Vergara v. Doan
593 N.E.2d 185 (1992)
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Rule of Law:
The standard of care for a physician is to exercise the degree of care, skill, and proficiency of a reasonably careful, skillful, and prudent practitioner in the same class, acting under the same or similar circumstances. Locality of practice is no longer a separate standard but is one of several factors to be considered as part of the overall circumstances.
Facts:
- On May 31, 1979, Javier Vergara was born at Adams Memorial Hospital in Decatur, Indiana.
- His parents, Jose and Concepcion Vergara, retained Dr. John Doan to manage the delivery.
- The Vergaras alleged that Dr. Doan was negligent during the delivery process.
- Javier Vergara suffered severe and permanent injuries as a result of the circumstances of his birth.
Procedural Posture:
- Jose and Concepcion Vergara sued Dr. John Doan for medical malpractice in an Indiana trial court.
- A jury returned a verdict in favor of the defendant, Dr. Doan.
- The Vergaras, as appellants, appealed to the Indiana Court of Appeals.
- The Court of Appeals affirmed the trial court's judgment for Dr. Doan.
- The Vergaras petitioned for transfer to the Supreme Court of Indiana, which was granted.
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Issue:
Does Indiana's 'modified locality rule,' which measures a physician's standard of care against that of physicians in the same or similar localities, remain the governing standard for medical malpractice cases?
Opinions:
Majority - Shepard, C.J.
No. The modified locality rule is abandoned in favor of a standard requiring a physician to exercise the degree of care, skill, and proficiency of a reasonably careful, skillful, and prudent practitioner in the same class, acting under the same or similar circumstances. The historical justifications for the locality rule, such as the disparity between rural and urban medical resources and training, have diminished with advances in communication, travel, and medical education. The old rule permitted a lower standard of care in smaller communities and created unnecessary litigation over defining a 'similar community.' The new standard treats locality as just one factor among many—such as advances in the profession, availability of facilities, and the doctor's specialty—in the comprehensive analysis of whether the physician acted reasonably under the circumstances. Although the trial court's jury instruction based on the old rule was erroneous, the error was harmless in this case because another instruction referenced a national standard and the jury's verdict would likely have been the same even with a proper instruction.
Concurring - Givan, J.
No, but the new standard announced by the majority does not materially differ from the modified locality rule it purports to abandon. The majority's 'new' standard requires consideration of the 'same or similar circumstances,' which includes the availability of facilities. This is functionally the same as the modified locality rule, as the ability of a physician to perform will naturally differ between a small rural hospital and a large, well-equipped urban one. The majority's opinion articulates a distinction without a difference and needlessly confuses the issue.
Analysis:
This decision officially abandons the antiquated 'modified locality rule' in Indiana, aligning the state with the modern trend in medical malpractice law. By adopting a standard that considers locality as just one factor in the overall 'circumstances,' the court creates a more uniform standard of care while retaining flexibility. This change may make it easier for plaintiffs to secure expert witnesses, as experts are no longer constrained by the need to have knowledge of 'similar localities.' The ruling balances the need for a consistent standard with the practical realities that physicians in different settings face different resource constraints.
