111 N.E.3d 232
Ind. Ct. App.2018Background
- Cindy Glon underwent a cementless right total hip replacement on June 6, 2011, at Memorial Hospital of South Bend.
- Post‑op she was numb from an epidural; while nursing staff rolled her onto her side in recovery she heard three audible “pops.”
- After the epidural wore off she experienced severe pain; x‑rays then revealed a three‑part displaced fracture of the right femur that was not visible on immediate post‑op x‑rays.
- Glon submitted a medical review panel claim; the three‑orthopedist panel unanimously found the Hospital did not breach the standard of care.
- Glon sued the Hospital asserting negligence and invoking res ipsa loquitur; the Hospital moved for summary judgment, designating panel opinion and an expert (Dr. Ireland) who testified the fracture was a known intraoperative hairline fracture that later displaced and could not have been caused by nursing maneuvers.
- The trial court granted summary judgment for the Hospital; the Court of Appeals affirmed (majority) but one judge dissented, arguing genuine issues of fact remained about whether a hairline fracture existed.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether res ipsa loquitur applies | Glon: nursing staff had exclusive control of positioning and a femur does not ordinarily break when properly positioned; negligence may be inferred. | Hospital: expert evidence shows the fracture is a known complication of cementless hip implantation and can occur despite proper care, so res ipsa is inapplicable. | Court: res ipsa inapplicable because expert evidence shows the injury can occur absent negligence (known surgical complication). |
| Whether genuine issues of material fact preclude summary judgment on breach/causation | Glon: testimony (pops heard, surgeon’s affidavit) raises triable issues that nurses’ actions caused the fracture; res ipsa and common sense relieve need for expert proof. | Hospital: panel opinion and Dr. Ireland affirm no breach; hairline fracture likely occurred intraoperatively and later displaced — no designated expert contradicting breach/causation. | Court: no genuine issue on breach/causation; Hospital met burden to negate causation and Glon failed to present contrary expert evidence — summary judgment affirmed. |
Key Cases Cited
- Thomson v. St. Joseph Reg’l Med. Ctr., 26 N.E.3d 89 (Ind. Ct. App. 2015) (explains res ipsa elements and that expert testimony is unnecessary when doctrine applies)
- Gary Cmty. Sch. Corp. v. Lardydell, 8 N.E.3d 241 (Ind. Ct. App. 2014) (res ipsa permits assumption liability when occurrence is unusual and unexplained)
- Wright v. Carter, 622 N.E.2d 170 (Ind. 1993) (example of res ipsa where foreign object left in body post‑surgery)
- Ross v. Olson, 825 N.E.2d 890 (Ind. Ct. App. 2005) (res ipsa inapplicable where injury is a known complication and expert causation testimony exists)
- Cleary v. Manning, 884 N.E.2d 335 (Ind. Ct. App. 2008) (res ipsa applied where oxygen mask caught fire during surgery)
- Smith v. Dermatology Assocs. of Fort Wayne, P.C., 977 N.E.2d 1 (Ind. Ct. App. 2012) (trial court properly refused res ipsa instruction where contrary evidence existed on doctrine elements)
- Siner v. Kindred Hosp. Ltd. P’ship, 51 N.E.3d 1184 (Ind. 2016) (conflicting expert opinions on ultimate issues defeat summary judgment)
- Chi Yun Ho v. Frye, 880 N.E.2d 1192 (Ind. 2008) (addressing role of expert testimony at summary judgment in medical malpractice)
- Mills v. Berrios, 851 N.E.2d 1066 (Ind. Ct. App. 2006) (medical malpractice breach ordinarily a jury question and rarely suitable for summary judgment)