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DTCI: Medical Negligence vs. Premises Liability

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DTCI murphy koenemanWhen a patient is harmed during a medical procedure, a patient may elect to file a medical negligence claim against his physician and the health care facility in which the procedure occurred. However, when a patient is harmed during a hospitalization, should the claim still be pursued as one of medical negligence or is it more appropriately a premises liability claim?

Indiana courts have been asked to determine the substance and resulting remedies of these claims, which decisions have been as varied as the unique factual circumstances presented to the courts. What about a patient who slips and falls in the hospital hallway; a patient who falls to the floor when a hospital bed breaks; or a patient who physically attacks or engages in an unwanted sexual encounter with another patient? How should these claims be pursued?

Whether a claim sounds in medical negligence or premises liability has far-reaching implications for the attorney. Which insurance carrier and insurance coverage is applicable: the hospital’s general liability coverage or its medical malpractice insurance? Procedurally, should the case proceed through the medical review panel process pursuant to the requirements of Indiana’s Medical Malpractice Act or can it be filed directly in state court as an ordinary negligence claim? Are there any limits to the amount of recoverable damages? If the claim is properly a medical negligence claim, then the Medical Malpractice Act limits recoverable damages. With an ordinary negligence claim, there is no ceiling on a potential judgment and potential liability.

The substance of the claim also necessarily affects the type of discovery that can and should be conducted. If a medical negligence claim, then the injured patient’s medical records are relevant. If a premises liability claim or failure to protect a patient from another patient’s attack, then do the nonparty patient’s records become relevant; and if so, are they appropriately discoverable under HIPAA? Knowing whether you are defending a medical malpractice claim or a premises liability claim affects every other decision in the litigation, which makes it imperative to resolve the answer as soon as possible.

Indiana courts have given us no definitive answer yet as to whether any given set of facts will be treated as a medical negligence claim or as a premises liability claim. The Indiana Supreme Court’s recent decision in McSwane v. Bloomington Hospital, 916 N.E. 2d 906 (2009), refused to extend a hospital’s duty of care to an off-premises attack of a patient. However, when the attack occurs on hospital premises, aren’t the hospital staff’s decisions as to where to house the patient, what medications to give the patient, and what level of supervision or protection to give to a patient medical decisions? The Medical Malpractice Act defines health care as decisions with respect to a patient’s treatment or confinement, which will be treated as a medical negligence claim. Ind. Code § 34-18-2-13. On the other hand, the Indiana Court of Appeals has held that the Medical Malpractice Act was designed to exclude conduct “unrelated to the promotion of a patient’s health or the provider’s exercise of professional expertise, skill, or judgment.” Murphy v. Mortell, 684 N.E.2d 1185, 1188 (Ind. Ct. App. 1997).

Which decisions regarding patient care and safety are medical decisions? As defense lawyers, our argument is that all decisions regarding a patient’s care and safety that occur on hospital premises are necessarily medical decisions. And with that determination, the claim can be pursued as a medical negligence claim with all of the duties, protections, and liability limitations afforded a hospital or health care facility by the Indiana Medical Malpractice Act.•

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Mr. Murphy and Ms. Koeneman are partners with the Murphy Law Group in Fort Wayne, Indiana. Mr. Murphy is a member of the Board of Directors of DTCI. The opinions expressed in this article are those of the authors.

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  1. As one of the many consumers affected by this breach, I found my bank data had been lifted and used to buy over $200 of various merchandise in New York. I did a pretty good job of tracing the purchases to stores around a college campus just from the info on my bank statement. Hm. Mr. Hill, I would like my $200 back! It doesn't belong to the state, in my opinion. Give it back to the consumers affected. I had to freeze my credit and take out data protection, order a new debit card and wait until it arrived. I deserve something for my trouble!

  2. Don't we have bigger issues to concern ourselves with?

  3. Anyone who takes the time to study disciplinary and bar admission cases in Indiana ... much of which is, as a matter of course and by intent, off the record, would have a very difficult time drawing lines that did not take into account things which are not supposed to matter, such as affiliations, associations, associates and the like. Justice Hoosier style is a far departure than what issues in most other parts of North America. (More like Central America, in fact.) See, e.g., http://www.theindianalawyer.com/indiana-attorney-illegally-practicing-in-florida-suspended-for-18-months/PARAMS/article/42200 When while the Indiana court system end the cruel practice of killing prophets of due process and those advocating for blind justice?

  4. Wouldn't this call for an investigation of Government corruption? Chief Justice Loretta Rush, wrote that the case warranted the high court’s review because the method the Indiana Court of Appeals used to reach its decision was “a significant departure from the law.” Specifically, David wrote that the appellate panel ruled after reweighing of the evidence, which is NOT permissible at the appellate level. **But yet, they look the other way while an innocent child was taken by a loving mother who did nothing wrong"

  5. Different rules for different folks....

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