, each case still depends heavily on its merits, the quality of legal representation, and the specific facts surrounding the alleged malpractice.
Why did the Pennsylvania Supreme Court amend Rule 1006? The court amended Rule 1006 to eliminate what it viewed as an unfair restriction on malpractice plaintiffs. The original version of the rule, adopted in 2003, limited medical malpractice filings to the county where the alleged incident occurred. This created a procedural hurdle not imposed on other civil litigants and, according to the Civil Procedural Rules Committee, lacked data supporting its ongoing necessity. The court determined that aligning medical malpractice venue rules with the rest of civil litigation would enhance fairness and access to justice.
Will this rule change lead to more lawsuits being filed? There is early evidence that suggests more malpractice lawsuits are now being filed in urban counties like Philadelphia and Allegheny since the reform took effect. These jurisdictions are often perceived as more favorable to plaintiffs due to their jury pools and historical verdict trends. While it is too soon to confirm whether the total number of malpractice suits has increased statewide, venue flexibility may encourage some individuals to pursue claims they may have previously deemed unfeasible under the old rule.
What should hospitals and healthcare providers do in response to the venue reform? Hospitals, physician groups, and healthcare systems should take proactive steps to assess how the reform may affect their legal risk profile. This includes reviewing where they have physical locations, business partnerships, or provide services across Pennsylvania. Many healthcare entities are now working closely with legal counsel to map out their exposure across various counties and to develop strategies for managing litigation in venues where they previously had little or no experience. Insurance carriers may also update their risk assessments, and providers should be prepared for potential premium adjustments or policy changes.
The Rule 1006 amendment is one of the most significant legal changes in Pennsylvania civil procedure in the past two decades. By removing the geographic restriction on medical malpractice filings, it empowers plaintiffs, reshapes legal strategy, and increases the responsibility on healthcare institutions to prepare for broader litigation risk.
Whether you’re a patient, attorney, or hospital administrator, understanding this reform is essential. The venue you choose—or are pulled into—can affect everything from jury selection to case outcomes to settlement terms.
If you or a loved one has suffered from medical negligence in Pennsylvania, the rules for pursuing justice have changed. You may now have options that were previously unavailable—options that could lead to a more favorable outcome.
To navigate this new legal landscape effectively, contact Matzus Law, LLC today for a free consultation. We can help you assess the best venue, gather critical evidence, and represent your interests with the full power of the law.
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