Katherine Chaffins and Roger Chaffins Sr. v. Clint Kauffman, M.D. Family and Women's Health Services and Pulaski County Memorial Hospital
2013 Ind. App. LEXIS 479
| Ind. Ct. App. | 2013Background
- Katherine Chaffins underwent a routine colonoscopy and awoke in severe abdominal pain; nurses attributed it to gas and encouraged ambulation.
- After ~25 minutes in recovery, Katherine was discharged while still in severe pain; about 12 hours later an X‑ray showed a colon perforation and she required emergency surgery (partial colectomy and temporary colostomy).
- The Chaffinses filed a medical‑malpractice complaint; a medical review panel unanimously found no negligence by defendants (physician Dr. Clint Kauffman, his practice, and Pulaski County Memorial Hospital).
- Defendants moved for summary judgment relying on the panel opinion; plaintiffs designated gastroenterology expert Dr. Kevin Olden and deposition evidence; the trial court granted summary judgment for defendants.
- The Court of Appeals reversed: it held there were genuine issues of material fact as to (1) whether Dr. Kauffman breached the standard of care by discharging a visibly painful patient and (2) whether the hospital nurses breached a duty by not reporting/documenting the pain; the court also held causation (12 hours of prolonged pain) remained disputed.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether evidence raises genuine issue that physician breached standard of care | Olden opines a prudent doctor would have recognized signs of perforation and would not discharge a patient in severe pain | Panel opinion and defendants argue Olden’s opinion is speculative and no evidence shows Kauffman knew of the pain at discharge | Reversed: designated evidence (patient testimony, record indicating physician saw patient) permits inference Kauffman knew of severe pain; expert negates panel opinion so summary judgment inappropriate |
| Whether nursing staff breached standard of care without expert testimony | Nurses failed to report/document patient's severe pain and told her pain was normal gas; plaintiffs invoke common‑knowledge exception | Hospital relies on need for expert testimony and panel opinion | Reversed: common‑knowledge exception applies; failure to report obvious severe pain can be judged by laypersons, so fact issue exists |
| Whether defendants made prima facie showing no issue as to causation | Plaintiffs claim defendants’ negligence caused 12 hours of prolonged pain (a compensable injury alleged) | Defendants and plaintiffs’ expert concede perforation itself not caused by negligence and ultimate surgical outcome was the same; defendants argued no causal link to compensable injury | Reversed: defendants conceded prolonged pain was within complaint’s damages and thus did not meet prima facie burden to eliminate causation issue |
| Whether medical review panel opinion precludes trial evidence | Panel opinion normally creates prima facie showing for defendants | Plaintiffs argue expert testimony can negate panel opinion | Held: panel opinion can be negated by admissible expert testimony and other designated evidence; here plaintiffs’ expert and facts sufficed to create genuine issues |
Key Cases Cited
- Hoskins v. Sharp, 629 N.E.2d 1271 (Ind. Ct. App. 1994) (summary judgment standard; resolve doubts for non‑movant)
- McIntosh v. Cummins, 759 N.E.2d 1180 (Ind. Ct. App. 2001) (summary judgment burdens)
- Bunch v. Tiwari, 711 N.E.2d 844 (Ind. Ct. App. 1999) (medical malpractice rarely appropriate for summary disposition)
- Whyde v. Czarkowski, 659 N.E.2d 625 (Ind. Ct. App. 1995) (elements of medical negligence claim)
- Methodist Hosps., Inc. v. Johnson, 856 N.E.2d 718 (Ind. Ct. App. 2006) (medical review panel opinion ordinarily suffices as prima facie showing for defendant)
- Mills v. Berrios, 851 N.E.2d 1066 (Ind. Ct. App. 2006) (plaintiff must present expert testimony to negate panel opinion)
- Jordan v. Deery, 609 N.E.2d 1104 (Ind. 1993) (expert testimony sufficiency on standard of care)
- Clark v. Sporre, 111 N.E.2d 1166 (Ind. Ct. App. 2002) (expert opinion must not be speculative under Rule 702)
- Malooley v. McIntyre, 597 N.E.2d 314 (Ind. Ct. App. 1992) (common‑knowledge exception to expert requirement)
- Perry v. Driehorst, 808 N.E.2d 765 (Ind. Ct. App. 2004) (lack of nursing expert typically fatal absent common‑knowledge exception)
- Payne v. Marion Gen. Hosp., 549 N.E.2d 1043 (Ind. Ct. App. 1990) (example applying common‑knowledge exception)
- Whitten v. Kentucky Fried Chicken Corp., 570 N.E.2d 1353 (Ind. Ct. App. 1991) (movant must first make prima facie showing to shift burden)