Kathy L. Siner, Personal Representative of the Estate of Geraldine A. Siner v. Kindred Hospital Limited Partnership, d/b/a Kindred Hospital of Indianapolis
51 N.E.3d 1184
| Ind. | 2016Background
- 83-year-old Geraldine Siner, with advanced dementia, was admitted to Kindred Hospital for aspiration pneumonia; her son John was her health care representative and POA.
- Family insisted on "full code" status; Kindred’s Ethics Committee overrode that designation and changed her to "no code," leading the family to transfer her to Methodist Hospital.
- On transfer, Geraldine had a collapsed lung, facial wounds, overwhelming infection, and septic shock; she died 20 days later.
- Kathy Siner filed a medical-malpractice claim; a medical review panel issued a unanimous opinion finding defendants failed to meet the standard of care and that their conduct "may have been a factor of some resultant damages, but not the death."
- Defendants (Kindred and Dr. Majid) moved for summary judgment, designating Dr. James Krueger’s affidavits (saying defendants did not cause injury relating to CPAP/pulmonary care) and the panel opinion; plaintiffs designated other expert affidavits addressing care generally.
- Trial court granted summary judgment to both defendants; Court of Appeals reversed as to Kindred but affirmed as to Dr. Majid; Indiana Supreme Court granted transfer and reversed both summary judgments.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether movants met burden to obtain summary judgment by negating at least one element of malpractice | Siners: conflicting expert opinions (medical panel and plaintiffs’ experts) create genuine factual disputes on causation and other claims | Kindred/Majid: Dr. Krueger’s affidavits negate causation (at least for pulmonary/CPAP claims); the panel opinion is too speculative to create a genuine issue | Movants failed to affirmatively negate plaintiffs’ claims; designated evidence (Krueger affidavits + panel opinion) conflicts on causation and precludes summary judgment |
| Whether the medical review panel’s opinion can create a genuine issue of material fact | Siners: panel conclusion that defendants "may have been a factor" creates a factual dispute on causation | Defendants: panel’s language is speculative and insufficient to defeat summary judgment | A panel opinion need not be conclusive or richly detailed; conflicting expert conclusions are enough to create a genuine issue for trial |
| Scope of defendants’ affirmative negation—were non-pulmonary claims negated? | Siners: defendants’ designated evidence addresses only pulmonary care; other claimed injuries remain unnegated | Defendants: sought summary judgment broadly based on Krueger affidavits and panel opinion | Krueger’s affidavits addressed only pulmonary/CPAP care; summary judgment inappropriate as to non-pulmonary claims |
| Standard for summary judgment when movant designates conflicting expert evidence | Siners: summary judgment inappropriate where movant’s own designated evidence conflicts | Defendants: federal-style no-evidence argument or require plaintiffs to show evidence to survive | Indiana requires movant to affirmatively negate an element; conflicting designated evidence creates a genuine issue and bars summary judgment |
Key Cases Cited
- Hughley v. State, 15 N.E.3d 1000 (Ind. 2014) (Indiana summary judgment standard; draw inferences for nonmovant)
- Manley v. Sherer, 992 N.E.2d 670 (Ind. 2013) (movant bears initial burden to affirmatively negate an element)
- Stafford v. Szymanowski, 31 N.E.3d 959 (Ind. 2015) (unanimous medical review panel opinion ordinarily meets movant’s initial burden)
- Chi Yun Ho v. Frye, 880 N.E.2d 1192 (Ind. 2008) (conflicting expert opinions on ultimate issues defeat summary judgment)
- Purcell v. Old Nat. Bank, 972 N.E.2d 835 (Ind. 2012) (summary judgment inappropriate when a conflict of evidence may exist)
- Jordan v. Deery, 609 N.E.2d 1104 (Ind. 1993) (expert affidavit lacking detail can still create a material factual issue)
- Tankersley v. Parkview Hosp., Inc., 791 N.E.2d 201 (Ind. 2003) (careful scrutiny to ensure losing party not improperly denied a day in court)
- Estate of Mintz v. Conn. Gen. Life Ins. Co., 905 N.E.2d 994 (Ind. 2009) (resolve doubts against movant when evaluating designated evidence)