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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. Frankly, it is tragic that you are even considering going to an expensive, unaccredited "law school." It is extremely difficult to get a job with a degree from a real school. If you are going to make the investment of time, money, and tears into law school, it should not be to a place that won't actually enable you to practice law when you graduate.

  2. As a lawyer who grew up in Fort Wayne (but went to a real law school), it is not that hard to find a mentor in the legal community without your school's assistance. One does not need to pay tens of thousands of dollars to go to an unaccredited legal diploma mill to get a mentor. Having a mentor means precisely nothing if you cannot get a job upon graduation, and considering that the legal job market is utterly terrible, these students from Indiana Tech are going to be adrift after graduation.

  3. 700,000 to 800,000 Americans are arrested for marijuana possession each year in the US. Do we need a new justice center if we decriminalize marijuana by having the City Council enact a $100 fine for marijuana possession and have the money go towards road repair?

  4. I am sorry to hear this.

  5. I tried a case in Judge Barker's court many years ago and I recall it vividly as a highlight of my career. I don't get in federal court very often but found myself back there again last Summer. We had both aged a bit but I must say she was just as I had remembered her. Authoritative, organized and yes, human ...with a good sense of humor. I also appreciated that even though we were dealing with difficult criminal cases, she treated my clients with dignity and understanding. My clients certainly respected her. Thanks for this nice article. Congratulations to Judge Barker for reaching another milestone in a remarkable career.

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