7th Circuit: Staff should have told inmate to stop taking aspirin

A District Court erred in granting summary judgment for the government on an inmate’s suit claiming his complications from a surgery were the result of the prison medical staff disregarding instructions he stop taking blood thinners prior to his surgery.

Maurice Gipson was taking aspirin to manage pain caused by a spinal disc disease. It was later determined that he needed surgery. The health company that helps the prison staff arrange for medical treatments outside of the prison notified the prison medical staff in writing that Gipson should stop all blood thinners five days before surgery.

The staff didn’t tell Gipson to stop taking the aspirin and he had serious complications from surgery because of internal bleeding. Evidence showed that the bleeding was caused by using aspirin, and it’s likely that the complications would have been avoided or lessened if he had stopped taking the drug at least five days before surgery.

Gipson sued under the Federal Tort Claims Act, claiming that because the prison’s medical staff didn’t advise him to stop using aspirin before the surgery, he suffered complications.

In Maurice Gipson v. United States of America, No. 09-2756, the 7th Circuit concluded that the Indiana rule governs this case, which requires a plaintiff in a medical malpractice claim to present expert evidence of the applicable standard of medical care unless the defendant’s conduct is “understandable without extensive technical input” or “so obviously substandard that one need not possess medical expertise to recognized the breach.”

The District Court granted summary judgment for the government because Gipson didn’t submit a medical expert’s opinion stating that by disregarding the directive, the prison’s medical staff violated the applicable standard of care.

Expert testimony would be necessary if there was a dispute as to when blood thinners should be stopped before surgery, but it’s conceded that five days was the minimum, wrote Judge Richard Posner. The only issue bearing on the standard of care is whether the prison’s medical staff was required to tell Gipson that aspirin is a blood thinner and that he must stop taking it at least five days before the surgery to try to prevent serious complications.

“It doesn’t require medical knowledge to answer ‘yes’ — indisputably, the staff should have told him,” wrote Judge Posner. “The ‘yes’ is so obvious in this case that Gipson should have been able to move successfully for partial summary judgment, establishing a breach of the standard of care and leaving only issues of causation and damages for further proceedings.”

Gipson presented expert evidence of causation in that the surgeon who operated opined that it was Gipson’s consumption of aspirin at least five days before the surgery that caused the complications. That opinion is in a medical report that is admissible. But there is conflicting evidence as to whether Gipson ran out of aspirin more than five days before his operation, as the government argued. The judges remanded for further proceedings.