Hoskins v. Sharp
629 N.E.2d 1271, 1994 Ind. App. LEXIS 230, 1994 WL 60630 (1994)
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Rule of Law:
A medical malpractice plaintiff can defeat a motion for summary judgment, even after an adverse medical review panel opinion, by presenting expert medical testimony that creates a genuine issue of material fact regarding the standard of care, and the plaintiff is not required to present expert testimony on proximate cause if the medical review panel's opinion was silent on that element.
Facts:
- Dr. Sharp, a family practice specialist, treated James Hoskins from approximately 1976 until James' death in June 1989.
- In 1985, Dr. Sharp ordered a blood test for James that revealed an abnormally low platelet count.
- In February 1989, Dr. Sharp ordered another blood test for James, which again showed an abnormally low platelet count, unchanged from the 1985 result.
- In May 1989, 45-year-old James was admitted to the emergency room of Hancock Memorial Hospital in serious condition and diagnosed with severe encephalopathy.
- James was later transferred to Community Ritter Hospital in Indianapolis, where he was diagnosed with acute promyelocytic leukemia.
- James remained hospitalized until his death on June 18, 1989.
Procedural Posture:
- Pamela Hoskins filed a proposed complaint against Dr. Sharp with the Indiana Department of Insurance under the Medical Malpractice Act.
- During this pre-litigation process, the trial court ruled on various discovery and other motions, including Pamela's challenge to the Act's constitutionality and a dispute over the formation of the medical review panel.
- Dr. Sharp moved the trial court to compel the formation of medical review striking panels that complied with the Act's requirements for specialist representation.
- The trial court granted Dr. Sharp's motion and ordered the panel chairman to compose new striking panels with the statutorily required number of family practitioners.
- A medical review panel, once formed, rendered a unanimous opinion that the evidence did not support the conclusion that Dr. Sharp failed to meet the applicable standard of care.
- Pamela Hoskins then filed a complaint in the trial court, specifically alleging Dr. Sharp's negligence caused James' death due to failure to refer him to a hematologist.
- Dr. Sharp moved for summary judgment in the trial court, submitting only the medical review panel's opinion in support.
- Pamela Hoskins submitted affidavits, letters, medical records, and James' cause of death report in opposition.
- The trial court entered summary judgment for Dr. Sharp.
- Pamela Hoskins appealed to the Indiana Court of Appeals.
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Issue:
Should the trial court's entry of summary judgment for Dr. Sharp in this medical malpractice action be reversed, given Pamela Hoskins' submission of expert testimony that refuted the medical review panel's opinion on the standard of care but did not address proximate cause?
Opinions:
Majority - Najam, Judge
Yes, the trial court's entry of summary judgment for Dr. Sharp should be reversed. The court first addressed preliminary issues. It held that Dr. Sharp did not waive his right to a medical review panel because waiver under Indiana Code § 16-9.5-9-2(b) requires a written agreement, which was absent here; Dr. Sharp merely insisted on compliance with statutory panel composition requirements. The court further determined that the trial court acted within its limited jurisdiction under Indiana Code § 16-9.5-10-1 by ordering the panel chairman to form properly constituted striking panels, as this facilitated panel selection without interfering with its informal operation, distinguishing Griffith v. Jones. Lastly, the court affirmed the constitutionality of the Medical Malpractice Act, citing Johnson v. St. Vincent’s Hospital, Inc. Turning to summary judgment, the court noted that medical malpractice cases are rarely appropriate for summary disposition. While Dr. Sharp met his initial burden as the movant by submitting the medical review panel's opinion finding no breach of the standard of care, thus shifting the burden to Pamela, Pamela successfully refuted this. Her expert, Dr. Brenda Woods, provided an affidavit that was properly verified by an affirmation of truth, meeting the 'chief test' for perjury prosecution from Jordan v. Deery. Substantively, Dr. Woods' affidavit, based on her personal knowledge as a board-certified family practitioner, stated that failure to refer James to a hematologist constituted a breach of the standard of care, thereby creating a genuine issue of material fact. Crucially, the court held that Pamela was not required to present expert evidence on proximate cause because the medical review panel's opinion was silent on this issue. The initial burden to negate proximate cause remained with Dr. Sharp, which he failed to meet, allowing Pamela to rest on her pleadings regarding causation. Therefore, the presence of a genuine issue of material fact on the standard of care precluded summary judgment.
Concurring - Baker and Rucker, JJ.
Yes, the trial court's entry of summary judgment for Dr. Sharp should be reversed. Judges Baker and Rucker concurred with the reasoning and conclusions presented in the majority opinion.
Analysis:
This case clarifies the burdens of proof and evidentiary requirements at the summary judgment stage in Indiana medical malpractice cases governed by the Medical Malpractice Act. It establishes that a plaintiff can overcome a medical review panel's adverse opinion on the standard of care with a sufficiently detailed expert affidavit, even if that affidavit does not address all elements of malpractice, particularly causation, if the panel's opinion itself was silent on those elements. The ruling underscores the high bar for granting summary judgment in complex medical negligence claims and provides flexibility for affidavit verification under Trial Rule 11(B).
