OPINION
Case Summary and Issues
Elwood and Lila Simmons appeal following a judgment awarding them each
Facts and Procedural History
On April 28, 2001, Elwood was involved in an automobile accident with a second vehicle driven by Billie Jo Wilcox. Neither party disputes that Wilcox was 100 percent at fault for this accident. Wilcox had insurance with a bodily injury coverage limit of $50,000, and Wilcox’s insurer paid this full amount to Elwood. At the time of the accident, the Simmonses held an automobile insurance pоlicy with Erie. This policy included underinsured motorist bodily injury protection.
Shortly after the accident, Elwood sought treatment from Dr. David Gurvis, who diagnosed Elwood with plantar fasciit-is, an ailment causing Elwood pain in his right foot. Dr. Gurvis treated Elwood with anti-inflammatory medicine, foot or-thotics, and finally cortisteroid injections. These injections temporarily relieved Elwood’s pain, but did not provide permanent relief. Dr. Gurvis administered the second and final injection on December 12, 2001.
At some point, Elwood began walking with his right foot turned out in order to avoid putting pressure on the sore parts of his foot. The doctors who testified in this case referred to this walking style as a “learned gait.”
In January 2002 Elwood sought treatment from Dr. Karl Raynor. Dr. Raynor treated Elwoоd with oral prednisone, a cast, and a walking boot. Elwood testified that after he was in a cast for four to six weeks, his foot “got better.” Transcript at 129. In September 2002, Elwood saw Dr. Michael Kramer in relation to hip pain. Dr. Kramer prescribed physical therapy. Elwood did not see Dr. Kramer again until June 2004, when he reported “knee popping” in his right knee. Dr. Kramer examined him and determined that the knee condition was not related to Elwood’s gait.
In July 2002, Dr. Raynor referred Elwood to Dr. Theodore Nukes, a neurologist. Dr. Nukes diagnosed Elwood with peripheral neuropathy, which causes, among other things, numbness or tingling in the legs and feet. Dr. Nukes indicated that the pain from Elwood’s plantar fasciit-is was unrelated to his symptoms from his peripheral neuropathy, as “they’re two very separate conditions with separate pathologies.” Tr. at 351. Elwood saw another neurologist, Dr. James Cook, who also diagnosed Elwood with peripheral neuropathy. Neither doctor had any reason to believe that Elwood’s neuropathy was connected to the accident.
Elwood testified that as a result of his injury, he was required to close the business in which he was a fifty-percent owner because he couldn’t “carry [his] load.”
Id.
at 138. He also testified that prior to his injury he had been extensively involved in the raising, training, and showing of dogs, but that he was unable to do so now. The Simmonses both testified that they began caring for a relative’s two children in 2000. These children have speciаl needs and require continuous care and attention. El
On March 23, 2004, the Simmonses filed their complaint seeking underinsured motorist insurance benefits from Erie. Elwood sought compensation for damages suffered as a result of his injuries and Lila sought damages for loss of services and consortium.
Before trial, in 2006, Elwood returned to Dr. Gurvis so that Dr. Gurvis could “evaluate [Elwood] for [Dr. Gurvis’s] deposition.” Id. at 181. Elwood reported that he had undergone various treatment plans with other physicians and “has had enough.” Id. at 181. Dr. Gurvis stated that Elwood was “[frustrated with being in pain for that long and apparently he’s seen other doctors. Nothing has helped so he figures he’s just going to have to live with it.” Id. Dr. Gurvis testified that surgery or shock therapy could provide Elwood relief, but did not state that he informed Elwood of these treatment options.
On June 7, 2004, a jury trial was scheduled for February 23, 2005. Over the next two years, the trial was continued nine times; three times on Erie’s motion, three times on the Simmonses’ motion, one time by joint motion, and two times on the court’s own initiative. The last motion to continue set the trial for August 29, 2007. On August 8, 2007, the Simmonses’ counsel received a report from Dr. Thomas Am-brose, whom Elwood consulted on June 11, 2007. Dr. Ambrose’s report indicated that Elwood may need a partial or complete knee replacement, but that further testing was required to determine the course of treatment. On August 9, 2007, the Sim-monses gave this report to Erie, and inquired whether thе parties should attempt to depose Dr. Ambrose or continue the trial. On August 10 Erie responded with a motion to bar expert testimony. The trial court granted this motion on August 13. On August 16, the Simmonses filed a motion to continue. On August 17, the trial court denied this motion, stating: “The Court denies the Plaintiffs Motion for Continuance as this case has been continued nine (9) times.” Appellant’s Appendix at 151. The trial court subsequently denied the Simmonses’ motion to reconsider and oral request for a continuance on the day of trial.
On the second day of trial, Erie tendered a proposed instruction on the affirmative defense of failure to mitigate damages. Erie had not raised this defense in the pleadings or included an instruction on the affirmative defense in its tendеred preliminary instructions. The Simmonses objected, but the trial court ultimately read the following instruction to the jury:
The plaintiff must use reasonable care to minimize his damages. This is called mitigation of damages.
If you find the plaintiff failed to use reasonable care to minimize any of the damages he alleges he sustained and that failure was the proximate cause of any of the damages he claims, then such conduct would reduce the amount of damages that the plaintiff would otherwise recover.
The defendant has the burden of proving by a preponderance of the evidence that the plaintiff failed to use reasonable care to minimize his damages.
Tr. at 404-05. The jury returned a verdict awarding $10,000 each to Elwood and Lila, and the trial court reduced these verdicts to judgments. On September 13, 2007, Erie filed a Request for Nunc Pro Tunc Entry, requesting that Erie be permitted to set off the $50,000 previously received by the Simmonses from Wilcox’s insurance company. The trial court granted this motion and issued an order stating that the Simmonses were not entitled to any pay
Discussion and Decision 2
I. Standard of Review 3
When we review a trial court’s decision to give or refuse a tendered instruction, we consider whether: “1) the instruction correctly states the law; 2) the evidence in the record supports giving the instruction, and 3) the substance of the instruction is covered by other instructions.”
Hoosier Ins. Co. v. N.S. Trucking Supplies, Inc.,
II. Failure to Mitigate Damages
“The principle of mitigation of damages addresses conduct by an injured party that aggravates or increase the party’s injuries.”
Willis v. Westerfield,
Erie argues that Elwood failed to mitigate damages due to his failure to undergo surgery to treat his plantar fasci-itis, his learned gait, and his alleged failure to regularly use his medications and or-thotics. We will address each in turn. 5
A. Surgery
The duty of one injured because of another’s fault to submit to invasive treatment has caused courts some trouble.
Since all surgery involves a more or less violent assault on the organism, it seems, superficially at least, somewhat incongruous to say to one who has been injured by another’s fault that he must suffer an additional invasion of his physical integrity in order to protect the wrongdoer from the full consequences of the wrong. On the other hand, it seems unfair and socially undesirable to permit, or even encourage, the tort victim to voluntarily extend or aggravate his pain or disability, and so enhance his damages, when surgery could readily correct the situation.
Indiana courts have not had the opportunity to address a plaintiffs duty to submit to surgery in almost a century. In
Suelzer v. Carpenter,
The law lays down no hard and fast rule as to the duty of the plaintiff under such circumstances. Whether an operation for his ailment, which might endanger his life in any degree, must be submitted to, is a question which the law cannot answer, nor does it lie in the mouth of a jury to say that the plaintiff should or should not do any particular thing. They are concerned simply with the affairs presented to them at the trial, and whether the damages then appearing to exist are the natural and probable result of the injuries diminished by the efforts for a cure which a reasonably prudent man would have made.
Haskell & Barker Car Co. v. Trzop,
Initially, we note that no evidence indicatеs that any doctor ever advised Elwood to submit to surgery. Dr. Gurvis testified that when he saw Elwood in 2006, he did not “prescribe any care or treatment.” Tr. at 180. Dr. Gurvis testified that Elwood seemed “[f]rustrated with being in pain for that long,” and told Dr. Gurvis “he has had enough ... [b]efore [Dr. Gurvis] could even offer treatment.”
Id.
at 181. Further, it appears that the purpose of Elwood seeing Dr. Gurvis at this appointment was “so that [Dr. Gurvis] would be aware of what his condition was for this deposition,” and that Elwood was not there “for care or treatment.”
Id.
Thus, it appears that not only did Dr. Gurvis not recommend surgery at this appointment, Elwood does not appear to have been at this appointment for further treatment. Indeed, he had not seen Dr. Gurvis in over three years. Elwood had a duty to seek medical advice regarding his injury, and he did seek such advice from several doctors. However, he did not have a duty to undergo surgery that was never prescribed, or even recommended. Not only did Dr. Gurvis not prescribe surgery, he was not even Elwood’s treating physician at the time of the 2006 meeting.
Cf. Lake v. Gautreaux,
Further, little evidence exists in the record regarding the surgery described by Dr. Gurvis. Dr. Gurvis did testify that surgery’s success rate “runs between ninety and ninety-five percent.” Tr. at 193. Dr. Gurvis also testified that this procedure “has all the risks attendant to surgery.” Id. However, no testimony or other evidence exists as to what risks these might be. Although we might surmise that the risks involved in this foot surgery are less serious than other types of surgery, it is not this court’s province to supplement the record with our speculations or personal knowledge. Instead, we must take the record as presented. In its present state, the record tells us nothing (and in turn told the jury nothing) about the risks involved in the surgery described by Dr. Gurvis. Without this information, we fail to see how a trier of fact could properly determine whether a decision to decline such a surgery was reasonable.
Also lacking from the record is any evidence regarding the cost,
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pain, or inconvenience associated with the surgery. Although we find no need to adopt a rule relating to the cost or inconvenience caused by surgery, we note that this information is clearly relevant to a determination of the reasonableness of a decision to forego surgery.
See Dubroc v. Swain,
Based on the circumstances at bar—1) no doctor recommended surgery to Elwood; 2) Elwood saw several doctors, who prescribed a variety of treatments other than surgery; and 3) Erie’s failure to introduce evidence regarding the risks, benefits, costs, or inconveniences of the surgery—we conclude Elwood’s failure to undergo surgery is insufficient to support an instruction on failure to mitigatе damages.
B. Elwood’s Gait
Erie also argues that the instruction on failure to mitigate damages was supported by evidence relating to Elwood’s “learned gait.” Although Erie attempts to paint Elwood’s gait as some sort of voluntary choice, it is clear that Elwood has developed this gait as a direct result of his plantar fasciitis. See Tr. 183 (Dr. Gurvis agreeing that patients with plantar fasciitis commonly develop learned gaits); id. at 199 (Dr. Gurvis testifying “that [Elwood] has altered his gait pattern even more in a learned fashion to try to avoid walking on the painful area of the heel”); id. at 200 (Dr. Gurvis testifying “What’s happening in his case, which happens to anybody who gets it once it starts, let’s just say there’s the arch and this is the heel bone back here. This ligament, called the plantar fascia, is going to run from the heel bone out to the front of the foot. And this is also why he’s learned a new gait pattern.”); id. at 111 (Elwood testifying that he could walk straight “but it puts a lot of pressure in the back area”). As Dr. Gur-vis testified, “If something hurts long enough, you start walking funny to avoid walking on the sore spot and you start changing your foot around and walk differently.” Id. at 180.' Although we need not decide the issue on this point, we question whether a reasonable juror could find that the “decision” to walk so as to avoid pain is unreasonable. Also, the record indicates that Elwood attended physical therapy at the instruction of Dr. Kramer to “unl-earnt ] that gait behavior,” id. at 307, indicating the involuntary nature of the gait.
Regardless of whether Elwood’s gait can be described as a “decision,” much less an unreasonable one, Elwood’s gait cannot support the failure to mitigate instruction because of the lack of evidence that this gait caused Elwood to suffer an identifiable harm not caused by Wilcox’s negligent conduct.
Erie argues that the newly discovered injury to Elwood’s knee is the identifiable harm caused by Elwood’s failure to act reasonably. However, the Simmonses are not asking for damages related to Elwood’s potential knee surgery. Indeed, the Simmonses other argument on appeal is that the trial court abused its discretion in denying their motion for a continuance to allow them to establish a foundation for Dr. Ambrose’s testimony regarding Elwood’s knee condition. As the Simmonses were prevented from establishing damages relating to Elwood’s knee condition,
8
we
Based on these considerations we conclude the trial court’s instruction on failure to mitigate damages cannot be supported by the evidence introduced at trial relating to Elwood’s learned gait.
C. Alleged Failure to Regularly Use Medications and Orthotics
Erie also argues that the instruction was supported because: “Dr. Raynor testified that Elwood did well when using his medications and orthotics, yet Elwood did not do so regularly, as evidenced by his comments to both doctors Gurvis and Ray-nоr.” Appellee’s Br. at 17.
9
This statement is the sole reference Erie makes in its argument section to Elwood’s alleged failure to use medications and orthotics. Erie does not cite to any legal authority indicating that Elwood’s alleged failure to regularly use his medications and orthotics would support a jury instruction on failure to mitigate damages. Erie also fails to cite to evidence indicating that these alleged failures have aggravated or increased his injuries.
See Nelson v. Maryland,
We conclude the trial court’s instruction on failure to mitigate damages cannot be supported by Elwood’s alleged failure to regularly take his medications or wear or-thotics, without more evidence in the record.
III. Harmless Error
A review of Indiana case law regarding harmless error analysis in the context of erroneous jury instructions reveals a somewhat inconsistent approach to the issue.
See Forbes v. Walgreen Co.,
This rule is consistent with our supreme court’s statement that “[a]n erroneous instruction merits reversal if it
could have
formed the basis for the jury’s verdict.”
Fleetwood Enters., Inc. v. Progressive N. Ins. Co.,
However, our supreme court has also used language contradicting the traditional rule. Our supreme court recently stated that “one seeking a new trial on the basis of an improper jury instruction must show ‘a reasonable probability that substantial rights of the comрlaining party have been adversely affected.’ ”
Elmer Buchta Trucking, Inc. v. Stanley,
In this case, we need not resolve the conflict as to the proper standard under which we analyze whether an improper instruction necessitates reversal, as we conclude that the giving of the instruction in this case is prejudicial and requires reversal under any of the standards identified above.
See Planned Parenthood of Idaho, Inc. v. Wasden,
A survey of Indiana cases dealing with erroneous jury instructions on failure to mitigate damages reveals that remand for a new trial is the proper remedy unless the record clearly demonstrates that the instruction did not prejudice the plaintiff.
See Willis,
Here, as thе jury instruction did not indicate whether the jury reduced the award based on a theory of failure to mitigate damages, we have no way of knowing whether the jury was improperly influenced by the erroneous instruction.
See Cahoon v. Cummings,
Under these conditions, we conclude that the trial court’s erroneous instruction was not harmless error. Therefore we must remand for a new trial.
Conclusion
We conclude the trial court abused its discretion in instructing the jury on the affirmative defense of failure to mitigate damages. We also conclude that this error was not harmless and therefore reverse and remand for a new trial.
Reversed and remanded.
Notes
. The Simmonses also argue that the trial court abused its discretion in denying their motion for a continuance prior to trial. As our resolution of the jury instruction issue requires that we remand for a new trial, we need not address the trial court’s refusal to grant a continuance.
.In its appellate brief, Erie makes numerous references to the record without citation.
See
Appellee’s Br. at 11, 13, 14, 15, 16, 17, 18, 21, 25. We admonish Erie's counsel to support its factual statements with citation to the record.
See Gates v. Caterpillar, Inc.,
. The Simmonses also argue the trial court abused its discretion in giving this instruction because Erie waived the affirmative defense by failing to plead it or otherwise give notice that it was raising the defense until it tendered its jury instruction on the second day of trial. Because we conclude insufficient evidence supports the instruction, we need not address this issue.
. If a party argues that a jury instruction incorrectly states the law, our review is de novo.
See Schumm v. State,
. We note that Erie notes Elwood’s refusal to undergo a spinal tap. However, this spinal tap was recommended in relation to treatment for Elwood’s peripheral neuropathy. The Simmonses specifically indicated that they were not seeking damages for anything related to peripheral neuropathy. Indeed, one of the central themes at trial was discussion over whether certain ailments were symptoms caused by plantar fasciitis (therefore caused by the accident) or symptoms of peripheral neuropathy (therefore not a result of the accident). Therefore, even if Elwood’s refusal to undergo a spinal tap could have constituted a failure to mitigate damages caused by his peripheral neuropathy, as the Simmonses did not claim damages based on his peripheral neuropathy, this refusal could not constitute evidence supporting an instruction on failure to mitigate damages caused by the accident.
. One decisiоn of the Illinois court of appeals has held that "while a patient has a duty to accept reasonable medical treatment, there is no duty to undergo surgery to mitigate the damages caused by a tortfeasor’s negligence.”
Hall v. Dumitru,
. We note that had Elwood elected to undergo surgery, and it was determined that such a decision was reasonably necessary, he would have been entitled to recover from Erie the costs of the surgery.
See Sheffet v. County of Los Angeles,
. We recognize that Dr. Gurvis mentioned that Elwood was “being worked up for a possible, either a total or a hemi knee replacement, on that side which is probably attributable to his learned gait pattern, which in turn, has worn down his knee. That’s a big change.” Tr. at 199. However, no evidence was introduced regarding the cost of this sur
. Erie does not support this factual allegation with any citation to the record. This statement in its brief is illustrative of Erie’s failure, throughout its argument section, to tie its arguments to the record. See supra, note 2.
.We note that this court questioned the strength of presumption of prejudice after the 1970 adoption of Indiana’s trial rules, stating that "[r]ecent cases exploring the effect of an erroneous instruction have not stressed a presumption of prejudice, but instead have asked if the appellant was really prejudiced by the instruction and whether the jury was misled.”
Old Town Dev. Co. v. Langford,
. We note that Morgen was decided after Stanley and Peak.
.
Calvary Temple Church, Inc. v. Paino,
.
Joseph E. Seagram & Sons Inc. v. Willis,
