IN Supreme Court: ‘Patient’ under med-mal act includes third-party plaintiffs

Answering a question posed by the 7th Circuit Court of Appeals, the Indiana Supreme Court on Wednesday ruled that Indiana’s Medical Malpractice Act applies to cases where a third-party plaintiff alleges that negligent treatment to someone else resulted in injury to the plaintiff. One justice, however, cautioned against the expansion of the Medical Malpractice Act.

Justice Geoffrey Slaughter wrote for the high court in Jeffrey B. Cutchin v. Amy L. Beard, 21S-CQ-48. Justice Steven David concurred in result.

The case involves then-72-year-old Sylvia Watson, who in 2017 took two prescription pills that resulted in her inability to lift her foot from the gas pedal at a red light. Watson ran the light and crashed into another vehicle, killing the other driver and her daughter, Claudine and Adelaide Cutchin, as well as Watson herself.

A blood test later showed that Watson had opiates in her system. The drugs were prescribed by a person named in the Wednesday opinion only as “physician,” who had prescribed Watson at least eight medications over the years at a clinic.

About one year after the crash, Jeffrey Cutchin, husband to Claudine and father to Adelaide, filed a medical malpractice complaint with the Indiana Department of Insurance as well as a civil complaint in the U.S. District Court for the Southern District of Indiana. Cutchin alleged the physician had breached the standard of care as to Watson and had negligently caused the wrongful deaths of his wife and daughter. He sought declaratory judgment that the Indiana Medical Malpractice Act applied to his case.

The case proceeded to a settlement conference in the district court, and the physician agreed to pay the $250,000 statutory cap under the act in exchange for Cutchin dropping proceedings before a medical review board. However, Cutchin reserved his rights under the Patient’s Compensation Fund, which could pay up to $1 million beyond the physician’s liability.

The fund argued it had no liability because the case wasn’t covered under the Medical Malpractice Act, and the district court ultimately entered judgment for the fund on its cross-motion for summary judgment as to Cutchin’s request for declaratory relief. The case then went to the 7th Circuit, which certified two questions to the Indiana Supreme Court:

  • Whether Indiana’s Medical Malpractice Act prohibits the Patient’s Compensation Fund from contesting the act’s applicability to a claim after the claimant concludes a court-approved settlement with a covered health care provider.
  • Whether Indiana’s Medical Malpractice Act applies to claims brought against qualified health care providers for individuals who did not receive medical care from the provider but who are injured as a result of the provider’s negligence in providing medical treatment to someone else.

Answering only the second question, the high court responded affirmatively based on the definition of “patient” in Indiana Code § 34-18-2-22: “an individual who receives or should have received health care from a health care provider, under a contract, express or implied, and includes the person having a claim of any kind, whether derivative or otherwise, as a result of alleged malpractice on the part of a health care provider.”

Based on that definition, Slaughter said, there are two categories of “patients”: a traditional patient and a third party with a claim against a health care provider under state law.

“This latter category refers to a third party whose claim results from a provider’s malpractice to someone in the first category, namely, a traditional patient,” Slaughter wrote. “Here, Cutchin is not a traditional patient because he has no patient-provider relationship with either Physician or Clinic. But he is nevertheless a statutory ‘patient’ because he has a wrongful-death claim resulting from Physician’s and Clinic’s alleged malpractice to Watson, who is their traditional patient.”

That holding is supported by precedent including Cram v. Howell, 680 N.E.2d 1096 (Ind. 1997), Goleski v. Fritz, 768 N.E.2d 889 (Ind. 2002), and Spangler v. Bechtel, 958 N.E.2d 458 (Ind. 2011), Slaughter said.

The fund supported its argument with Midtown Community Mental Health Center v. Estate of Gahl, 540 N.E.2d 1259 (Ind. Ct. App. 1989), but the high court on Wednesday disapproved of Gahl’s implicit reasoning to the extent that it conflicts with the Legislature’s broad definition of “patient.” It likewise disapproved of Preferred Professional Insurance Co. v. West, 23 N.E.3d 716 (Ind. Ct. App. 2014), which the fund also cited.

“Section 34-18-2-22 says that a third party who did not receive medical care from a provider but who has a claim due to the provider’s medical malpractice to a traditional patient also is a ‘patient’ under the Act. We thus answer the second certified question in the affirmative,” Slaughter concluded.

“In doing so, we reject the Fund’s argument that the legislature intended that a third party injured by a provider’s malpractice to a traditional patient has only a generic negligence claim not subject to the Act,” he wrote. “Such a claim would not be subject to any cap on damages recoverable from the provider and would afford no relief from the Fund.

“But the Fund’s view ignores the structure and text of the statute. We will not ignore the statute’s language in favor of what the Fund perceives to be the legislature’s intent.”

Because answering the second question resolved the case, the justices declined to answer the first regarding whether the fund can contest the applicability of the act after a claimant concludes a settlement.

While Justice David concurred in result “given the unique factual background and procedural posture of the case,” he wrote separately to “express (his) concerns about the expansion of the Medical Malpractice Act.”

“While the majority makes much of the language ‘claim of any kind’ and ‘and,’ I believe the opinion’s broad definition of ‘patient’ renders the whole opening clause of its definition meaningless,” David wrote. “Additionally, I interpret the ‘and’ differently as I do not think it is separating two kinds of patients, but rather setting guardrails for who may bring a claim under the Act.

“… Because the statute is open to more than one reasonable interpretation, it is ambiguous. Therefore, I believe it must be construed narrowly,” he wrote.

David pointed to his similar dissent to the denial of transfer in the case of Martinez v. Oaklawn Psychiatric Ctr., Inc., 128 N.E.3d 549 (Ind. Ct. App.), clarified on reh’g, 131 N.E.3d 777 (Ind. Ct. App. 2019), trans. denied, 140 N.E.3d 286 (Ind. 2020).

“I remain concerned with continued expansion of the Act and believe that this expansion may have unintended consequences,” David concluded. “While it may help this particular plaintiff, it may hurt future litigants who would be better served filing their claims not through the Medical Review Panel, but directly and initially through the court.”

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