The Court of Appeals of Indiana (“Indiana Appellate Court”) in its Memorandum Decision filed on May 28, 2019 overturned a $3 million Indiana medical malpracyice verdict in favor of the parents of a five-year-old child who died after receiving a chemotherapy treatment due to chemotherapy toxicity (an “extremely bad reaction” to the methotrexate administered to him on June 8, 2010, leading to his death on June 25, 2010).
The child began treatment on May 3, 2010 at the defendant hospital for acute lymphoblastic leukemia/lymphoma (“ALL”). The child received chemotherapy at the defendant hospital on May 4, May 11, May 18, May 25, and June 2, 2010. After the injection of intrathecal methotrexate on June 2, he developed a fever three days later and was treated in a local hospital’s emergency room. The next day, he had a fever and a headache and was brought back to the same hospital, where he was treated and released.
On June 8, the child received another round of chemotherapy at the defendant hospital, including a lumbar puncture and injection of intrathecal methotrexate (he had no complaints at that time). After the lumbar puncture, he developed a headache, which resolved after he was given morphine and other medications. The child was discharged that evening, and they began the long drive home (the parents lived several hours from the defendant hospital).
On the drive home, the child “was screaming saying his head was hurting.” The next morning, the child “woke up screaming . . . [and] kept saying that his legs hurt, he couldn’t walk,” and said that “his head hurt[.]” He was transported to the local hospital by ambulance where he was admitted and initially diagnosed with meningitis. On June 17, when his symptoms had not improved, he was transferred to the pediatric intensive care unit at the defendant hospital. On June 24, he was finally diagnosed as suffering from chemotherapy toxicity and died on June 25, 2010.
The parents’ Indiana medical malpractice wrongful death lawsuit alleged, in part, that the defendant hospital, through its agents and representatives, were medically negligent in failing to delay the June 8 intrathecal dose of methotrexate and that the failure to postpone the intrathecal methotrexate was the cause of their child’s death on June 25, 2010.
The plaintiffs’ expert did not testify during his deposition that the defendant hospital’s conduct had breached the applicable standard of care. The same expert witness testified during trial after which the defendants moved for a directed verdict, arguing that the expert did not testify that the defendant hospital’s conduct had breached the applicable standard of care. The defendants’ motion was denied and the Indiana medical malpractice jury subsequently returned its verdict in favor of the plaintiffs in the amount of $3 million, which the trial judge reduced to $1,250,000, pursuant to Indiana’s Medical Malpractice Act’s statutory cap on damages. The defendants appealed.
The Indiana Appellate Court stated that the plaintiffs’ expert testified in response to the question “And based on your statement that [the defendant doctor] and [the defendant hospital] just missed this, you believe the Doctor’s conduct fell below the standard of care?” that “I do believe that the conduct fell below the standard of care.” Nonetheless, the jury entered a verdict in favor of the defendant doctor. And in response to the question “You’re not testifying in this case that the nurses at [the defendant hospital] breached the standard of care in treating [the child], are you?”, the expert answered, “They did not. I am not testifying to that.” In response to the question, “And you don’t have any criticism with the nursing care provided to [the child], do you?, the expert responded, “No, sir.”
The Indiana Appellate Court thus stated, “[The plaintiffs’ expert] explicitly testified at trial that [the defendant hospital] had not breached the standard of care. Accordingly, we must agree with [the defendant hospital] that [the plaintiffs’ expert’s] testimony did not rebut the medical review panel’s opinion that [the defendant hospital] was not negligent in its treatment of [the child] … We hold that the [plaintiffs] did not present evidence at trial to prove that [the defendant hospital] breached the applicable standard of care in its provision of health care to [the child]. Accordingly, the trial court erred when it denied [the defendant hospital’s] motion for directed verdict at the close of the [plaintiffs’] presentation of evidence at trial.”
Source IU Health, Inc. d/b/a Riley Hospital for Children v. Meece, Court of Appeals Case No. 18A-CT-2968.
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