Whitfield v. Wren
14 N.E.3d 792
| Ind. Ct. App. | 2014Background
- Leslie Wren, age 24, underwent major abdominal surgery and was discharged to a rehab facility (Windsor Estates) where Dr. James Whitfield (medical director, employed by St. Joseph Primary Care, LLC) had supervisory duties; she later died of acute mixed drug intoxication.
- Prior to death, records reflect hyperglycemia, rising potassium/BUN, dehydration signs, pressure ulcers, and administration of opioid pain meds; Dr. Whitfield ordered insulin adjustments but was not involved in all medication decisions (some orders from surgeon Dr. Robb).
- Wren submitted a Proposed Complaint to the statutory Medical Review Panel alleging generally that defendants’ care fell below the standard of care and contributed to Leslie’s death; the Panel issued an opinion that the evidence did not support a breach as charged.
- In state court Wren filed suit; Appellants moved for summary judgment arguing Wren failed to produce expert evidence to rebut the Panel and, alternatively, that Wren sought to litigate breaches not presented to the Panel.
- Wren designated Dr. Robert Gregori’s affidavit alleging specific breaches by Dr. Whitfield (failures to monitor intake/output, reweigh, treat vomiting, monitor dehydration/electrolytes) and causation; Appellants argued these claims were beyond what was presented to the Panel.
- The trial court denied Appellants’ summary judgment motion; the court found Wren’s Panel submission sufficiently raised management of fluids/electrolytes and blood sugar issues and that a jury should resolve the care issues. Appellants appealed; the appellate court affirmed.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the trial court erred in denying Appellants’ motion for summary judgment | Wren: Panel process does not require pleading particularized breaches; his submission (and the medical records before the Panel) put the Panel on notice of fluid/electrolyte and monitoring breaches; his expert creates a triable issue | Appellants: Wren’s submission to the Panel only alleged Whitfield failed to respond to high blood sugar; Gregori’s opinions raise different, unpresented breaches and thus are barred by K.D. v. Chambers and the Medical Malpractice Act | Court: Affirmed — Wren’s submission and evidence to the Panel included management of fluids/electrolytes and blood sugar; the Panel could and did consider those issues, so the expert affidavit raised a genuine issue precluding summary judgment |
Key Cases Cited
- Miller v. Memorial Hosp. of South Bend, 679 N.E.2d 1329 (Ind. 1997) (medical-review-panel process does not require plaintiff to fully explicate particulars of legal contentions to the panel)
- K.D. v. Chambers, 951 N.E.2d 855 (Ind. Ct. App. 2011) (plaintiff cannot present at trial separate breaches of standard of care that were not presented to the medical review panel)
- Kroger Co. v. Plonski, 930 N.E.2d 1 (Ind. 2010) (standard of review for summary judgment)
- Johnson v. St. Vincent Hosp., Inc., 404 N.E.2d 585 (Ind. 1980) (describing the informal, evidence-focused role of the medical review panel)