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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 have been on this program while on parole from 2011-2013. No person should be forced mentally to share private details of their personal life with total strangers. Also giving permission for a mental therapist to report to your parole agent that your not participating in group therapy because you don't have the financial mean to be in the group therapy. I was personally singled out and sent back three times for not having money and also sent back within the six month when you aren't to be sent according to state law. I will work to het this INSOMM's removed from this state. I also had twelve or thirteen parole agents with a fifteen month period. Thanks for your time.

  2. Our nation produces very few jurists of the caliber of Justice DOUGLAS and his peers these days. Here is that great civil libertarian, who recognized government as both a blessing and, when corrupted by ideological interests, a curse: "Once the investigator has only the conscience of government as a guide, the conscience can become ‘ravenous,’ as Cromwell, bent on destroying Thomas More, said in Bolt, A Man For All Seasons (1960), p. 120. The First Amendment mirrors many episodes where men, harried and harassed by government, sought refuge in their conscience, as these lines of Thomas More show: ‘MORE: And when we stand before God, and you are sent to Paradise for doing according to your conscience, *575 and I am damned for not doing according to mine, will you come with me, for fellowship? ‘CRANMER: So those of us whose names are there are damned, Sir Thomas? ‘MORE: I don't know, Your Grace. I have no window to look into another man's conscience. I condemn no one. ‘CRANMER: Then the matter is capable of question? ‘MORE: Certainly. ‘CRANMER: But that you owe obedience to your King is not capable of question. So weigh a doubt against a certainty—and sign. ‘MORE: Some men think the Earth is round, others think it flat; it is a matter capable of question. But if it is flat, will the King's command make it round? And if it is round, will the King's command flatten it? No, I will not sign.’ Id., pp. 132—133. DOUGLAS THEN WROTE: Where government is the Big Brother,11 privacy gives way to surveillance. **909 But our commitment is otherwise. *576 By the First Amendment we have staked our security on freedom to promote a multiplicity of ideas, to associate at will with kindred spirits, and to defy governmental intrusion into these precincts" Gibson v. Florida Legislative Investigation Comm., 372 U.S. 539, 574-76, 83 S. Ct. 889, 908-09, 9 L. Ed. 2d 929 (1963) Mr. Justice DOUGLAS, concurring. I write: Happy Memorial Day to all -- God please bless our fallen who lived and died to preserve constitutional governance in our wonderful series of Republics. And God open the eyes of those government officials who denounce the constitutions of these Republics by arbitrary actions arising out capricious motives.

  3. From back in the day before secularism got a stranglehold on Hoosier jurists comes this great excerpt via Indiana federal court judge Allan Sharp, dedicated to those many Indiana government attorneys (with whom I have dealt) who count the law as a mere tool, an optional tool that is not to be used when political correctness compels a more acceptable result than merely following the path that the law directs: ALLEN SHARP, District Judge. I. In a scene following a visit by Henry VIII to the home of Sir Thomas More, playwriter Robert Bolt puts the following words into the mouths of his characters: Margaret: Father, that man's bad. MORE: There is no law against that. ROPER: There is! God's law! MORE: Then God can arrest him. ROPER: Sophistication upon sophistication! MORE: No, sheer simplicity. The law, Roper, the law. I know what's legal not what's right. And I'll stick to what's legal. ROPER: Then you set man's law above God's! MORE: No, far below; but let me draw your attention to a fact I'm not God. The currents and eddies of right and wrong, which you find such plain sailing, I can't navigate. I'm no voyager. But in the thickets of law, oh, there I'm a forester. I doubt if there's a man alive who could follow me there, thank God... ALICE: (Exasperated, pointing after Rich) While you talk, he's gone! MORE: And go he should, if he was the Devil himself, until he broke the law! ROPER: So now you'd give the Devil benefit of law! MORE: Yes. What would you do? Cut a great road through the law to get after the Devil? ROPER: I'd cut down every law in England to do that! MORE: (Roused and excited) Oh? (Advances on Roper) And when the last law was down, and the Devil turned round on you where would you hide, Roper, the laws being flat? (He leaves *1257 him) This country's planted thick with laws from coast to coast man's laws, not God's and if you cut them down and you're just the man to do it d'you really think you would stand upright in the winds that would blow then? (Quietly) Yes, I'd give the Devil benefit of law, for my own safety's sake. ROPER: I have long suspected this; this is the golden calf; the law's your god. MORE: (Wearily) Oh, Roper, you're a fool, God's my god... (Rather bitterly) But I find him rather too (Very bitterly) subtle... I don't know where he is nor what he wants. ROPER: My God wants service, to the end and unremitting; nothing else! MORE: (Dryly) Are you sure that's God! He sounds like Moloch. But indeed it may be God And whoever hunts for me, Roper, God or Devil, will find me hiding in the thickets of the law! And I'll hide my daughter with me! Not hoist her up the mainmast of your seagoing principles! They put about too nimbly! (Exit More. They all look after him). Pgs. 65-67, A MAN FOR ALL SEASONS A Play in Two Acts, Robert Bolt, Random House, New York, 1960. Linley E. Pearson, Atty. Gen. of Indiana, Indianapolis, for defendants. Childs v. Duckworth, 509 F. Supp. 1254, 1256 (N.D. Ind. 1981) aff'd, 705 F.2d 915 (7th Cir. 1983)

  4. "Meanwhile small- and mid-size firms are getting squeezed and likely will not survive unless they become a boutique firm." I've been a business attorney in small, and now mid-size firm for over 30 years, and for over 30 years legal consultants have been preaching this exact same mantra of impending doom for small and mid-sized firms -- verbatim. This claim apparently helps them gin up merger opportunities from smaller firms who become convinced that they need to become larger overnight. The claim that large corporations are interested in cost-saving and efficiency has likewise been preached for decades, and is likewise bunk. If large corporations had any real interest in saving money they wouldn't use large law firms whose rates are substantially higher than those of high-quality mid-sized firms.

  5. The family is the foundation of all human government. That is the Grand Design. Modern governments throw off this Design and make bureaucratic war against the family, as does Hollywood and cultural elitists such as third wave feminists. Since WWII we have been on a ship of fools that way, with both the elite and government and their social engineering hacks relentlessly attacking the very foundation of social order. And their success? See it in the streets of Fergusson, on the food stamp doles (mostly broken families)and in the above article. Reject the Grand Design for true social function, enter the Glorious State to manage social dysfunction. Our Brave New World will be a prison camp, and we will welcome it as the only way to manage given the anarchy without it.

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