Collins v. Thakkar
552 N.E.2d 507, 89 A.L.R. 4th 877, 1990 Ind. App. LEXIS 446 (1990)
Rule of Law:
The Indiana Medical Malpractice Act's pre-litigation medical review panel requirement does not apply to intentional tort claims against a healthcare provider if the alleged conduct, though occurring during medical care, is wanton, gratuitous, and not designed to promote the patient's health or involve the provider's professional expertise, skill, or judgment.
Facts:
- In March 1984, Collins became a patient of Dr. Thakkar.
- Collins's professional relationship with Dr. Thakkar developed into a social one, including periodic sexual intercourse.
- In January 1988, Collins consulted Dr. Thakkar about a possible pregnancy, which she believed was by him.
- Dr. Thakkar agreed to perform an examination of Collins on January 9, 1988, after ordinary office hours, to determine if she was pregnant.
- During this purported examination, Dr. Thakkar advised Collins that she was not pregnant.
- Without Collins's consent and over her protest, Dr. Thakkar twice performed acts with a metal instrument inside her, causing excruciating pain.
- Collins alleges that Dr. Thakkar intentionally aborted her unborn fetus, of which he was the father, causing her to miscarry.
Procedural Posture:
- Collins filed a three-count complaint in trial court, alleging wrongful abortion, assault and battery, and intentional infliction of emotional distress against Dr. Thakkar.
- Dr. Thakkar moved to dismiss the complaint for want of subject matter jurisdiction under Ind. Trial Rule 12(B)(1), arguing the claims fell within the Indiana Medical Malpractice Act, which requires prior submission to a medical review panel.
- The trial court granted Dr. Thakkar's motion, dismissing Collins's complaint for want of subject matter jurisdiction.
- Collins filed an interlocutory appeal of the trial court's dismissal to the Indiana Court of Appeals.
Premium Content
Subscribe to Lexplug to view the complete brief
You're viewing a preview with Rule of Law, Facts, and Procedural Posture
Issue:
Does the Indiana Medical Malpractice Act, which mandates submission of claims to a medical review panel, apply to a patient's complaint alleging intentional torts of wrongful abortion, assault and battery, and intentional infliction of emotional distress against a physician when the alleged conduct occurred during a medical examination but was not designed to promote the patient's health or involve professional skill?
Opinions:
Majority - Robertson, Judge
No, the Indiana Medical Malpractice Act does not apply to Collins's intentional tort claims because the alleged conduct, though occurring during a medical examination, was not designed to promote her health or involve Dr. Thakkar's professional expertise. The court interprets the Act's definitions of 'malpractice' and 'health care' to encompass acts or omissions of a physician acting in their professional capacity, specifically those 'for, to, or on behalf of a patient' during medical care, treatment, or confinement. This implies conduct that is curative, salutary, or involves the exercise of professional expertise, skill, or judgment. The legislature intended to exclude conduct unrelated to promoting a patient's health or the provider's professional role. The purpose of the Act and its medical review panel is to evaluate a provider's compliance with the appropriate standard of care, which is relevant to actions based on professional judgment, not wanton or gratuitous acts. Collins's allegations describe the purposeful use of medical instruments to cause a miscarriage, without consent and over protest, which is wanton and gratuitous and does not constitute the rendition of health care or professional services designed to promote the patient's health or call into question the physician's medical skill. Such factual issues can be resolved by a jury without applying a medical standard of care. Therefore, the trial court erred in dismissing the complaint for want of subject matter jurisdiction.
Dissenting - Sullivan, Judge
Yes, the Indiana Medical Malpractice Act should apply to Collins's claims, and the trial court's dismissal should be affirmed. The Act defines 'malpractice' as 'a tort' and includes 'legal wrong' or 'unlawful act,' not just negligence or unintentional torts. Previous cases, such as Gooley v. Moss, indicate that intentional torts like false imprisonment can fall within the Act's purview if the conduct occurs within the clear context of medical care or services. In this case, Dr. Thakkar utilized his medical knowledge, experience, and license to examine Collins and effect an abortion, which occurred in the course of his activity as a health care provider. The intentional and malevolent aspects of the torts relate to the physician's mental state and motivation, but the conduct itself—using medical instruments during an examination—falls under 'health care' as contemplated by the Act. While these acts remove the claims from 'medical negligence,' they do not remove them from the Act's coverage. Additionally, the dissent expresses a different view on subject matter jurisdiction, stating that compliance with the Act is a condition precedent, not an issue of subject matter jurisdiction.
Analysis:
This case significantly narrows the scope of Indiana's Medical Malpractice Act, clarifying that not all torts committed by a healthcare provider against a patient during a medical encounter are subject to the Act's pre-litigation medical review panel requirement. It establishes a distinction between professional services that require medical judgment and intentional, non-therapeutic acts, even if medical instruments are used. This ruling protects a patient's ability to pursue direct claims in court for egregious intentional misconduct, preventing the Act from becoming a shield for actions entirely outside the realm of legitimate medical practice, and impacts how future intentional tort claims against healthcare providers will be channeled through the legal system.
