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Testimony based on medical journals allowed

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A physician testifying at a medical malpractice case should have been allowed to offer testimony based on her reading of medical journals, and a Marion County judge erred when he excluded part of her statements, the Indiana Court of Appeals decided.

The error, however, was harmless and didn't affect the overall outcome in a medical negligence case against a Wishard Memorial Hospital doctor stemming from a relative's death following post-operative treatment.

The court issued its unanimous ruling today in Linda Spaulding, et al. v. Erinn R. Harris, M.D. and Health and Hospital Corp. of Marion County d/b/a Wishard Memorial Hospital, No. 49A02-0810-CV-954. The case involves the medical treatment and subsequent death of Mattie Spaulding, a morbidly obese 58-year-old woman who underwent emergency aortic valve replacement surgery for congestive heart failure. A couple months after the procedure in March 2002, she consulted with Harris at Wishard's Blackburn Community Health Center for post-operative blood monitoring for possible clots. She had blood tests to monitor her coagulation factor because of being on a blood thinner. On June 20, 2002, an ambulance was called to her house; however, she refused three times to be transported. Three days later, she was taken to Community Hospital and diagnosed with a subdural hematoma for which she underwent a craniotomy. She was later transferred to a rehabilitation facility, where she suffered acute respiratory failure and died. The cause of death was a blood clot traveling to the lungs and preventing oxygenation.

After her death, the Spaulding family filed a complaint with the Indiana Department of Insurance against Dr. Erinn Harris and Wishard Memorial Hospital, alleging the doctor failed to adequately monitor Mattie's coagulation and that she developed her injuries because of negligence. Two members of a medical review panel found in May 2006 that a material issue of fact existed and should be heard by a jury, while a third panelist determined the defendants had failed to provide the appropriate standard of care. The Spauldings then filed suit in Marion Superior Court.

An issue arose when one of the medical review panelists, a primary care doctor, testified based on her experience in administering blood thinners and monitoring coagulation like Mattie's. She testified in a video deposition that a medical article she'd consulted showed higher blood levels could present a greater danger for spontaneous bleeds, and that her belief was that Harris should have tested Mattie more often; she had no tests between June 4 and 23. Judge Gerald Zore redacted portions of the expert's causation testimony that was based on medical literature, but the Spauldings argued that testimony was improperly excluded.

The Court of Appeals agreed, citing caselaw from the 1980s to show expert witnesses can draw upon all sources of information and consult authoritative sources to reach a conclusion. Finding that Indiana Code Section 34-18-10-23 does not give review panel members a "free pass to testify on any matters they so choose," the court acknowledged that she could consult medical periodicals during the deposition under Rule 702. However, the exclusion was harmless because at least three others statements from that doctor were admitted and other testimony showed a similar connection about the medical issue.

The court also determined that the trial court didn't abuse its discretion by excluding the words "Department of Insurance" on the medical review panel opinion and that admitting a redacted copy of that certified opinion was allowed.

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  1. My mother got temporary guardianship of my children in 2012. my husband and I got divorced 2015 the judge ordered me to have full custody of all my children. Does this mean the temporary guardianship is over? I'm confused because my divorce papers say I have custody and he gets visits and i get to claim the kids every year on my taxes. So just wondered since I have in black and white that I have custody if I can go get my kids from my moms and not go to jail?

  2. Someone off their meds? C'mon John, it is called the politics of Empire. Get with the program, will ya? How can we build one world under secularist ideals without breaking a few eggs? Of course, once it is fully built, is the American public who will feel the deadly grip of the velvet glove. One cannot lay down with dogs without getting fleas. The cup of wrath is nearly full, John Smith, nearly full. Oops, there I go, almost sounding as alarmist as Smith. Guess he and I both need to listen to this again: https://www.youtube.com/watch?v=CRnQ65J02XA

  3. Charles Rice was one of the greatest of the so-called great generation in America. I was privileged to count him among my mentors. He stood firm for Christ and Christ's Church in the Spirit of Thomas More, always quick to be a good servant of the King, but always God's first. I had Rice come speak to 700 in Fort Wayne as Obama took office. Rice was concerned that this rise of aggressive secularism and militant Islam were dual threats to Christendom,er, please forgive, I meant to say "Western Civilization". RIP Charlie. You are safe at home.

  4. It's a big fat black mark against the US that they radicalized a lot of these Afghan jihadis in the 80s to fight the soviets and then when they predictably got around to biting the hand that fed them, the US had to invade their homelands, install a bunch of corrupt drug kingpins and kleptocrats, take these guys and torture the hell out of them. Why for example did the US have to sodomize them? Dubya said "they hate us for our freedoms!" Here, try some of that freedom whether you like it or not!!! Now they got even more reasons to hate us-- lets just keep bombing the crap out of their populations, installing more puppet regimes, arming one faction against another, etc etc etc.... the US is becoming a monster. No wonder they hate us. Here's my modest recommendation. How about we follow "Just War" theory in the future. St Augustine had it right. How about we treat these obvious prisoners of war according to the Geneva convention instead of torturing them in sadistic and perverted ways.

  5. As usual, John is "spot-on." The subtle but poignant points he makes are numerous and warrant reflection by mediators and users. Oh but were it so simple.

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