Charles Aillones v. Glen D. Minton
2017 Ind. App. LEXIS 226
| Ind. Ct. App. | 2017Background
- On June 2, 2012, Charles Aillones was rear-ended by Glen Minton and sought treatment for neck and back pain from Alan Swartz, a licensed nurse practitioner.
- Swartz has a BSN and a master’s as a nurse practitioner, is licensed and board-certified in Indiana and Kentucky, prescribes medications, refers to PT, and has treated 100+ auto-injury patients.
- In deposition Swartz testified the injuries were "consistent with" a motor-vehicle accident; defense counsel objected for lack of foundation when asked to state causation to a reasonable degree of medical probability.
- Aillones moved to qualify Swartz as an expert on causation; the trial court denied the motion, relying on Nasser v. St. Vincent Hosp., and certified the order for interlocutory appeal.
- The Court of Appeals reviewed admissibility under Indiana Evidence Rule 702 and considered prior decisions limiting nurses from offering medical-causation opinions in medical-malpractice contexts.
- The court concluded Swartz could be qualified as an expert under Rule 702 and reversed: he may opine that injuries are consistent with an auto accident, but not testify that the accident proximately caused the injuries since he did not witness the crash.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether a nurse practitioner may qualify as an expert on causation under Evid. R. 702 | Swartz’s education, licensing, experience, and specialty care render him qualified to give expert opinions on whether injuries are consistent with an auto accident | Prior cases (Long, Nasser, Wagler) bar nurses from giving medical-causation opinions; nurse lacks physician-level training to opine on causation | A nurse practitioner can qualify as an expert under Rule 702 if sufficient knowledge, skill, experience, training, or education is shown; no per se ban |
| Whether Swartz may testify that the automobile accident proximately caused Aillones’s injuries | Swartz can opine to a reasonable degree of medical probability that the accident caused the injuries | Swartz lacks foundation and is not allowed to testify to causation | Swartz may not testify that the accident proximately caused the injuries (was not present); he may testify that the injuries are consistent with injuries from an automobile accident |
Key Cases Cited
- Nasser v. St. Vincent Hosp. & Health Servs., 926 N.E.2d 43 (Ind. Ct. App. 2010) (held nurse could not qualify as expert on medical causation in malpractice context)
- Long v. Methodist Hosp. of Ind., Inc., 699 N.E.2d 1164 (Ind. Ct. App. 1998) (refused nurse’s expert affidavit on medical causation due to differences between physicians and nurses)
- Clarian Health Partners v. Wagler, 925 N.E.2d 388 (Ind. Ct. App. 2010) (followed Long; nurse affidavit inadmissible to create fact issue on causation)
- Curts v. Miller’s Health Sys., Inc., 972 N.E.2d 966 (Ind. Ct. App. 2012) (held nurses might qualify as experts in some circumstances; no blanket exclusion)
- Bennett v. Richmond, 960 N.E.2d 782 (Ind. 2012) (rejected per se exclusion of psychologists and emphasized Rule 702’s flexible criteria)