Cavens v. Zaberdac
849 N.E.2d 526, 2006 Ind. LEXIS 520, 2006 WL 1719935 (2006)
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Rule of Law:
A patient's negligent conduct that occurs prior to seeking medical treatment, and which merely creates the condition necessitating that treatment, cannot be asserted as a contributory negligence defense by a physician in a subsequent medical malpractice action.
Facts:
- Peggy Miller had a history of severe and persistent asthma, for which she had been treated in an emergency room or hospital on at least eight prior occasions.
- Her regular pulmonologist had provided specific instructions regarding medication use and the need for emergency care in the event of significant asthma symptoms.
- On the morning of July 21, 1996, Miller began experiencing profound shortness of breath.
- Over the course of the morning, Miller took several doses of medication with limited success, and ultimately called for an ambulance at 11:29 a.m.
- Miller was transported to a hospital emergency room and came under the care of Dr. Robert Cavens, the emergency room physician.
- Dr. Cavens administered medications and arranged for an EKG test.
- While under Dr. Cavens's care, Peggy Miller went into cardiac arrest and died at approximately 11:45 p.m.
Procedural Posture:
- Tim Zaberdac, on behalf of Peggy Miller's estate, filed a medical malpractice action against Dr. Robert Cavens in a state trial court.
- The case proceeded to a jury trial against Dr. Cavens.
- At the close of evidence, the trial court granted the plaintiff's motion for judgment on the evidence, barring Dr. Cavens from asserting the defense of contributory negligence.
- The jury returned a verdict for the plaintiff in the amount of $1,570,000.
- The trial court reduced the award to the statutory cap of $750,000.
- Dr. Cavens, as appellant, appealed the judgment to the Indiana Court of Appeals (an intermediate appellate court).
- The case was subsequently brought before the Indiana Supreme Court (the state's highest court) on a petition to transfer.
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Issue:
Does a patient's pre-treatment negligence, which creates the condition for which the patient seeks medical care, constitute contributory negligence that a physician can assert as a defense against a subsequent medical malpractice claim?
Opinions:
Majority - Dickson, J.
No. A patient’s pre-treatment negligence is not available as a contributory negligence defense in a medical malpractice action because it is not simultaneous and cooperating with the physician's alleged negligence. The court reasoned that this conclusion is supported by the long-standing tort principle that a tortfeasor takes the victim as they find them. To permit healthcare providers to use a patient's pre-treatment conduct as a defense would undermine their duty of reasonable care, as many patients seek treatment for conditions resulting, in part, from their own carelessness. The patient's alleged negligence (delaying treatment and overusing medication) merely created the condition for which she sought Dr. Cavens's care; it did not occur concurrently with his treatment and thus could not legally contribute to the harm he allegedly caused.
Concurring - Shepard, C.J.
No. The concurring opinion agrees with the majority's legal conclusion regarding the contributory negligence defense but writes separately to express that the trial court likely erred by preventing the defense from arguing that the patient's conduct was the sole proximate cause of her death. However, this issue was not properly preserved for appeal because the defense counsel failed to make a formal objection at trial. Therefore, the Chief Justice joins in affirming the judgment due to procedural default, despite believing the jury may have decided the case under a misapprehension of the law.
Analysis:
This decision solidifies the 'take your victim as you find him' or 'eggshell plaintiff' rule within Indiana medical malpractice law, creating a clear temporal distinction for the defense of contributory negligence. The court established that a patient's negligence must be concurrent with the physician's alleged malpractice to be a valid defense. This holding prevents healthcare providers from deflecting liability by blaming patients for the very conditions they are duty-bound to treat, thereby reinforcing the provider's duty of care. The ruling aligns Indiana with the majority of jurisdictions that separate pre-treatment conduct from the subsequent medical care provided.
