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Court addresses use of epidemiological evidence in med mal cases

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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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  1. This law is troubling in two respects: First, why wasn't the law reviewed "with the intention of getting all the facts surrounding the legislation and its actual impact on the marketplace" BEFORE it was passed and signed? Seems a bit backwards to me (even acknowledging that this is the Indiana state legislature we're talking about. Second, what is it with the laws in this state that seem to create artificial monopolies in various industries? Besides this one, the other law that comes to mind is the legislation that governed the granting of licenses to firms that wanted to set up craft distilleries. The licensing was limited to only those entities that were already in the craft beer brewing business. Republicans in this state talk a big game when it comes to being "business friendly". They're friendly alright . . . to certain businesses.

  2. Gretchen, Asia, Roberto, Tonia, Shannon, Cheri, Nicholas, Sondra, Carey, Laura ... my heart breaks for you, reaching out in a forum in which you are ignored by a professional suffering through both compassion fatigue and the love of filthy lucre. Most if not all of you seek a warm blooded Hoosier attorney unafraid to take on the government and plead that government officials have acted unconstitutionally to try to save a family and/or rescue children in need and/or press individual rights against the Leviathan state. I know an attorney from Kansas who has taken such cases across the country, arguing before half of the federal courts of appeal and presenting cases to the US S.Ct. numerous times seeking cert. Unfortunately, due to his zeal for the constitutional rights of peasants and willingness to confront powerful government bureaucrats seemingly violating the same ... he was denied character and fitness certification to join the Indiana bar, even after he was cleared to sit for, and passed, both the bar exam and ethics exam. And was even admitted to the Indiana federal bar! NOW KNOW THIS .... you will face headwinds and difficulties in locating a zealously motivated Hoosier attorney to face off against powerful government agents who violate the constitution, for those who do so tend to end up as marginalized as Paul Odgen, who was driven from the profession. So beware, many are mere expensive lapdogs, the kind of breed who will gladly take a large retainer, but then fail to press against the status quo and powers that be when told to heel to. It is a common belief among some in Indiana that those attorneys who truly fight the power and rigorously confront corruption often end up, actually or metaphorically, in real life or at least as to their careers, as dead as the late, great Gary Welch. All of that said, I wish you the very best in finding a Hoosier attorney with a fighting spirit to press your rights as far as you can, for you do have rights against government actors, no matter what said actors may tell you otherwise. Attorneys outside the elitist camp are often better fighters that those owing the powers that be for their salaries, corner offices and end of year bonuses. So do not be afraid to retain a green horn or unconnected lawyer, many of them are fine men and woman who are yet untainted by the "unique" Hoosier system.

  3. I am not the John below. He is a journalist and talk show host who knows me through my years working in Kansas government. I did no ask John to post the note below ...

  4. "...not those committed in the heat of an argument." If I ever see a man physically abusing a woman or a child and I'm close enough to intercede I will not ask him why he is abusing her/him. I will give him a split second to cease his attack and put his hands in the air while I call the police. If he continues, I will still call the police but to report, "Man down with a gunshot wound,"instead.

  5. And so the therapeutic state is weaonized. How soon until those with ideologies opposing the elite are disarmed in the name of mental health? If it can start anywhere it can start in the hoosiers' slavishly politically correct capital city.

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