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Creasy v. Rusk
696 N.E.2d 442
Ind. Ct. App.
1998
Check Treatment

*1 CREASY, Appellant-Plaintiff, Carol RUSK,

Lloyd Appellee-Defendant.

No. 08A02-9709-CV-604. Appeals of Indiana.

Court 29, 1998.

June Aug.

Rehearing Denied *2 Todd,

Edgar Bayliff, W.- Bayliff, Ronald S. P.C., Harrigan, Maugans, Kokomo, Cord & Appellant-Plaintiff, ^or Wheeler, Stephen Hermann, C. Renae L. Jennings Taylor P.C., Bouwkamp, Wheeler & Carmel, Appellee-Defendant. OPINION KIRSCH, Judge. Creasy appeals grant

Carol of sum- mary judgment Lloyd favor of Rusk in personal injuries action for she suf- caring fered while for Rusk in a health care facility. The issues we must decide are: I. Whether who is institution disability with a alized owes a caregiver of care to his to re frain from conduct that results in injury caregiver. to the genuine if. Whether issues of material precluding summary judg- fact exist question ment- on the of whether duty was breached. genuine

III. Whether issues of material precluding summary fact judg- exist ment on the of fault alloca- tion.

We reverse. FACTS AND PROCEDURAL HISTORY Lloyd Rusk was admitted to the Brethren (BHC) July Healthcare Center 1992with a primary diagnosis of Alzheimer’s Disease. facility He was admitted to the because he confusion, memory suffered from loss and his wife was him. unable care for BHC, anxious, confused, While Rusk was disoriented, agitated. On several occa- sions, he resisted when staff at- members tempted to remove him from areas of facility belong. he did not On other where occasions, belligerent Rusk was and combat- patients. particu- ive with both staff and' lar, combative, agitated, Rusk was often aggressive hit at and' would staff members him. while cared-for ruling a motion for sum- court when nursing assistant trial a certified required mary judgment we our decision Creasy’s duties base employed at BHC. Alzheimer’s, 56(C) properly pre- Trial Rule materials her to care a short BHC Campbell Spade, Rusk. She attended including to the trial court. sented pathological ef- concerning presentation (Ind.Ct.App.1993). 582-83 *3 Alzheimer’s, not otherwise but had fects of if the Summary judgment granted shall be training on how to care for special received evidentiary matter demonstrates designated Creasy had been those with the disease. to genuine no issue as that there is with by patients on several occasions bruised moving party is that the material fact and Alzheimer’s, she knew that Rusk suf- and judgment a matter of law. entitled to as Alzheimer’s. fered from 56(C); Barga Indiana Rule v. Ind.Trial Inc., Group, N.E.2d Mut. Ins. 687 Farmers Davis, 16,1995, May Creasy and Linda On 575, (Ind.Ct.App.1997), denied 576 trans. employed nursing another certified assistant (1998). summary determining whether BHC, attempted put Rusk to bed. to judgment appropriate, all facts and reason- “very Creasy that Rusk had been was aware against must be construed able inferences evening.” Rec- agitated combative that and moving party. Wickey, 642 N.E.2d at According Creasy: to ord at 228. to holding wrists “[Davis] [Rusk’s] was [Creasy]

keep hitting him from and [them] put him in trying get legs to his to was I. DUTY wildly. hitting kicking bed. He and has not been The issue we must decide time, [Creasy] sever- During this he kicked person directly in Indiana: Does a addressed hip [Her] al times in knee and area. [her] disability with a mental owe institutionalized popped yelled out [she] lower back caregiver to his to refrain from con- left pain with from lower back and [her] caregiver? injury to the duct that results knee.” against parties argue for and the wisdom Record at 228. rule, adopting general used in several Rusk, Creasy against a civil suit seek- filed jurisdictions, mentally in- disabled other injuries she suf- ing monetary damages for for their tortious dividuals be held liable of the incident. The trial fered as a result regard to the individuals’ activities without granted Rusk’s motion for capacity actions or mental to control their owe a judgment concluding that Rusk did not understand the thereof. Such duty Creasy, Creasy the risk to incurred general rule is embodied in the Restate- comparative injuries, of her (Second) provides: Torts which “Un- ment proximately all other fault fault exceeded child, insanity or less the actor is other Creasy contributing injuries, to her and that deficiency does not relieve the actor bring forth that Rusk had failed evidence liability not for conduct which does any duty owed to her. had breached man conform to the standard of a reasonable appeals. under like circumstances.” Restatement (1964). § (Second) 283B While of Torts AND DECISION DISCUSSION man the Restatement uses the reasonable summary judgment is to purpose adults, regardless their men- standard for litigation about which there can be no end for a capacity, tal the standard of conduct dispute factual and which be determined person of child is “that of a reasonable like Arnold, law. v. as a matter of Sizemore experience age, intelligence, and under like 697, (Ind.Ct.App.1995). When N.E.2d § circumstances.” Id. 283A. Such a stan- summary judgment reviewing a on a decision takes a child’s mental into ac- dard motion, applies this court the same standard § count. Id. 283B cmt. a. Wickey Sparks, does the trial court. v. children, incor- regard With Indiana has (Ind.Ct.App.1994), trans. 642 N.E.2d (1995). Thus, by porated the Restatement standard into a we are not bound denied analysis. The three tiers are: findings conclusions entered three-tiered “[Cjhildren age years of 7 “Although under the are the case of it adults has incapable impracticable been deemed conclusively presumed to be and unwise to contributory negligence determine being eontributorily negligent, from 7 to 14 party basis of mentally whether the presumption they may a rebuttable exists slow-witted, thereof, acute or inclined to be dull or guilty spe- be and over absent deficient, although not circumstances, chargeable cial are absolutely who is so intelligence devoid of exercising standard care of an apprehend apparent as to be unable to adult.” danger exposure and to avoid to it cannot (Ind.Ct. Martz, Bailey v. guilty be of negligence. said be Knowl- Diamond, App.1986) (citing Smith edge appreciation peril are essential (Ind.Ct.App.1981)), 1177-79 contributory negligence, elements of age category, trans. denied.1 In the middle evidence is admissible plaintiffs to show a *4 of in the standard care is accord with the jury mental condition to aid in the deter- the Restatement: whether child exercised mining appre- whether he understood and the care under the circumstances of a child of Am.Jur., danger. ciated the Negli- 38 age, knowledge, judgment like experi and gence, p. Sec. 201 882.” long ago recognized ence. Id. This court 475, 39 Id. at N.E.2d at 779. “the wisdom of the rule which a holds child to subsequently This court appli- limited the proportionate the exercise of care to its ca foregoing principles cation of the in Kroger pacity.” Baltimore & Ohio Southwestern Haun, 403, v. 177 Ind.App. Co. 379 N.E.2d Hickman, 315, 318, R.R. v. Ind.App. Co. 40 (1978). questions 1004 One of the decided in (1907). 1086, 1087 81 N.E. Kroger was whether the doctrine of contribu- Restatement, Unlike the which treats chil- tory negligence required plaintiffs the actual differently dren in than adults terms of the knowledge peril of the or whether construc- each, required standard of care of Indiana knowledge tive would suffice. This court has willingness indicated a to factor in an Wray first noted that the court’s reliance on capacity determining adult’s mental when Jurisprudence authority the American “re- person responsible whether to a hold such veals that the section cited deals with the negligence. Drug for In Riesbeck Co. v. extenuating age, existence of circumstances — 467, Wray, Ind.App. 111 39 N.E.2d 776 illiteracy, incompetency call mental. —which (1942), presented this ap- court was with an special applying consideration in the stan- peal against pharmacy from an action a dard ‘reasonable man’ test.” Id. at 379 plaintiff’s connection with the death of the Kroger at 1009-10. N.E.2d The court ac- deceased, ill, husband. The who was unem- knowledged import the of the existence of ployed, suffering depression, and from sent extenuating such circumstances when it ulti- eight-year-old pharmacy son to the local mately held that: “We believe the actual pharmacy carbolic obtain acid. The dis- be, state of the law to absent extenuating brought tributed the acid to the child who it age circumstances such as or mental incom- home to his father. The father then took his petency, contributory negligence may be by ingesting own life the acid. This court plaintiff found either where has actual knowl- or, stated that evidence of the mental edge deceased’s danger, of the in the exercise of care, condition at the time he sent his son to obtain appreciated reasonable should have or question the acid was material on the anticipated danger.” of the Id. at 379 contributory negligence and declared: N.E .2d at 1010-11.2 ability recognize danger 1. The United District States Court for the North- old child’s and exer- recently safety questions ern District of Indiana has criticized the cise care for his were of fact Bailey ground given conflicting presented by case on the that it mischaracter- the evidence the presumption regarding parties summary judgment proceedings. izes the children between Id. ages the of and seven fourteen and because it at 1136-37. incorrectly Maynard cited the Smith case. v. F.Supp. Bailey, Wray Kroger principles Indiana Harbor Belt R.R. all involved Nonetheless, (N.D.Ind.1998). contributory negligence. principles the court held that of Such presumption, thirteen-year- comparative with or without a have been subsumed in Indiana's Extenuating precedent, Based we hold circumstances that alter relationship person’s capacity, patient’s mental whether that mental include adult, relationship capacity. patient-caregiver fac The person is a child or an must be vary according to will the nature and extent whether a tored determination of patient’s of the to control his legal duty exists. of The determination actions and understand the frequently such a whether exists is most greater degree pa The thereof. accomplished by balancing three factors impairment,- weight to be tient’s the less Jarvis, v. set forth in Webb given relationship to the factor determin 1) (Ind.1991): the relationship between duty. ing legal 2) foreseeability parties; reasonable 3) and, public person injured; harm to the Foreseeability B. Harm Although of a policy concerns.3 the existence analyzed foreseeability fac factor is duty arising balancing of these by considering type plaintiff “the generally question law broad tors is involved, decide, regard harm without to the genuine of material court to issues Goldsberry facts of the actual relationship occurrence.” fact be interwoven with the Grubbs, (Ind.Ct.App. foreseeability factors, making the exis 1996). type plaintiff involved here is law tence of mixed caregiver fact, with Alzheimer’s dis ultimately to be the finder of decided *5 found, trial ease. As the Alzheimer’s Cornelius, 195, 198 fact. v. N.E.2d State 637 patients signs often exhibit violence and (Ind.Ct.App.1994), trans. denied.

combativeness. Record at 255. It is foresee an patient able that when Alzheimer’s be A.Relationship the Parties Between in presence comes combative of his care Thus, giver, caregiver injured. will be In determining whether a relation foreseeability in weighs factor favor of ship parties upon exists between two which a imposing duty. based, duty may be legal there must be some part knowledge purported on the of the tort Policy C. Public Concerns may feasor that his or her him conduct draw legal relationship public policy or her into a with another. concerns involved with 1253, Clinard, duty by imposing Dant v. on an men- T.S.B. institutionalized tally patient pas- (Ind.Ct.App.1990) charged disabled are the cause of (party being 1256 Supreme negligence knowledge must of situ sionate debate. The with have Wisconsin public policy has stated the concerns surrounding Court ation or circumstances relation as: ship). In extenuating the absence of circum

stances, relationship patient in between a by “where a loss must be borne one of two facility caregivers a health care persons, innocent it him shall be borne it, working facility in the is sufficient who occasioned it also held and has been legal duty. public policy which to base a requires the enforcement Nonetheless, principles precautions monitoring, releasing, fault scheme. utory negligence of contrib in reasonable applied have in been in cases warning patient physician his whom had volving negligence the determination of and the given immunizations which vaccinations and/or See, comparative e.g., determination of fault. patient caused to lose while driv- consciousness Dean, 247, (Ind.Ct. Walters v. 497 254 N.E.2d Farms, Pryor, ing). See Perdue Inc. v. 683 also 413, Kroger, App.1986); Ind.App. 177 379 239, (Ind.1997) (stating N.E.2d 241 determi- N.E.2d at 1010. legal duty may nation of three factors consider forth in Webb in other set addition to “various supreme recently 3. The court has stated that the Thus, factors.”). analytical a different frame- balancing "provides extremely Webb test use capacity work could be utilized which mental analysis, necessarily method of ful but not a fourth factor to be where is considered infirmi- test, determining exclusive of [a] the existence ty Howell, of the tortfeasor at issue. Our result under duty under Indiana law." Cram v. 680 1096, analysis 1997) (Ind. such an would be the same as that (holding 1097 n. 1 motion, 12(B)(6) using purposes which we reach the Webbv. Jarvis method- of Indiana Trial Rule physician duty persons ology. owed to to take third

447 liability in order that those interest- incredible to assert that a tortfeasor would person, in the estate of the ed insane as pretend insanity’ ‘simulate or pro- over a otherwise, may or in- relatives be under longed period of time and even be institu- him ducement restrain and that tort- being tionalized order to avoid held lia- may pretend feasors not simulate or insan- damages ble for for some future civil act.” ity wrongful causing to defend their acts (quoting Meyer). Id. recognized The court damage to others.” rejected that other courts “have the common Family v. Gould American Mut. Ins. law rule within the limited context of se 282, 198 Wis.2d 543 N.W.2d verely mentally persons disabled confined in (quoting Meyer’s Guardianship, In re public institutions based on similar policy (1935)). Wis. N.W. These (citing Mujica considerations.” Id. n. 7 v. public policy prompted considerations Wis- Turner, (Fla.Dist.Ct.App. So.2d general consin to subscribe to the rule 1991); Gant, (Fla. Anicet 580 So.2d 273 mentally responsible disabled adults are held Dist.Ct.App.1991)). regard for their torts without to their mental In addition to the Gould, considerations identified capacity. See 543 N.W.2d at 284-85 Florida, public Wisconsin and policy other (noting general adopted Meyer). rule On weigh against concerns both in favor of theory public that none of policy these imposing duty on an present institutionalized'men considerations are with an institu- tally hand, person. disabled mentally On one im patient tionalized disabled who can- posing conduct, mentally appreciate not control or institutionalized or her patients Supreme encourage the Wisconsin disabled will Court created a nar- individuáis exception general provide accept positions row to the seek and caregivers rule to “that a injuries ... because know their go institutionalized will not disability, uncompensated. Imposing and who does not have the on institu d or control his or her tionalized disable injuries conduct cannot be liable for equal application caused also make of the law diffi *6 employed caretakers who are for financial cult challenges because inherent Id., compensation.” at 287. See distinguishing N.W.2d those individuals who between Family also Burch v. American Mut. Ins. incapacity suffer a mental degree of such a 198 Wis.2d 543 N.W.2d legal duty imposed that a not be should (1996) (recognizing that Gould decision those individuals who suffer from a less se very “carves out a exception narrow for insti- upon vere emotional imbalance duty whom a mentally persons tutionalized disabled who imposed. hand, pub should be On the other appreciate are unable to control or the conse- policy by imposing duty lic is not served a on quences they injure of their conduct when mentally institutionalized disabled employed caretakers who are for financial who are to control their unable actions or compensation.”). justification The court’s for consequences know the thereof and also are creating exception was that the circum- liability coverage unable to obtain to insure stances of “totally negate the case the ratio- against addition, negligence. the risk of In place nale behind the rule and would an justification there is no rational for distin negligent unreasonable burden on the institu- guishing between children who are unable Gould, mentally tionalized disabled.” 543 appreciate danger impose whom we explained: N.W.2d at 287. The court duty incapacity resulting no because of person injures “When disabled age, knowledge, judgment, experience caretaker, employed an injured party appreciate and adults who are unable to dan reasonably can danger foresee the and is ger incapacity resulting because of from Al By not ‘innocent’ of the risk involved. zheimer’s or other dementia. placing mentally in an disabled factor, relationship setting, institution or similar Like the we restrictive con per- public policy implications ‘those interested in the estate’ of that clude that likely imposing son are not to be in on an need of institutionalized men greater inducement tally patient dependent upon restraint. It disabled are ability to control his on his incapacity. The and its effect patient’s degree of the impairment, degree of actions or understand patient’s greater weigh concerns fact public policy genuine issues of material the more the thereof are him for the rea- imposing against summary judgment. precluding set forth Gould. sons material fact genuine issues of Because degree of Rusk’s mental regarding the exist Application of Factors D. conduct, appreciate or his capacity to control to Present Case inappropriately en- summary judgment was us, before we Turning to the Record question of whether Rusk owed on the tered fact exist genuine issues of material hold that Creasy legal duty of care. impairment degree of Rusk’s concerning the Incurred Risk II. and, legal of a accordingly, the existence materials establish duty. designated also found that Rusk The trial court impairment of his some that Rusk suffered summary judgment because entitled to was admitted to BHC capacity. Rusk injuries. In the risk of her incurred memory loss and he suffered from because longer exists as an absolute curred risk no patient at BHC confusion. He had been light negligence claim defense to a years the incident with nearly three when comparative fault. adoption of Indiana’s history at BHC Creasy occurred. Rusk’s (Ind. Robey, Heck v. disorientation, anxiousness, demonstrated 1995). plaintiff’s risk-taking is a consid “[A] combativeness, belliger aggressiveness, and Comparative eration embodied Indiana’s ence. Fault Act and must be assessed thereunder.” however, Record, does not establish Steffen, 685 N.E.2d Johnson v. impairment or its effect degree Heck), of Rusk’s (Ind.Ct.App.1997) (discussing trans. ability his actions or under (1998).5 on his to control analyze Accordingly, we will denied consequences thereof. this re stand the by Creasy following any risk-taking that there gard, the trial court determined simply of fault allocation. We discussion pre of material fact genuine was no issue here that Rusk was not entitled state patient in an an Alzheimer’s “[a]s sented theory on the judgment as a matter law disease, Rusk stage of the Mr. advanced incurred risk. consequences of his unable to Record at 255. acts or control behavior.” III. Fault Allocation reveals that the Our review of the Record found that The trial court further only is the affida basis for this determination *7 summary judgment entitled to be Rusk was Ayres designated Rusk vit of Sharon which Creasy’s comparative fault exceeded all cause support summary judg of his motion proximately contributing to her other fault Ayres Practical Nurse. ment. is Licensed injuries. Generally, fault allocation under nothing setting forth There is her affidavit ques Comparative Fault Act is Indiana’s expert opinion qualifications her to render an Dean, tion for the trier of fact. Walters v. condition. as to Rusk’s medical Without (Ind.Ct.App.1986). 497 N.E.2d con qualifications, opinion her does not such Fault allocation be decided as a matter expert status of Rusk’s stitute an one only undisputed of law if the evidence is capacity.4 See Rule Ind.Evidence s 702(a) (witnes only reach one conclu the fact finder could qualified must be as an ex plaintiff To allocate fault to a as a skill, sion. Id. knowledge, experience, train pert “by risk, edueation[.]”). theory of incurred matter of law on opinion by ing, or Absent conclusively undisputed must evidence person qualified expert, as an the extent of plaintiff appreciated knew and resulting from Alzheimer’s show that Rusk’s dementia 34-4-33-2(a)(l) sufficiency Ayres’ fault include in- Although 5. IC defines 4. we decide the contents, solely we affidavit on the basis of its curred risk. practical nursing also note the definition diag- rendering not include the of medical does noses. Sec IC 25-23-1-1.3. SULLIVAN, J., danger negligence, caused a defendant’s concurs separate voluntarily accepted opinion. but nevertheless it. Inc.,

Lilge Repair, v. Russell’s Trailer1 FRIEDLANDER, J., dissents with (Ind.Ct.App.1991). 1150-5 separate opinion. plaintiff must have had more than a general potential mishap; awareness of a SULLIVAN-,'Judge, concurring. had,actual knowledge she must have of the subject I concur to a respect caveat with specific risk. Id. 1151. Under the Com majority dissenting opinions’ analysis Act, parative Creasy preclud Fault would be “duty”. recovering if ed from Rusk the amount of fault greater, to her was than attributed Dickson, speaking Justice for the court in the fault attributed to Rusk. See IC 34-4-33- Co., Gariup Construction Inc. v. Foster 4(a). (1988) Ind., 1224, 1227, 519 N.E.2d noted that duty determination is made “not without Here, Creasy was familiar with car and, difficulty”, in quoting from a well-re ing patients, including for Alzheimer’s Rusk. “ treatise, garded concluded that better ‘[n]o She was aware that Rusk from Al suffered general statement can be made than that the very agitat zheimer’s and knew that he was where, duty courts will find a in general, ed evening and combative on the that she persons reasonable recognize would it and injured. say We cannot as a matter of agree Tidmarsh, Jay it exists.’” See law, however, that undisputed these facts , Tort Languages Duty Law: The 25 Ind. only Creasy’s lead to the conclusion that fault (1992). L.Rev. 1419 greater than Rusk’s. Such a determina reason, It is for perhaps, that we have tion is best left to the finder of fact. Rusk past' in the principié articulated the that: judgment was not entitled to as a matter of imposes law on the basis that fault was “The Law but one common law comparatively greater duty duty than Rusk’s. and that is to use due care

(citation omitted). is the same relations, for all regard without to the facts IV. Breach of the case.” South Eastern Indiana Nat finally The trial court found that ural Ingram Gas Inc. v. 1st Rusk was summary judgment entitled to be Ind.App., Dist. Creasy bring cause did not forth evidence a.-corollary As premise to this we have that Rusk breached owed to her. said: required was not to do so. Under standard, Indiana’s judgment “the “[T]he substantive' law establishes party séeking summary judgment must dem met, i.e., standard care which must be any genuine onstrate the absence of issue of care. The reasonable standard is a fixed issue, fact as to a only determinative independent one and is of the conduct of then is required the non-movant to come but required others the conduct contrary forward with evidence.” Goldsber up individual to measure to the fixed stan *8 ry, (quoting 672 N.E.2d at 481 Jarboe v. depending upon dard varies the nature of Community Newspapers, Landmark duty the owed surrounding and the cir (Ind.1994)). N.E.2d The Record cumstances.” Foley Walters Kellam & Rusk, (1977) here does not party Dist., show that as the 2d 172 Ind.App, seeking summary judgment, demonstrated any genuine the absence of fact on issue of short, duty the is that of reasonable the issue of breach. Absent such demonstra care under the circumstances. That tion, Creasy required was not to come forth changes. always never It although exists evidence to establish breach. Rusk may circumstances differ from case to case. judgment was not entitled to aas matter of same, While the remains the con- law on the breach element of claim. required may duct to meet that standard be by

Reversed. capacity. affected tbe actor’s mental It is patient will creasing that the be the chances agree that I for this reason institutionalized”). inappropriate and judgment was the trier of matter should be submitted to person whether a We are asked to decide fact for determination.6 Alzheimer’s is with advanced institutionalized injures in if out and a liable tort he strikes FRIEDLANDER, dissenting. Judge, employed by institution. I caretaker in such readily acknowledge that some cases in I that the trial court was correct believe this, summary inappro- judgment be as Rusk summary judgment favor of granting question a material of fact priate because respectfully from the and therefore dissent concerning whether the defendant’s exists contrary. holding to majority’s stage has advanced to Alzheimer’s disease indicates, majority we are confront- As the patient-defendant has no where the of first im- ed in this case with his violent behavior. to or control decided pression in Indiana. The issues believe, however, that this is such a I do not heightened practical and so- herein take on case. because, unfortunately, Al- importance cial initially admitted to the Breth- Rusk was study is not rare. One zheimer’s disease (BHC) Healthcare Center because ren of prevalence of Alzheimer’s disease shows him confused Alzheimer’s condition rendered increasing age group, to 74 3% the 65 memory to such an suffering and loss range, high as in the 75 to 84 and as 18.7% longer care for extent that his wife could no Evans, range. D. et 47% in the 85 and over By May when sustained him. al, Alzheimer’s Disease in Prevalence of injuries, at her Rusk had been resident Persons, Community Population Older years. During BHC for more than three Assoc. 262 Journal of the American Medical time, continued the Alzheimer’s disease (1989). It can be inferred that as the occurrence, progress. By the time of the increases, will average age of Americans so by aggressiveness, his condition was marked the incidence of Alzheimer’s disease. Office belligerence, and violent behavior directed at Assessment, Losing Million Technology others. All of these behaviors are character- Confronting Tragedy Al- Minds: stage istic of a the advanced zheimer’s Disease and other Dementias Alzheimer’s.7 (Pub. OTA-BA324). Many those who No. Ayres practical a licensed develop require institutionali- Sharon the disease will (while employed at BHC. At the time of the at 76-27 some retain nurse See id. zation. occurrence, Ayres had worked BHC personality their normal traits as the disease Ayres changes approximately years. nine submitted progresses, “others exhibit drastic serious, stating that Rusk was in the complex management an affidavit that can create physicians, stage in- of Alzheimer’s and was there- problems caregivers and advanced aside, Generally, changes displayed. that are would also note that the trial ioral 6. As an I recognized stages used the term "incurred risk” to describe there are four of Alzheimer's— warranting summary judgment middle, advanced, the doctrine early, and terminal'—-which respective parties in their disorientation, the arguments. use same term by worsening are marked levels of It is not uncommon for the terms failure, deterioration, memory intellectual "incurred risk” and "assumed risk” to be used personality change. Neurological impairment interchangeably little, reported There is decisions. apparent in the advanced and terminal becomes any, practical applica in the if difference stage, stages advanced illness. In the principle contained within the doc tion (1) dependence symptoms on others for include: However, is the trines. the term "assumed risk” (such food, daily requirements life shel relating appropriate the defense term describe ter, (2) protection); responses verbal have exposed to a risk to a claim made one who is asked; inabili little correlation to what is City (cid:127)arising relationship. within a contractual o *9 ty by needs other than resort to to communicate f (1990) Ind.App., v. Allen 552 N.E.2 Alexandria d noisiness, yelling, and caustic behavior such as out; likely striking such behavior is also to occur Russ, any relationship to needs. Lee R. without progressive illness that has 7. Alzheimer's is McQuade, Freeman, Stanley & J. Attor pro- Bruce F. stages according to the been divided into 76.12(1994). neys § gression Medical Advisor clinical and behav- of the characteristic (1) appreciate consequences fore unable to the of Whether the defendant committed a rejects majority Ayres’s wrong kicking, his actions. The twisting, pulling back; Ms. ground leg statement on the left there is noth- ing qualifying in her affidavit her as an ex- (2) Whether the defendant of is relieved pert testimony. witness to offer such I dis- responsibility for his actions because of agree with this conclusion. have; deficiency might that he (3) percentage The defendant’s of fault for provides Ind. Evidence Rule 702 that a causing injuries by the sustained the qualified by witness be an expert as plaintiff; skill, “knowledge, experience, virtue of train (4) plaintiff Whether incurred the risk of ing, Any or education.” one characteristic conduct, wrongful and, defendant’s if may qualify alone expert. an individual as an so, percentage her of fault for incur- State, Fleener v. (Ind.Ct.App. 648 N.E.2d 652 risk; ring the 1995), part vacated in grounds, on other grounds, on all other 656 N.E.2d 1140 plaintiff Whether committed con- affd. (Ind.1995). Therefore, person may and, qualify tributory so, negligence per- if her expert as an practical experi centage on the basis of of contributory fault for her negligence; Napier, ence alone. Fowler v. (Ind.Ct.App.1996). question (6) The plain- total amount of damages the person qualifies

whether a expert as an rests tiff would be entitled to if recover fault (cid:127) within the sound discretion of the trial court. disregarded. were Id. (Creasy’s Record at 188 Designation of Gen- uine Issues Material Fact That Preclude Ayres’s affidavit states that she is a li- Entry Summary Judgment on Defen- nurse, practical censed signifying that she Motion). view, my dant’s In designation the had at training necessary least the medical of issues Creasy reflects that did not chal- obtain that importantly, license. More the lenge regarding the assertion the advanced Ayres affidavit states that had worked condition, nature of Rusk’s and does not do years BHC for nine at the time upon Rather, appeal. so now Creasy’s argu- injured. view, my In practical experi- the ments both in opposing summary judg- the gained through ence working with Alzheim- ment motion and in appealing ruling the* er’s on a basis for nine regular thereon assumed -as true the assertion that years, specifically through working with incapable Rusk’s condition him rendered Rusk on years, occasion for three qualified understanding consequences the of his ac- Ayres expert an purpose for the of ren- tions. dering opinion regarding whether Rusk level, At the trial parties focused stage the advanced of Alzheimer’s and arguments upon their question and the whether appreciate he was able to the conse- trial court judgment upon rendered quences of his actions. Again upon this basis. appeal, parties significant It is also degree to me that the argument have their concentrated disability placed of Rusk’s was never at issue question of whether a with advanced by Creasy. sought summary judgment Rusk paid Alzheimer’s can be liable in tort to his on the basis that Alzheimer’s disease ren- while, parties caretakers. All the have incapable him appreciating dered the con- question treated the of whether Al- Rusk’s sequences Ayres’s of his supporting actions. zheimer’s him incapable appreci- rendered prove affidavit both asserted and tended to ating consequences of his actions as if it stage Rusk was Al- advanced issue-they were not an háve assumed that it zheimer’s and was unable to I majority did. believe the errs charac- response of his action. terizing as a of fact a matter motion, Creasy Rusk’s designated genu- six parties regarded have as settled. There- precluded fore, ine issues of material fact that my analysis proceeds upon assump- summary judgment, including: tion that Rusk’s- him Alzheimer’s rendered

452 may in cases such policy considerations the

incapable appreciating public pol- liability. The preclude sometimes his actions. (1) in include: icy concerns identified Gould decide, view, my in is left for us to What parties to innocent third providing recourse person in the law: Is a pure question of (2) acts; person’s by the disabled harmed liable in tort stage of Alzheimer’s advanced responsible for providing incentive for those injure paid caretakers that for his actions person to shield others mentally disabled majority facility? the special care As in a by the disabil- that be caused from harm recently indicates, jurisdictions have several (3) possibility faking obviating the ity; and In each precisely the same issue. addressed escape liability. civil disability to a mental cases, concluded the court of those recent view, counsel my the same concerns In because, liable patient was not that the liability in the instant case. against imposing not owe things, patient the did among other duty to refrain from caregiver a regarded as an fairly be cannot v. No injury-inflicting conduct. See Colman public, as that “innocent” member of Home, Inc., 968 tre Dame Convalescent Creasy had in this context. term is used (D.Conn.1997) (predicting Con F.Supp. 809 in knowledge dangers inherent express Marshall, law); Herrle v. Estate necticut general in Alzheimer’s dealing with 1761, Cal.Rptr.2d 713 Cal.App.4th 53 45 fact, Creasy In particular. in and with Rusk (Fla. Turner, (1996); 24 Mujica v. 582 So.2d attended Rusk and was aware before she denied; Anicet v. Dist.Ct.App.1991), review “very agitated injured he had been that Gant, (Fla.Dist.Ct.App.1991), So.2d 273 228, evening”, that Record combative denied; Family American Gould v. review kicking wildly imme- hitting that he 450, Co., 543 N.W.2d Mut. Ins. 198 Wis.2d Holding Rusk diately before the incident. (1996); Almy, 297 but see McGuire negligence under those cir- accountable (1937) 323, (imposing N.E.2d 760 Mass. “places great too a burden on cumstances liability person for intentional on insane potential him because his disorientation and Cook, 88, torts); App.Div. Vooren v. Van very reason he was institu- for violence is (imposing civil 75 N.Y.S.2d employed aid of tionalized and needed the liability “suffering from a defective on one Gould, at 287. 543 N.W.2d caretakers.” battery). agree I reasoning” for assault and Mey- upon which the The second rationale cases, reasoning in those ex with the basic provides premised is that it incen- er rule is aspects opinions that cept certain of those for mentally responsible for those dis- tive below, fully and would explained will be more him. In the instant abled to restrain Rusk was entitled to hold that case, family placed long-term him in a Rusk’s duty. judgment lack of staffed, and facility equipped, care which was brief, appellate Creasy points out her As others, for, among Alzheim- intended to care juris- American widely accepted it is in most exhibiting patients, including those vio- er’s mentally are that disabled adults dictions every- doing, they In did lent behavior. so objective person stan- to an reasonable held I thing they to restrain Rusk and could do responsible for thereby dard and are deemed further, humane restraint cannot conceive of they regardless of their torts commit In circum- sought. have that could comprehend their actions. See capacity to stance, obviously to do more is not incentive Family Mut. Ins. v. American Gould a valid consideration. 450, 543 N.W.2d 282. Based 198 Wis.2d Meyer final reason for the rule is to Meyer’s Guardianship, 218 Wis. re (1935), simulating insanity prevent persons from 261 N.W. Gould liability against civil for their Meyer order to defend to this as “the rule”. court referred As the court stated about acknowledged general torts. Gould Gould case, in that disabled civil defendant liability, that rule of defendant would ‘sim- negli- suggest defendant] negligent, “[t]o [the that said case had been symptoms Alzheim- injuries. pretend’ the plaintiffs ulate or gence was a cause of the concluded, however, period years in order to public er’s over a disease The court *11 liability avoid future tort persons incredible.” caused to employed by who are Gould, 543 N.W.2d at 287. institution to care for patients. Alzheimer’s

I disagree majority’s do not with the con- public policy

clusion that require concerns degree patient’s

consideration of the

impairment deciding when

duty. majority’s opinion, however, cre- (“[t]he sliding greater

ates a pa- scale degree impairment,

tient’s the more the public policy weigh against impos- concerns SQUARE, Subsidiary BUILDERS ing duty on him for the reasons set forth Kmart, Kmart, Corporation, 448) Gould”, Op. arguably at renders Appellants-Defendants, summary judgment practically. unavailable assigns because it the determination of the v. degree impairment exclusively to Daryle HAINES, Appellee-Plaintiff. agree I gen- factfinder. While with the eral rule that persons disabled are No. 45A03-9710-CV-364. ordinarily responsible torts, their it apply should not where “circumstances total- Appeals Court of of Indiana. ly negate the rationale behind the rule.” Gould, view, at In my N.W.2d 287. June patient injuring institutionalized Alzheimer’s compensated, trained caretaker is one set negates liability circumstances that and is

appropriate summary disposition.

Finally, reject I Creasy’s argument

Gould, Herrle, Anicet, along with Muji

ca, persuasive are not in Indiana because principles contravene announced our

supreme Robey, court Heck v. (Ind.1995). Creasy contends that

Gould court relied on primary the doctrine of

assumption of the risk expansion and an My

the fireman’s rule. depen view is not upon

dent portions of Gould that refer to fact,

those doctrines. I do not consider

primary assumption of the risk or the fire

man’s rule to the extent principles those

consider the plaintiff conduct of the which

bars reliance an otherwise existing tort.

Rather, Gant, as did the court in Anicet 277,1 So.2d “conclude that no

refrain from violent conduct arises on the

part of a capacity who has no

control it to specifically employed one who is just (Emphasis do that.” original.) that,

In summary, I would hold as a matter public policy, person sound institutional-

ized because of Alzheimer’s who does not

have the to control or

or her injuries conduct cannot be liable for

Case Details

Case Name: Creasy v. Rusk
Court Name: Indiana Court of Appeals
Date Published: Jun 29, 1998
Citation: 696 N.E.2d 442
Docket Number: 08A02-9709-CV-604
Court Abbreviation: Ind. Ct. App.
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