Ruling in favor of doctors in med mal case upheld

The trial court properly tendered a jury instruction in a medical malpractice case that advised the jury that physicians are not liable for an error in diagnosis or treatment when exercising reasonable care, the Indiana Court of Appeals held Thursday.

John Hill III and his wife sued Parkview Hospital and the doctors involved in his medical care after coronary artery bypass surgery in December 1999 led to severe complications. Hill experienced a drop in platelets, an autoimmune response to the drug Heparin and thrombosis that led to extreme swelling in his limbs and eventual amputation of his legs and left arm. Dr. Thomas Ryan, a cardiologist, ordered Hill’s treatment to stop including Heparin, but unbeknownst to the doctor, he continued to receive a minimal dose because of hospital protocol to flush I.V. lines with Heparin.

Hill settled his claim with the hospital for $250,000 and recovered an additional $1 million from the Indiana Patient’s Compensation Fund. His lawsuit involving the doctors who treated him is at issue in John A. Hill, III and Susan Hill v. Steven N. Rhinehart, M.D. and Fort Wayne Medical Oncology and Hematology, Inc.; John F. Csicsko, M.D. and David P. Lloyd, M.D., as Individuals, et al., 02A03-1405-CT-146. The trial court granted direct verdicts in favor of Drs. John Csicsko and David Lloyd, and the jury ruled in favor of Drs. Ryan and Steven Rhinehart.

The Court of Appeals affirmed the directed verdict, noting that Hill did not suggest he had incurred a separate and distinct injury from the one already satisfied by the agreement he entered into with Parkview and the release with the IPCF. That agreement led to a settlement for the amputation of his three limbs as a result of negligent care and treatment. Nowhere in the record in the instant case did Hill establish he incurred any separate and distinct injuries from the amputations, the judges held.

The trial court did not err in entering in the directed verdict because it did not prevent Hill from fully presenting his case, so there was no prejudice to Hill in explaining the temporal relationship between the physicians and their respective collaborative actions with respect to his care and treatment.

Finally, the appeals court held the Jury Instruction No. 23 was a correct statement of the law and properly tendered to the jury. It said, “… a physician will not be negligent if he exercises such reasonable care and ordinary skill, even though he mistakes a diagnosis, makes an error during treatment, or fails to appreciate the seriousness of the patient’s problem.” Hill argued that the instruction left the jury in doubt as to the proper standard for determining medical malpractice.

But that instruction has been upheld in previous case law and it reminds the jury that a poor outcome does not constitute negligence if the doctor exercises the requisite standard of care, Judge Patricia Riley wrote.  

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