In its decision filed on April 28, 2016, the Indiana Supreme Court reversed the trial court’s granting summary judgment to the defendants in an Indiana medical malpractice case, finding that the Indiana medical malpractice defendants themselves “created a genuine issue of material fact by designating for summary judgment [their expert’s] affidavits and the conflicting medical review panel’s opinion. Because their designated evidence shows that a conflict of evidence may exist on the element of causation, summary judgment for [the defendants] is inappropriate. The conflicting evidence must be resolved by a trier of fact, and we therefore reverse the trial court’s grants of summary judgment to [the defendants].”
The Indiana medical malpractice case involves an 83-year-old woman who was being treated in the defendant hospital for aspirational pneumonia in October 2007. The woman, who had advanced dementia, had appointed her son as her designated health care representative. The son instructed the defendant hospital and the defendant physician to classify his mother as “full code” so she would receive all life-sustaining therapies in the event of cardiac or pulmonary arrest, but the defendant hospital’s ethics committee subsequently determined that the woman’s condition was unlikely to improve, that “[t]he greatest benefit with least burden [was] to make the patient a no code,” and that the family had “unrealistic expectations and strong religious beliefs.” The defendant hospital’s ethics committee ultimately overruled the “full code” decision in mid-November 2007, and changed the woman’s classification to “no code” so that she would not receive any life-sustaining therapies.
The woman’s children were advised that if they wanted their mother to remain a full code, they would need to find another hospital and doctor. The woman’s children arranged to have their mother transferred to another hospital where she was admitted on December 8, 2007, requiring immediate treatment for a collapsed lung – she was also suffering from wounds on her cheeks, overwhelming infection, and septic shock. The woman died 20 days later.
The family filed an Indiana medical malpractice complaint with the Indiana Department of Insurance, and a medical review panel subsequently issued a unanimous opinion “that the evidence supports the conclusion that the defendants failed to comply with the appropriate standard of care, and that their conduct may have been a factor of some resultant damages, but not the death of the patient.” The family then filed their Indiana medical malpractice case in court, alleging that the defendants “failed to comply with the appropriate standard of care under the circumstances, proximately resulting in injuries and damages of a nature requiring compensation.”
The Indiana medical malpractice defendants filed motions for summary judgment and designated as evidence the medical review panel’s opinion and affidavits from a member of the medical review panel stating that the defendants did not cause injury to the woman in administering her pulmonary care. The trial court granted the defendants’ motions for summary judgment, and the plaintiffs appealed to the Indiana Court of Appeals, which affirmed in part and reversed in part in a divided opinion.
The Indiana Supreme Court Decision
In reversing summary judgment for the defendants, the Indiana Supreme Court stated that the defendants’ expert’s affidavits were limited to the woman’s pulmonary care “so they could support summary judgment on only that aspect of her medical care,” and “[b]ecause the evidence designated here can affirmatively negate only the claims related to pulmonary care, summary judgment on the [plaintiffs’] non-pulmonary claims is inappropriate.”
The Indiana Supreme Court stated that the defendants’ expert’s affidavits would be sufficient, standing alone, to shift the burden to the plaintiffs on the pulmonary care claims, but the affidavits do not stand alone because the defendants also designated as evidence the medical review panel’s opinion that the defendants’ “conduct may have been a factor of some resultant damages, but not the death of the patient.”
The Indiana Supreme Court held that “[d]rawing all reasonable inferences in favor of the non-moving party, as we must, we find that the medical review panel’s opinion conflicts with [the defendants’ expert’s] affidavits on the pulmonary claims. [The defendants’] own designated evidence establishes a genuine issue of material fact on the element of causation, preventing them from affirmatively negating the [plaintiffs’] claims, as Indiana summary judgment practice requires … Although [the defendants’ expert] unequivocally stated that [the defendants] ‘did not cause any injury to [the woman] in regard to the issue of CPAP application,’ the medical review panel’s opinion was that the defendants’ ‘conduct may have been a factor of some resultant damages.’ This disagreement on the ultimate issue of causation demonstrates that a conflict of evidence may exist, even before ‘resolv[ing] all doubts against the moving party’ … While the medical review panel’s opinion here contains no specific facts, its medical conclusions do create a genuine issue of fact. Any lack of detail ‘goes to the weight and credibility to be assigned to [the opinion], not to whether it is adequate to create a question of fact’ … defeating summary judgment requires only a genuine issue of material fact, not necessarily a persuasive issue of material fact … [a] trier of fact must decide whether the [the plaintiffs’] evidence is persuasive, and we must leave that determination in its capable hands.”
Source Siner, et al. v. Kindred Hospital Limited Partnership, et al., No. 49S05-1604-CT-219.
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