An appellate panel considered Wednesday whether a healthcare facility employee’s act of kicking a resident, resulting in his death, could be shielded from liability under the Indiana Medical Malpractice Act.
In the case of Linda Martinez, et al. v. Oaklawn Psychiatric Center, Inc., 18A-CT-02883, a scuffle ensued between resident Roy Martinez and Kennedy Kafatia, a resident assistant at voluntary group home, after Martinez refused to go to bed. Martinez lived at the facility, operated by Oaklawn Psychiatric Center, which offered supervised living for patients who do not require inpatient services.
On the night of his death, Martinez wanted to continue watching his television show, but Kafatia told him it was past curfew. A struggle followed that left Martinez with a bleeding cut in his leg after Kafatia kicked him. Martinez ultimately died from his leg injury, and his estate sued Oaklawn, alleging liability for Martinez’s injuries and resulting death under the Wrongful Death Act.
Oaklawn, however, filed a motion to dismiss, asserting that because Oaklawn was a qualified health care provider under Indiana’s Medical Malpractice Act, the estate was required to file its claim with a medical review panel.
A trial court granted Oaklawn’s motion to dismiss, finding that Kafatia was acting within the scope of his employment and was attempting to enforce the terms of Martinez’s residence in its health care facility. But Jeffrey Stesiak, representing Martinez’s estate, argued that the act of kicking someone is not under the health care provider’s job description.
“I believe that because he is an employee under the (Medical Malpractice) Act, he is defined as a healthcare provider, but his actions take him outside that,” Stesiak told the appellate panel during Wednesday oral arguments.
Stesiak maintained that the issue at hand was a general negligence case, not a medical malpractice case. He argued that Oaklawn breached its duty to exercise reasonable care for the safety of its invitees and that the act against Martinez was battery.
But Judge Paul Mathias posed that there were two ways to look at the situation, and that Kafatia could have been acting in self-defense when he kicked Martinez. Likewise, Judge Margret Robb asked if the situation wouldn’t be different if the suit was purely focused on battery, as opposed to someone who was injured and the result of the failure to call medical help being death.
“Isn’t that medical in nature, failure to call medical help?” Robb asked.
“That’s not medical,” Stesiak said, even though Kafatia was trained in CPR and first aid. He further reiterated that the act of putting someone to bed was not medical treatment.
Representing Oaklawn, Robert J. Palmer held the position that whether the kick was a medical act, the whole nature of the provider fell within the act because Oaklawn was a healthcare facility.
When asked as to whether kicking was a part of enforcing the rules of the facility, Palmer turned to the standard of care.
“Is any force whatsoever within the standard of care to enforce the terms and conditions of that facility? Whether he went beyond that standard of care in the kicking itself, that’s for the medical review panel to say,” Palmer said. “They use that standard of care, and if it says there is a time and place to use force in these conditions, the question becomes, is that kicking negligent under that standard?”
Additionally, both parties answered questions as to what sort of test should be applied in the case, and other like cases, moving forward. Palmer said the test should consider what the purpose of the services being provided to a patient are. In the case at hand, the services were psychiatric, he said. Therefore, following the rules was part of the facility’s efforts to reintegrate patients back into society.
“And because of that, enforcing those rules is part of the health care,” he said.
But the inability to provide a broad test, Mathias noted, means that trial judges will be left “bleeding on the front lines, case by case,” leaving the appellate court to try to apply first aid to make sense of it.
Stesiak said the test should be a medical provider furthering a medical treatment to be under the Act. In Martinez’s case, there was not furtherance of medical treatment, he argued.
“It’s not different than a parent enforcing them to go to bed early. You don’t force them or kick them,” Stesiak said. “You tell them.”
“Although if they’re teenagers and they charge you, you defend yourself, don’t you?” Mathias asked.
“You do,” Stesiak replied.
Oral arguments in the St. Joseph County case took place Wednesday at the Indianapolis Jewish Community Center.