Court of Appeals of Indiana | Opinion 22A-CT-2585 | June 19, 2023 Page 1 of 15

ATTORNEYS FOR APPELLANT

Rodney L. Scott

John R. Hofmann

Waters Tyler Hofmann & Scott, LLC

New Albany, Indiana

ATTORNEYS FOR APPELLEE

D. Tysen Smith, II

Morgan & Morgan

Louisville, Kentucky

Amicus Curiae

Jerry Garau

Garau Germano, P.C.

Indiana Trial Lawyers

Indianapolis, Indiana

IN THE

COURT OF APPEALS OF INDIANA

Baptist Health Medical Group, 

Inc., 

Appellant-Defendant,

v. 

Carla Wellman, Individually and 

as Surviving Spouse of David 

Wellman, Deceased, 

Appellee-Plaintiff. 

June 19, 2023

Court of Appeals Case No. 22ACT-2585 

Appeal from the Floyd Superior 

Court

The Honorable Maria D. Granger, 

Judge

Trial Court Cause No.

22D03-2108-CT-1055 

Opinion by Judge Riley 

Chief Judge Altice and Judge Pyle concur.

Riley, Judge. 
Court of Appeals of Indiana | Opinion 22A-CT-2585 | June 19, 2023 Page 2 of 15

STATEMENT OF THE CASE

[1] Appellant-Defendant, Baptist Health Medical Group, Inc. (Baptist Health), 

appeals the trial court’s partial summary judgment in favor of AppelleePlaintiff, Carla Wellman, Individually and as Surviving Spouse of David 

Wellman, Deceased (Wellman), on Wellman’s Complaint of medical 

malpractice arising from medical care provided by Baptist Health to David 

Wellman (David).1

 

[2] We reverse and remand.

ISSUE

[3] Baptist Health presents this court with one issue on appeal, which we restate as: 

Whether the designated evidence regarding the physician’s standard of care 

provided to David created a genuine issue of material fact precluding partial 

summary judgment. 

FACTS AND PROCEDURAL HISTORY

[4] This is a malpractice action involving the August 2017 medical treatment of 

David by multiple providers employed by Baptist Health for a complex 

presentation of health issues, including weight-related cardiac problems, 

respiratory issues, heart disease, congestive heart failure, obstructive sleep 

apnea, hyperlipidemia, hypertension, morbid obesity, COPD, and diabetes. 

1 The Indiana Trial Lawyers Association appeared as amicus in support of Wellman.
Court of Appeals of Indiana | Opinion 22A-CT-2585 | June 19, 2023 Page 3 of 15

Previously, in 2011, David had received a mitral valve replacement after 

contracting sepsis and pneumonia. Upon arrival at Baptist Health’s emergency 

room on August 22, 2017, David was lethargic and unable to communicate. 

Due to respiratory failure, he was immediately placed on a ventilator. Multiple 

specialists employed by Baptist Health consulted on his care, including the 

emergency room physician, hospitalists, cardiologists, pulmonary, and 

infectious disease doctors. Srinivas Manchikalapudi, M.D. (Dr. Manchi)2

consulted on David’s cardiac issues due to the risk of endocarditis from the 

mechanical mitral valve. 

[5] After David was admitted, Dr. Manchi performed a transesophageal 

echocardiogram (TEE) and noted that although it was a “technically difficult 

study,” he did not believe evidence of vegetation or endocarditis was present. 

(Appellant’s App. Vol. II, p. 65). Dr. Manchi prescribed continued medical 

therapy including antibiotics. David’s condition improved in the days 

following the TEE. The ventilator was removed and a possible discharge from 

the hospital was discussed. However, David suffered a brain bleed and his anticoagulant medication had to be reversed. He was subsequently transferred to 

the University of Louisville Hospital where physicians conducted further 

testing, including an additional TEE which indicated several lesions on the 

2 As the parties refer to Dr. Manchikalapudi by a shortened version of his name, we will do likewise. 
Court of Appeals of Indiana | Opinion 22A-CT-2585 | June 19, 2023 Page 4 of 15

mitral valve and which were believed to be thrombus rather than vegetation. 

David passed away while at the University of Louisville Hospital. 

[6] On July 31, 2019, Wellman filed her second amended proposed complaint

before the Indiana Department of Insurance, claiming that Baptist Health and 

its cardiologist, Dr. Manchi, had committed medical malpractice which 

resulted in David’s death. The proposed complaint was evaluated by the threeperson medical review panel which consisted of an emergency medicine doctor, 

an infectious disease physician, and a cardiologist. On June 3, 2021, the 

emergency medicine doctor and the infectious disease doctor found in favor of

Baptist Health and Dr. Manchi on the standard of care and causation but noted 

that they could not “give an opinion as to the read[ing] of the TEE.” 

(Appellant’s App. Vol. II, pp. 31, 37). However, the cardiologist panel 

member, Dr. Jarrod Frizzell (Dr. Frizzell), concluded that Baptist Health and 

Dr. Manchi had “failed to meet the applicable standard of care as to the reading

of the TEE.” (Appellant’s App. Vol. II, p. 34). 

[7] On the basis of the medical review panel’s opinion, on August 31, 2021, 

Wellman filed a Complaint against Baptist Health sounding in negligence 

regarding Dr. Manchi’s cardiology care. On January 6, 2022, Wellman filed a 

partial motion for summary judgment with respect to the standard of care, 

along with a memorandum and designation of evidence, designating Dr. 

Frizzell’s panel opinion and affidavit. On March 7, 2022, Baptist Health filed a 

response, a memorandum in opposition to Wellman’s motion, and a 

designation of evidence. Baptist Health’s designation included a three-page, 
Court of Appeals of Indiana | Opinion 22A-CT-2585 | June 19, 2023 Page 5 of 15

fifteen-paragraph affidavit from Dr. Manchi which detailed his treatment of 

David and his perceived compliance with the standard of care in performing 

and interpreting the TEE, deposition testimony of Dr. Frizzell, analyzing the 

basis for his opinion on the standard of care on reading a TEE, and certified 

medical records from the University of Louisville Hospital. On March 31, 

2022, Wellman replied to Baptist Health’s response. 

[8] On September 6, 2022, after a hearing, the trial court granted Wellman’s 

motion for partial summary judgment on the issue of the standard of care. 

Although the trial court in its judgment mentioned that the testimony of Dr. 

Frizzell and the University of Louisville Hospital records had been designated

by Baptist Health, it did not further analyze this evidence. Ultimately, the trial 

court concluded that no genuine issue of material fact existed with respect to 

the reading of the TEE, and it granted partial summary judgment to Wellman

on David’s received standard of care, ruling that Dr. Manchi’s affidavit alone 

was not sufficient to create an issue of material fact to rebut a unanimous 

medical review panel’s opinion and that an opinion from an outside expert was 

required. 

[9] On September 19, 2022, Baptist Health filed its motion to certify the 

interlocutory order for appeal, which was granted by the trial court on October 

7, 2022. This court accepted the interlocutory appeal on December 5, 2022. 

Baptist Health now appeals. Additional facts will be provided as necessary.
Court of Appeals of Indiana | Opinion 22A-CT-2585 | June 19, 2023 Page 6 of 15

DISCUSSION AND DECISION

[10] Initially, we note that the issue is not, as suggested by the parties and amicus,

whether a defendant doctor’s own affidavit standing alone is sufficient to defeat 

summary judgment. Although Baptist Health did designate Dr. Manchi’s own 

affidavit claiming he did not violate the standard of care, this case does not 

solely rest on the adequacy of the factual content of his affidavit. Rather, in 

response to Wellman’s motion for summary judgment, Baptist Health also 

designated the medical records from the University of Louisville Hospital and 

portions of Dr. Frizzell’s deposition. Accordingly, the issue presented for our 

review is whether the totality of the designated evidence is sufficient to raise a 

genuine issue of material fact.

[11] When reviewing the grant or denial of summary judgment, we apply the same 

test as the trial court: summary judgment is appropriate only if the designated 

evidence shows there is no genuine issue of material fact and the moving party 

is entitled to judgment as a matter of law. Ind. Trial Rule 56(C); Sedam v. 2JR 

Pizza Enters., LLC, 84 N.E.3d 1174, 1176 (Ind. 2017). “A fact is ‘material’ if its 

resolution would affect the outcome of the case, and an issue is ‘genuine’ if a 

trier of fact is required to resolve the parties’ differing accounts of the truth, or if 

the undisputed material facts support conflicting reasonable inferences.” 

Hughley v. State, 15 N.E.3d 1000, 1003 (Ind. 2014). The moving party bears the 

initial burden of showing the absence of any genuine issue of material fact as to 

a determinative issue. Id.
Court of Appeals of Indiana | Opinion 22A-CT-2585 | June 19, 2023 Page 7 of 15

[12] Our review is limited to those facts designated to the trial court, and we 

construe all facts and reasonable inferences drawn from those facts in favor of 

the non-moving party. T.R. 56(H); Meredith v. Pence, 984 N.E.2d 1213, 1218 

(Ind. 2013). Because we review a summary judgment ruling de novo, a trial 

court’s findings and conclusions offer insight into the rationale for the court’s 

judgment and facilitate appellate review but are not binding on this court. 

Denson v. Estate of Dillard, 116 N.E.3d 535, 539 (Ind. Ct. App. 2018). 

Additionally, we are not constrained by the claims and arguments presented to 

the trial court, and we may affirm a summary judgment ruling on any theory 

supported by the designated evidence. Id.

[13] In support of her motion for summary judgment, Wellman submitted and 

designated the opinion of the medical review panel, in which Dr. Frizzell 

determined that Baptist Health and Dr. Manchi had failed to meet the 

applicable standard of care when reading the TEE. In addition, in his 

affidavit—which was also designated by Wellman— Dr. Frizzell criticized the 

number of images taken during the TEE and averred that had “the 

interpretation [of the TEE] met the standard of care, [it] would have likely 

changed [David’s] course in that he would have undergone timely studies and 

investigation to rule-in or rule-out infective endocarditis, more likely than not 

resulting in the diagnosis of endocarditis being ruled in and treated.” 

(Appellant’s App. Vol. II, pp. 39-40). He further specified that “the failure to 

meet the applicable standard of care [] increased the risk of [David’s] death 

from infective endocarditis and reduced his chance to survive.” (Appellant’s 
Court of Appeals of Indiana | Opinion 22A-CT-2585 | June 19, 2023 Page 8 of 15

App. Vol. II, p. 40). This designation satisfied Wellman’s prima facie burden to 

show there was no genuine issue of material fact; it was then up to Baptist 

Health and Dr. Manchi to designate sufficient expert testimony setting forth 

specific facts showing the existence of a genuine issue for trial. See Scripture v. 

Roberts, 51 N.E.3d 248, 252 (Ind. Ct. App. 2016) (Plaintiffs’ introduction of 

medical review panel opinion in their favor “satisfied [their] burden to show 

there was no genuine issue of material fact[.]”); T.R. 56(E) (“When a motion 

for summary judgment is made and supported as provided in this rule, an 

adverse party may not rest upon the mere allegations or denials of his pleading,

but his response, by affidavits or as otherwise provided in this rule, must set 

forth specific facts showing that there is a genuine issue for trial”). 

[14] In response to Wellman’s motion for partial summary judgment, Baptist Health 

designated Dr. Manchi’s affidavit which included extensive facts and detailed 

medical information, explaining his treatment and his perceived adherence to 

the standard of care in performing and interpreting the TEE. In addition, 

Baptist Health designated certified medical records from the University of 

Louisville Hospital, which bolstered Dr. Manchi’s conclusions by noting that 

clots—and not vegetation—were present on the mitral valve and that 

endocarditis was never conclusively diagnosed, as well as the deposition 

testimony of Dr. Frizzell in which he conceded that the medical guidelines for 

the standard of care on which he based his opinion allow for variations in the 

ability to perform all aspects of a TEE depending on the individual patient’s
Court of Appeals of Indiana | Opinion 22A-CT-2585 | June 19, 2023 Page 9 of 15

characteristics, anatomic variations, pathologic features, time constraints, and 

the judgment of the treating physician. 

[15] In Chi Yun Ho v. Frye, 880 N.E.2d 1192, 1195 (Ind. 2008), Frye brought a 

medical malpractice claim against Dr. Ho, a surgeon, for failure to remove all 

of the surgical sponges following abdominal surgery. In response to Frye’s 

motion for summary judgment in which Frye designated the unanimous 

medical review panel’s conclusion in his favor, Dr. Ho designated his own 

affidavit and the deposition testimony of another treating doctor, averring that 

Dr. Ho had complied with the standard of care. Id. The trial court denied 

Frye’s summary judgment motion and both parties appealed various issues, 

including the denial of summary judgment. Id. On appeal, our supreme court 

considered “whether conflicting opinions [in medical malpractice cases] 

regarding whether a physician met the applicable standard of care, in the absence 

of facts supporting such opinions, operate to create a genuine issue of material fact 

precluding summary judgment.” Id. at 1201 (emphasis added). Although Dr. 

Ho’s designation was “extremely sparse in factual content,” and did not set out 

in terms what the applicable standard of care was, but affirmed that the 

defendant had met it, our supreme court held that, together, the affidavit and 

deposition extract sufficed to preclude summary judgment in Frye’s favor 

because they created a genuine issue of material fact. Id. at 1201. “Medical 

negligence is . . . not generally a conclusion that may be reached by a jury 

without . . . an expert opinion [as to the applicable standard of care] among the 

evidence presented. Such expert opinion takes on the character of an 
Court of Appeals of Indiana | Opinion 22A-CT-2585 | June 19, 2023 Page 10 of 15

evidentiary fact in medical malpractice cases.” Id. In such cases, therefore, “an 

opinion on the ultimate fact of whether a defendant physician’s conduct fell 

below the applicable standard of care may be seen as qualitatively different,” 

from cases where mere “speculation, not evidence” is designated by a defendant 

in an attempt to furnish nonnegligent explanations for his conduct. Id.

[16] Indiana’s jurisprudence has further elaborated that “[o]f course, [such 

conclusory] opinions would be greatly enhanced by detailing the factual 

circumstances upon which they were based. Numerous cases, however, have 

treated such detailing as affecting the weight and credibility to be given to the 

opinion [by the trier of fact] rather than its admissibility” and sufficiency to 

defeat a motion for summary judgment. Jordan v. Deery, 609 N.E.2d 1104, 1111 

(Ind. 1993) (“reluctantly” reversing summary judgment); see also Scripture, 51 

N.E.3d 252 (Defendant-Doctors’ affidavits did not raise a genuine issue of 

material fact precluding summary judgment because the affidavits did not set 

forth specific facts regarding the patient’s care, but instead, echoed the denials 

of their pleading and consisted of conclusory statements). Our supreme court 

has emphasized that the question on summary judgment is not whether the 

evidence would support a verdict in favor of the non-moving party, but whether 

“a conflict of evidence may exist” on a material issue. Siner v. Kindred Hosp. Ltd. 

P’ship, 51 N.E.3d 1184, 1189 (Ind. 2016) (original emphasis) (quoting Purcell v. Old 

Nat’l Bank, 972 N.E.2d 835, 841 (Ind. 2012)).

[17] Chi Yun Ho is to be further distinguished from cases in which an affiant 

physician affirmed merely that “he would have treated [the patient] differently, 
Court of Appeals of Indiana | Opinion 22A-CT-2585 | June 19, 2023 Page 11 of 15

not that [defendant physician]’s treatment fell below the applicable standard [of 

care].” Oelling v. Rao, 593 N.E.2d 189, 190-91 (Ind. 1992) (emphasis in 

original). Such a designation is insufficient as a matter of law to preclude 

summary judgment because it does not address the applicable legal standard:

whether the patient’s treatment fell below the applicable standard of care. Id. 

Thus, “[t]o refute the defendants’ evidence, the affidavit needed to set out the 

applicable standard of care and a statement that the treatment in question fell 

below that standard.” Id. at 190.

[18] Here, resolving, as we must, all reasonable inferences and all ambiguities in 

Baptist Health’s favor, we conclude that a fair reading of Dr. Manchi’s affidavit, 

together with the University of Louisville Hospital records and Dr. Frizzell’s 

deposition testimony, created a genuine issue of material fact that precluded the 

entry of summary judgment. Whereas Dr. Frizzell’s medical review panel’s

conclusion of breach of standard of care and his subsequent affidavit criticizing 

Dr. Manchi’s interpretation and reading of the TEE was prima facie sufficient to 

support Wellman’s motion for summary judgment, in response thereto Dr. 

Manchi’s affidavit averred an explicit factual basis to support his standard of 

medical care provided, course of treatment, opinions, and conclusions. Dr.

Manchi’s affidavit commenced with the introduction of his education and 

credentials, recognizing that he had “been practicing in clinical cardiology in 

Indiana for over twenty years and ha[d] performed hundreds of TEEs in [his] 

career, and perform[ed] over fifty every year.” (Appellant’s App. Vol. II, p. 64). 

Maintaining that he is “familiar with the standard of care applicable to 
Court of Appeals of Indiana | Opinion 22A-CT-2585 | June 19, 2023 Page 12 of 15

cardiologists,” Dr. Manchi asserted that his “interpretation of and report on 

[David’s] TEE complied with the applicable standard of care.” (Appellant’s 

App. Vol. II, p. 64). In his explanation of the standard of care, Dr. Manchi 

elaborated that “the standard of care allows for variation in the number of 

images obtained and duration of the exam depending on the clinical 

circumstances with the patient.” (Appellant’s App. Vol. II, pp. 64-65). While a 

probe is inserted into the patient and a number of images are recorded during 

the procedure, Dr. Manchi asserted to be able to see more than merely those 

recorded images as the “TEE is a continuous imaging process.” (Appellant’s 

App. Vol. II, p. 64). Through this process, Dr. Manchi was able to visualize 

“the prosthetic mitral valve to determine whether there [was] evidence of 

vegetation.” (Appellant’s App. Vol. II, pp. 64-65). The affidavit explained in 

detail the difficulty of the study as David “was on a monitor” and “morbidly

obese per BMI[,]” and as a result the “number of images [was limited] to 18[.]” 

(Appellant’s App. Vol. II, p. 65). Based on his “adequate and desirable 

visualization of the prosthetic mitral valve,” Dr. Manchi concluded there was 

an absence of vegetation or structural abnormalities. (Appellant’s App. Vol. II, 

p. 65). Dr. Manchi further noted that David’s subsequent improvement 

supported the accuracy of his reading of the TEE. 

[19] In addition to Dr. Manchi’s affidavit, Baptist Health designated the University 

of Louisville Hospital’s medical records for David. While further testing and an 

additional TEE were conducted, these results indicated that “given the 

sequence of events, the mitral valve lesions are most likely thrombotic.” 
Court of Appeals of Indiana | Opinion 22A-CT-2585 | June 19, 2023 Page 13 of 15

(Appellant’s App. Vol. II, p. 68). The University of Louisville Hospital’s

physicians noted that “[w]hile off anticoagulation, the [mitral valve 

replacement] thrombosis rate/risk will continue to grow and causing [sic] flash 

pulmonary edema;” there was no diagnosis of endocarditis. (Appellant’s App. 

Vol. II, p. 75). Also, Dr. Frizzell’s deposition, which was designated in support 

of Baptist Health’s position, appeared to signal Dr. Frizzell’s concession that 

the standard of care allowed for certain variations depending on individual 

patient characteristics, anatomic variations, pathologic features, time 

constraints, and the judgment of the treating physician.

[20] In sum, Dr. Manchi’s affidavit, which detailed the standard of care, the 

procedure and its difficulties, and the resulting conclusion drawn from the 

procedure, together with the testing results at the University of Louisville 

Hospital and Dr. Frizzell’s deposition, were sufficient to create a genuine fact 

issue requiring resolution by the trier of fact.

[21] Nevertheless, in an effort to encourage this court to disregard Dr. Manchi’s 

affidavit, Wellman characterizes the affidavit as “self-serving.” (Appellant’s Br. 

p. 21). Despite this characterization, we find that Dr. Manchi’s affidavit 

comports with the Indiana Supreme Court’s Hughley standard. Hughley

involved a civil proceeding initiated by the State seeking forfeiture of the 

defendant’s cash and car, which the State alleged were proceeds of, or meant to 

be used to facilitate, the defendant’s drug dealing. See Hughley, 15 N.E.3d at 

1002. The defendant’s affidavit recited his competence to testify and then 

stated in full that the currency seized during this arrest was not the proceeds of 
Court of Appeals of Indiana | Opinion 22A-CT-2585 | June 19, 2023 Page 14 of 15

criminal activity nor was it intended to be used for anything other than legal 

activities, and the car was never used to transport controlled substances and was 

not the proceeds from any unlawful activity. See id. Our supreme court found 

that Hughley had designated facts with specificity sufficient to defeat summary 

judgment:

[H]ere, Defendant did not merely rest on his “pleadings”—that 

is, the complaint, answer, or counter-, cross-, and third-party 

claims with answers or replies thereto. T.R. 7(A). Rather, he 

designated an affidavit—albeit a perfunctory and self-serving 

one—that specifically controverted the State’s prima facie case, 

denying under oath that the cash or car were proceeds of or used 

in furtherance of drug crimes.

Id. at 1004. Likewise, here, Dr. Manchi submitted a three-page, fifteen 

paragraph affidavit, in which he detailed, under oath, the extensive facts and 

medical information, explained the treatment and procedure, and his method in 

interpreting the TEE. Accordingly, Dr. Manchi’s affidavit, combined with the 

University of Louisville Hospital’s medical records and Dr. Frizzell’s 

deposition, included sufficient specificity to controvert Wellman’s prima facie

case and precluded the entry of summary judgment.

CONCLUSION

[22] Based on the foregoing, we conclude that Baptist Health’s designated evidence 

created a genuine issue of material fact as to whether Dr. Manchi’s treatment of 

David complied with the standard of care to preclude the entry of summary 

judgment in favor of Wellman.
Court of Appeals of Indiana | Opinion 22A-CT-2585 | June 19, 2023 Page 15 of 15

[23] Reversed and remanded for further proceedings.

Altice, C. J. and Pyle, J. concur