In its opinion filed on October 4, 2016, the Court of Appeals of Indiana (“Appellate Court”) held that the Indiana Medical Malpractice Act requires that an Indiana medical malpractice plaintiff need only present the following to a medical review panel (“MRP”): (1) a proposed complaint that encompasses the theories of malpractice alleged in the subsequent litigation sufficiently to satisfy Indiana’s notice pleading requirements; and (2) evidence relating to the theories of alleged malpractice that the plaintiff seeks to raise during the subsequent litigation. The Appellate Court further held that narrative statements submitted to the medical review panel do not subsequently bind the parties.
The Appellate Court held that the plain language of the Indiana Medical Malpractice Act (“Act”) does not require that the submission to the MRP contain specifications of the breaches of standards of care. Furthermore, based upon the language and intent of the Act, the narrative statements commonly included among MRP submissions do not constitute evidence to be considered by the MRP and the narrative statements provided to the MRP by the attorneys do not constitute “evidence”: the MRP is only to consider “evidence” and the proposed complaint. Therefore, to hold that a medical malpractice claimant is bound by narrative and argumentative statements made by his attorneys, which the MRP need not consider in rendering its opinion and which need not be included in the submission at all, is contrary to the plain language of the Act (nothing in the Act prohibits the narrative statements, which are likely helpful to the MRP and opposing counsel, but nothing in the Act countenances an approach that treats these statements as evidence or as binding legal documents).
The Appellate Court further held that in light of the Act and an Indiana Supreme Court case, two things are required of a medical malpractice plaintiff seeking to raise new breaches of the standard of care after the MRP process has concluded: first, under the rules of notice pleading, the proposed complaint must encompass the theories regarding breach sought to be raised at trial; and, second, “evidence,” as defined by the Act, related to the theories must have been submitted to the MRP. If the plaintiff has complied with both of these requirements, then evidence related to the new theories of negligence may be admitted during litigation following the MRP process.
The Appellate Court reasoned that to depart from these basic guidelines would be to defeat the purposes of the MRP process, which is intended to be informal and limited, and is also intended to place little to no risk to the participants. The Appellate Court stated that if plaintiffs were required to present each and every possible theory of negligence to the MRP, and were bound by those allegations, then plaintiffs would be required to conduct full and complete discovery long before the litigation even began, which would create barriers of expense and time that would be insurmountable for most, if not all, potential plaintiffs, and the cost of the process would also be borne by the defendants. The Appellate Court concluded that it did not believe that the Indiana Legislature intended such a result in creating the MRP process.
The Appellate Court concluded: “[t]he Act requires that the MRP consider two things in reaching its conclusion on a claim of medical malpractice: (1) the proposed complaint; and (2) the evidence submitted by the plaintiff. Our Supreme Court has held that so long as, under principles of notice pleading, the proposed complaint encompasses specific allegations regarding the defendant’s alleged malpractice that were not explicitly raised to the MRP, those allegations may be raised for the first time during subsequent litigation. In other words, the plaintiff’s narrative at trial need not be identical to his MRP narrative so long as evidence relating to his theories of malpractice was before the panel.”
Source McKeen v. Turner, 53A05-1511-CT-2047.
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