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Phillip Panzarella prior to 5GS LLC was founder and CEO for CPS Professional Services, LLC, a service-disabled veteran-owned small delivering enterprise performance solutions and training to government clients. He was Founder and Partner at 5th Grade Simple, LLC (5GS) delivering strategic planning, leadership training and executive coaching – helping executives achieve the next level of sustainable success. Previously Phil was Chief Growth Officer for Easterseals DC MD VA helping people with disabilities and special needs live, work and play in their communities. He helps others achieve a positive trajectory to accomplish life’s goals. He is a positive leader, ICF Certified Coach focusing on executives, team builder and entrepreneur. Panzarella who draws on 40 years of progressive leadership and management experience. at 1103.Our firm is focused on leveraging our leadership, executive coaching, consulting and management experience to help organizations and individuals in the commercial (for profit or nonprofit) or government space achieve the next level of sustainable success! We work with you through the transition which can be the most difficult part of the change journey. Orenstein testified that although she did not 'advocate transplant,' she never advised against it. Orenstein's care, and that the Alexanders 'were very clear about the treatment options.' App. She also testified that the Alexanders were 'provided with all relevant medical information concerning treatment options and concerning risks, benefits and possible complications, available treatment options,' during the period of time in which Alyssa was under Dr. Orenstein remembered specifically communicating the risks involved in rejecting a liver. Orenstein testified that when the first liver was offered, she and the Alexanders 'had a very detailed discussion about the significant risks of deterioration abruptly without being able to get another liver.' App. Scheinberg opined that survival without a liver transplant was unlikely. Scheinberg (the New York expert in Wilson's Disease) wrote, in which Dr. Orenstein testified that she told the Alexanders about the note Dr. Alexander told him that they (the Alexanders) 'had made a mistake and a bad decision' in refusing the livers. Reyes also testified that when Alyssa was in intensive care, Mr. Reyes testified that he provided the Alexanders with all the appropriate information concerning a transplant, including the risks in transplantation and in refusing transplantation, because he 'felt that there was going to be a bad outcome without a transplant,' but that he never directly stated that Alyssa must have a transplant.

Alexander 'did not want a liver transplant.' Id. Reyes testified that he told Alyssa and her parents that 'Alyssa had a better chance of recovery with a liver transplant.' App. He testified that he spoke directly to the Alexanders because he was concerned about Alyssa and her family and wanted to make sure they knew 'the risks for and against transplantation.' App. Reyes testified that he told the Alexanders that Alyssa needed a transplant.

Of course, in Pennsylvania contributory negligence if established will be an aspect of a comparative negligence analysis.

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In addition, the plaintiff's negligent conduct must be a proximate cause of her injury if there is no evidence of causation between the plaintiff's negligence and her injuries, the trial court properly may refuse to instruct the jury on contributory negligence. 1977) (recognizing Pennsylvania law in submitting issue of contributory negligence to jury). Under Pennsylvania law, which is applicable here, if there is any evidence of contributory negligence in a medical malpractice case, the court must submit the issue to the jury, even if the evidence to the contrary is strong. Orenstein initiated the chelation therapy, and Alyssa's condition stabilized. Reyes also relayed to the Alexanders his belief that a transplant was necessary. Orenstein, she relayed all this information to the Alexanders. Scheinberg also stated that if Alyssa's liver function continued to deteriorate on chelation therapy in the first few days, her chances of survival without a transplant were very slim. Scheinberg opined that Alyssa first could receive an alternate treatment to remove copper from the body (chelation), but that her chances of survival on this therapy were only about 25%.

Israel Scheinberg, a New York expert in Wilson's Disease. Reyes opined that a liver transplant was probably the only way to save Alyssa. Jorge Reyes, head of the liver transplant team at Children's Hospital. Susan Orenstein diagnosed her as having Wilson's Disease, a rare disorder of the liver that allows excessive amounts of copper to accumulate in various organs. Shortly after Alyssa was admitted to Children's Hospital, Dr.