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Court addresses use of epidemiological evidence in med mal cases

August 22, 2012

The Indiana Court of Appeals held that the trial court ruled correctly when it did not allow certain epidemiological evidence by a plaintiff’s expert witness in a medical malpractice lawsuit, but the court stopped short of saying this type of evidence could never be admitted in a medical malpractice case.

Ashley Tucker filed a medical malpractice complaint against Dr. Michelle Harrison, alleging the doctor’s negligence in performing a surgical procedure damaged her ovaries and left her infertile. The jury ruled in favor of Harrison, and Tucker appealed on three grounds. She claimed the trial court abused its discretion in excluding testimony from her expert witness, epidemiologist Dr. Michael Freeman, Ph.D.; in denying Tucker the opportunity to question witnesses about possible financial bias; and in refusing to give the jury a res ipsa loquitur instruction.

Freeman described his profession as dealing with populations of people and the kind of injuries or diseases they get and what causes them, and doing statistical analysis of what you find in populations to draw conclusions that are reliable. The court allowed into evidence Freeman’s testimony that one in 700 procedures ever year done in Tucker’s age group resulted in iatrogenic ovarian failure, but excluded his testimony that the procedure is 99 percent likely to be the cause of ovarian failure when it occurs in someone who has had the same procedure as Tucker.

No Indiana case has directly addressed the admissibility of epidemiological evidence in a medical malpractice case, or otherwise. Other jurisdictions have allowed this type of evidence, but the appellate court pointed out those cases cited by Tucker did not involve medical malpractice.

“Testimony establishing that the fact of a surgery makes ovarian failure more likely could mean that Dr. Harrison did everything right and ovarian failure is simply a risk of having any sort of ovarian surgery. It does not establish a causal relationship between Dr. Harrison’s acts or omissions and Tucker’s injury,” Chief Judge Margret Robb wrote in Ashley T. Tucker v. Michelle R. Harrison, M.D., 79A05-1108-CT-404.

Epidemiological testimony is not relevant to the issue of causation in this case, so the trial court did not abuse its discretion in excluding part of Freeman’s testimony, she wrote, noting this testimony may be admitted in the appropriate medical malpractice case.

The trial court excluded evidence from a physician witness called by Tucker that she says alleges bias on the part of every Indiana doctor because they are all participants in the Indiana Patient’s Compensation Fund, and therefore have a financial interest in whether payouts are made from the fund. The COA affirmed, finding Tucker’s proffered evidence merely speculates through the physician’s testimony that every doctor in Indiana has an interest in limiting financial exposure by limiting payouts from the Patient’s Compensation Fund.

The judges also upheld that Tucker was not entitled to a res ipsa loquitur instruction.

 

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