Charles McKeen, M.D. v. Billy Turner
2016 Ind. App. LEXIS 363
| Ind. Ct. App. | 2016Background
- Patient Rowena Turner underwent colon surgery on May 23, 2008 and was discharged; she returned May 31, 2008 and later died June 20, 2008 from complications including deep vein thrombosis and bowel ischemia.
- Husband Billy Turner filed a proposed medical-malpractice complaint covering care from May 23–June 20, 2008 and submitted full medical records to a Medical Review Panel (MRP).
- Turner’s MRP submission focused on alleged delay in exploratory surgery during the second hospital stay; narrative statements did not press a separate claim about anticoagulation adequacy after the first discharge.
- The MRP unanimously opined the evidence did not show McKeen breached the standard of care.
- During later litigation Turner designated an expert (Dr. Manges) to opine that anticoagulation after the first stay was inadequate and caused the fatal clots; McKeen moved to strike that testimony as not presented to the MRP.
- The trial court ultimately denied the motion to strike, holding (1) the proposed complaint encompassed the anticoagulation theory under notice pleading, and (2) medical records concerning anticoagulation had been submitted to the MRP.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether attorney narrative statements submitted to the MRP constitute "evidence" that bind the plaintiff | Turner: narratives are not required and should not bind the plaintiff; only the proposed complaint and evidence matter | McKeen: plaintiff’s failure to present the anticoagulation theory in MRP narratives bars raising it later | Held: Narrative/argumentative statements are not "evidence" under the Act and do not bind the parties. |
| Whether a plaintiff may advance new theories of breach at trial that were not argued in MRP submissions | Turner: under notice pleading, so long as the proposed complaint and evidence to the MRP encompass the theory, it may be raised later | McKeen: theories not presented to the MRP cannot be introduced at trial | Held: A plaintiff may raise theories at trial so long as (1) the proposed complaint encompasses them under notice pleading and (2) evidence related to them was submitted to the MRP. |
| Whether Turner’s anticoagulation theory was preserved for trial | Turner: proposed complaint covered May 23–June 20 and records including anticoagulation were before the MRP | McKeen: Turner didn’t present anticoagulation breach to the MRP and failed to question panelists about it | Held: The complaint’s broad allegations plus submission of medical records satisfied the two-part test; anticoagulation evidence/admission allowed. |
| Proper construction of Miller v. Memorial Hospital and subsequent cases (e.g., K.D.) | Turner/ITLA: Miller controls; notice pleading suffices and narrative statements should not be required | McKeen: K.D. limits Miller by requiring breaches be presented to the panel | Held: Miller governs; K.D. to the extent it requires narratives or binds parties beyond Miller/Act is misplaced. |
Key Cases Cited
- Miller v. Memorial Hospital of South Bend, Inc., 679 N.E.2d 1329 (Ind. 1997) (proposed complaint under notice pleading—not MRP submission substance—controls which theories may be pursued later)
- K.D. v. Chambers, 951 N.E.2d 855 (Ind. Ct. App. 2011) (MRP must receive evidence of breaches; court excluded theories not supported by panel submission)
- Whitfield v. Wren, 14 N.E.3d 792 (Ind. Ct. App. 2014) (distinguishes K.D. where evidence of contested breaches was before the MRP)
- Ball Mem. Hosp., Inc. v. Fair, 26 N.E.3d 674 (Ind. Ct. App. 2015) (emphasizes Miller and notice pleading; broad complaint can put defendant on notice)
- Sherrow v. Gyn, Ltd., 745 N.E.2d 880 (Ind. Ct. App. 2001) (argumentative legal submissions to MRP are inappropriate and should not convert into binding evidence)
- Johnson v. St. Vincent Hosp., 404 N.E.2d 585 (Ind. 1980) (MRP process is intended to be informal and limited)