Bader v. Johnson
732 NE2d 1212, 2000 Ind. LEXIS 676, 2000 WL 1022654 (2000)
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Rule of Law:
A healthcare provider's negligent failure to inform parents of prenatal abnormalities, which deprives them of the opportunity to terminate the pregnancy, constitutes a cognizable claim for medical malpractice, not a distinct tort of 'wrongful birth'.
Facts:
- In 1979, Ronald and Connie Johnson's first child was born with hydrocephalus and severe defects, dying at four months of age.
- In 1991, during Connie Johnson's third pregnancy, the couple consulted Dr. Patricia Bader for genetic counseling due to their history.
- At 19.5 weeks gestation, Dr. Bader performed an ultrasound that revealed a fetus with a larger than expected brain cavity and an unusual head shape.
- Dr. Bader instructed her staff to schedule follow-up testing, but due to an office error, the appointment was never scheduled, and the ultrasound report was not forwarded to Connie's treating physician.
- At 33 weeks gestation, Connie's treating physician discovered via his own ultrasound that the fetus had hydrocephalus, by which time it was too late to terminate the pregnancy.
- On September 4, 1991, Connie gave birth to a child with hydrocephalus and other severe defects.
- The child required extensive medical care and died four months later.
Procedural Posture:
- Ronald and Connie Johnson filed a proposed complaint with the Indiana Department of Insurance.
- A medical review panel issued an opinion concluding that the Healthcare Providers failed to meet the applicable standard of care.
- The Johnsons filed a complaint for medical malpractice in the Allen Circuit Court (trial court).
- Healthcare Providers filed a motion for summary judgment, which the trial court denied.
- Healthcare Providers, as appellants, appealed the denial to the Indiana Court of Appeals (intermediate appellate court).
- The Court of Appeals affirmed the trial court's denial of summary judgment but ruled that emotional distress damages were not recoverable.
- Healthcare Providers petitioned the Indiana Supreme Court for transfer.
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Issue:
Does a healthcare provider's negligent failure to inform parents of prenatal abnormalities, which deprives them of the opportunity to terminate the pregnancy, give rise to a cognizable claim for medical malpractice under Indiana law?
Opinions:
Majority - Justice Rucker
Yes. A claim based on a healthcare provider's negligent failure to inform parents of fetal abnormalities, thereby depriving them of the choice to terminate the pregnancy, is a cognizable medical malpractice action. The court rejected the 'wrongful birth' label, finding it unnecessary and confusing, and instead analyzed the claim using traditional tort principles of duty, breach, causation, and damages. A physician has a duty to disclose material facts relevant to a patient's decision about treatment, which includes the decision to terminate a pregnancy. The injury is not the child's impaired life, but the parents' lost opportunity to make an informed choice, which resulted in the financial and emotional costs of carrying the child to term and providing care. The court held Connie Johnson could claim emotional distress damages under the modified impact rule, as the continued pregnancy and physical transformation of her body constituted a 'direct impact.' Ronald Johnson's claim for emotional distress could potentially proceed under the bystander rule.
Dissenting - Justice Dickson
No. The court should not expand the common law to permit parents to seek damages for the loss of an opportunity to terminate a pregnancy. This action, despite the majority's relabeling, is a 'wrongful birth' claim that is conceptually indistinct from the 'wrongful life' claims rejected in Cowe v. Forum Group, Inc. It improperly requires a court to treat life, even an impaired one, as a legal injury and calculate damages based on a comparison of an impaired life versus non-existence. Recognizing this cause of action opens the door to troubling public policy consequences, including litigation over minor defects or undesired gender, and injects the contentious issue of abortion into medical malpractice litigation.
Concurring - Justice Sullivan
Yes. The trial court properly denied the defendants' motion for summary judgment. While agreeing with the majority's ultimate result, this opinion would have adopted the reasoning of the intermediate Court of Appeals regarding liability and damages generally. However, it explicitly concurs with the majority's specific analysis concerning the availability of damages for emotional distress.
Analysis:
This case is significant for reframing 'wrongful birth' claims as standard medical malpractice actions in Indiana, thereby avoiding the philosophically difficult question of whether life can be considered a legal injury. By focusing on the physician's duty to inform and the parents' lost autonomy, the court provides a clear path for recovery based on established tort principles. The decision also clarifies and expands the application of emotional distress damages by creatively applying the modified impact rule to the mother's continued pregnancy, recognizing it as the required 'direct impact.' This precedent solidifies a physician's duty to provide information material to reproductive choices and establishes a framework for damages that flow from the breach of that duty.
