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COA: jury should have had access to images

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The Indiana Court of Appeals today reversed and remanded a jury verdict in favor of medical care providers in a medical-malpractice case involving a permanent eye injury following laser eye surgery. The appellate court concluded the trial court’s evidentiary and instructional rulings constituted reversible error.

In Paul Arlton v. Gary Schraut, M.D., and Lafayette Retina Clinic, No. 79A02-0906-CV-541, Paul Arlton presented three issues: whether the trial court abused its discretion when it sustained Dr. Gary Schraut’s objections to Arlton’s proffer of printed, enlarged copies of angiograms depicting Arlton’s retina; whether the trial court abused its discretion when it refused to provide the jury with access to digital evidence during deliberations; and whether the trial court abused its discretion in refusing Arlton’s tendered instruction informing the jury that they could review the digital evidence during deliberations.

In the late 1980s, Arlton was diagnosed with a condition known as choroidal neovascularization, an abnormal growth of blood vessels near the retina. If untreated, this condition can cause loss of vision and possibly blindness.

He was treated for the illness in 1987 and again in 1989. He noted no new problems until 2002, when he visited an emergency room and was referred to Dr. Schraut.

The doctor then ordered a fluorescein angiogram, where fluorescent dye was injected into his blood, and a series of photos were taken of his retina. While photos in September 2002 didn’t show a recurrence, photos taken in October 2002 revealed choroidal neovascularization had recurred.

On Nov. 5, 2002, Dr. Schraut performed laser photocoagulation surgery on Arlton’s left eye. Dr. Schraut claimed that during that surgery, Arlton jumped and a shape on his retina reflected that he had moved.

The two disagreed over whether the doctor admitted to further damaging a scar Arlton already had during surgery. An angiogram taken Nov. 27, 2002, showed the condition had been treated and swelling had decreased, but the blind spot remained.

Experts also had different takes on whether the doctor made the blind spot worse or if he had any impact after examining the angiograms and/or Arlton.

On Nov. 4, 2004, Arlton filed a proposed complaint against Dr. Schraut and the Lafayette Retina Clinic with the Indiana Department of Insurance. A Medical Review Panel found in favor of the medical care providers on March 28, 2007, and a jury trial took place May 11-14, 2009.

At trial, jurors had access to color copies of images taken from the angiograms from Sept. 24, 2002, Oct. 31, 2002, and Nov. 27, 2002 – nine images of each angiogram were printed on 8.5 x 11 inch paper. Three CD-ROM discs of the digital images were also admitted. Enlarged photos were shown to the jury using a projector and a screen.

However, following objections from the medical care providers, enlargements Arlton personally made of the images were not made available to the jurors, and the discs were also not available to jurors because of concerns from the medical care providers that the images might be enlarged or focused by the jurors.

The Court of Appeals found that there was no reason to believe the enlargements by Arlton were not authentic; that the jurors should have somehow had access to the digital evidence – “ideally … before deliberations begin … so that the trial court does not have to scramble just before deliberations trying to find a way to let the jury access admitted digital evidence”; and that a jury instruction Arlton suggested regarding the digital evidence, “informing the jury that, if they so desired, they could review the digital evidence during deliberations,” was proper, wrote Court of Appeals Judge Paul D. Mathias.

He added the case came down to an issue of credibility.

“Even Dr. Schraut admitted that placing a laser burn within a pre-existing retinal scar was below his personal standards and below the standard of care. … Dr. Schraut simply denied that he had placed a laser burn within Arlton’s pre-existing scar, whereas (a professor of ophthalmology at the Johns Hopkins University who specializes in retinal and macular diseases and treatment) testified that the angiograms contained evidence that Dr. Schraut did indeed place a laser burn within the pre-existing scar,” he wrote.

“We conclude that the trial court’s evidentiary and instructional rulings constitute reversible error because the end result of these decisions was to deny the jury access to evidence which directly implicated the heart of the matter the jury was asked to decide,” Judge Mathias wrote. “We therefore reverse the judgment of the trial court and remand this cause for a new trial consistent with this opinion.”
 

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  1. I will be filing a lawsuit in Tippecanoe County for so many violations in a case we became involved in, including failure to contact through mail, Violation of 4th Amendment rights, Violation of Civil Rights, and so on. Even the Indiana Ombudsmen Bureau found violations and I have now received the report and they are demanding further training in Tippecanoe County. I am going to make sure they follow through!!!

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  3. I thought the purpose of the criminal justice center was to consolidate all the criminal services and get them out of downtown to clean up the place. Why in the HELL are the civil courts moving? What a burden to all the downtown law firms. Now we all get to work downtown, but then have to get in a car and COMMUTE to court? Who approved this idiocy?

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  5. I have had an ongoing custody case for 6 yrs. I should have been the sole legal custodial parent but was a victim of a vindictive ex and the system biasedly supported him. He is an alcoholic and doesn't even have a license for two yrs now after his 2nd DUI. Fast frwd 6 yrs later my kids are suffering poor nutritional health, psychological issues, failing in school, have NO MD and the GAL could care less, DCS doesn't care. The child isn't getting his ADHD med he needs and will not succeed in life living this way. NO one will HELP our family.I tried for over 6 yrs. The judge called me an idiot for not knowing how to enter evidence and the last hearing was 8 mths ago. That in itself is unjust! The kids want to be with their Mother! They are being alienated from her and fed lies by their Father! I was hit in a car accident 3 yrs ago and am declared handicapped myself. Poor poor way to treat the indigent in Indiana!

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