Santiago v. Kilmer
605 N.E.2d 237, 1992 Ind. App. LEXIS 1967, 1992 WL 385498 (1992)
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Rule of Law:
Under the Indiana Medical Malpractice Act, a trial court lacks subject matter jurisdiction to decide issues requiring expert medical opinion, such as whether the standard of care was met, or to grant summary judgment based on such issues, before a medical review panel has rendered its opinion.
Facts:
- On March 6, 1985, George Kilmer took his wife, Martha, to Grant-Blackford Mental Health, Inc., where she was seen by Dr. Rebecca Santiago.
- Dr. Santiago prescribed medication, ordered tests, and instructed Martha to return to the clinic in two days.
- Less than six hours later, Martha died at her home.
- On January 21, 1986, George Kilmer filed a proposed complaint with the Indiana Insurance Commissioner pursuant to the Medical Malpractice Act, claiming the health care providers were negligent in their diagnosis, care, and treatment of Martha, which proximately resulted in her death.
Procedural Posture:
- George Kilmer filed a proposed complaint with the Indiana Insurance Commissioner against Dr. Rebecca Santiago and Grant-Blackford Mental Health, Inc. under the Medical Malpractice Act, alleging negligence.
- While the matter was pending before the medical review board, the health care providers served Kilmer's counsel with T.R. 36 requests for admission.
- Kilmer and his counsel failed to answer the requests.
- The health care providers filed a motion with the Grant Circuit Court (trial court) asking that the unanswered T.R. 36 requests be deemed admitted.
- The Grant Circuit Court ruled that the unanswered requests for admission were deemed admitted.
- The health care providers then filed a motion for summary judgment with the Grant Circuit Court, based on a deemed admission stating the medical care met or exceeded the standard of care.
- The Grant Circuit Court granted the health care providers’ motion for summary judgment on September 22, 1988.
- Kilmer subsequently filed a motion to strike the admissions and to reconsider the court’s order, arguing the trial court had exceeded its limited jurisdiction.
- Kilmer also filed a T.R. 60(B)(6) motion for relief from judgment, supported by a physician’s affidavit to show a meritorious case.
- After a hearing, the Grant Circuit Court granted Kilmer's motion for relief from judgment and vacated its September 22, 1988, order and judgment.
- The health care providers (appellants) appealed the Grant Circuit Court’s granting of Kilmer’s motion for relief from judgment to the Court of Appeals of Indiana (intermediate appellate court).
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Issue:
Does a trial court have subject matter jurisdiction under the Indiana Medical Malpractice Act to deem admitted requests for admission stating the applicable standard of medical care had been met, and then grant summary judgment based on that admission, before the medical review panel has rendered its opinion?
Opinions:
Majority - Judge Conover
No, a trial court does not have subject matter jurisdiction under the Indiana Medical Malpractice Act to deem admitted requests for admission concerning the medical standard of care and subsequently grant summary judgment based on those admissions, before the medical review panel has rendered its opinion. The court reasoned that to render a valid judgment, a court must possess subject matter jurisdiction, which is the power to hear a general class of cases derived from the constitution or statute. The Medical Malpractice Act explicitly states that no action against a health care provider may be commenced in any court before a medical review panel has rendered an opinion. Prior to the panel's decision, the trial court's jurisdiction in such cases is limited to (1) preliminarily determining any affirmative defense or issue of law or fact that may be preliminarily determined under the Indiana Rules of Procedure, and/or (2) compelling discovery. This grant of power is to be narrowly construed, and the court is without subject matter jurisdiction to rule on issues reserved for the medical review panel. Since the question of whether the health care providers met the appropriate standard of care is an issue of fact requiring expert opinion and is specifically reserved for the medical review panel under IC 16-9.5-9-7, the trial court's entry of summary judgment, based on a deemed admission on this issue, was beyond its limited subject matter jurisdiction and thus rendered the judgment void. The court distinguished prior cases, Johnson v. Padilla and Castillo v. Ruggiero, noting they involved issues not requiring expert medical opinion (e.g., identity of physician, employment status) unlike the standard of care. Furthermore, the court emphasized that subject matter jurisdiction cannot be waived and a void judgment can be attacked at any time. Therefore, the trial court did not abuse its discretion in granting Kilmer's motion for relief from judgment.
Analysis:
This case significantly clarifies the strict limitations on a trial court's subject matter jurisdiction in medical malpractice actions under the Indiana Medical Malpractice Act, particularly before the medical review panel renders its opinion. It reinforces the procedural prerequisite of expert medical review for core negligence issues, preventing parties from circumventing this process through procedural mechanisms like requests for admission leading to summary judgment. The ruling underscores the policy intent behind the Act to filter claims requiring expert medical judgment through a specialized panel first, thereby streamlining litigation and ensuring a medically informed initial assessment, preserving judicial resources and potentially fostering early settlements. It serves as a critical reminder that jurisdictional limitations on preliminary determinations in statutory schemes are to be narrowly construed.
