Opinion ID: 852304
Heading Depth: 1
Heading Rank: 3

Heading: Medical Providers and Domestic Violence

Text: As counsel for McSwane properly observes, the elements of a claim for medical malpractice are the same as for any other claim for negligence. The claimant must show that the defendant owed her a duty of care at the time the injury occurred, that the defendant's behavior did not conform to that standard of care, and that the claimant's injuries were proximately caused by the breach. While the existence of a duty is regarded as a matter of law, summary judgment based on application of law to particular facts is rarely suitable. The parties have largely argued this appeal based on the trial court's finding that there was no duty and that the claim is barred by contributory negligence. McSwane argues that a duty existed on three grounds: that the hospital had assumed a duty to its patients, that the possibility of injury was foreseeable, and that public policy supports legal imposition of a duty. The hospital has argued that its duty to McSwane did not extend to protecting her from harm caused by Monty off its premises. It counters McSwane's argument about assumption of duty, which rests on the hospital's implementation of an internal domestic violence policy, by noting that there is no indication McSwane relied upon or knew about its policy. Cf. Ward v. First Ind. Plaza Joint Venture, 725 N.E.2d 134, 137 (Ind.Ct.App.2000). It cites the downside of imposing duties based on an actor's adoption of protocols designed to protect patrons, Lawson v. Lafayette Home Hospital, 760 N.E.2d 1126, 1129-30 (Ind.Ct.App.2002), namely, the risk that doing so will discourage adoption of prophylactic measures. The parties' debate over assumed duty seems unnecessary. It is straightforward enough to say that a hospital's duty of care to a patient who presents observable signs of domestic abuse includes some reasonable measures to address the patient's risk. The hospital in this instance took several such actions, including direct suggestions that abuse might be the cause, providing a chance to so indicate outside the earshot of the abuser, security examinations of the suspected abuser, facilitating telephone calls to law enforcement, and declarations that Malia need not leave the hospital with him. While counsel for McSwane argues that the hospital's failure to separate its patient from her ex-husband so that she could safely report his attack, Appellant's Reply Br. at 4, the record reflects that the hospital did keep them apart on multiple occasions. While counsel does not suggest that the hospital should have physically restrained Malia from leaving the building, it appears plain that little short of that would have kept her from leaving with Monty. Holding that the hospital's duty encompassed such measures obviously bumps right up against patient autonomy and informed consent, two touchstones of medical malpractice law. See, e.g., Auler v. VanNatta, 686 N.E.2d 172 (Ind.Ct.App. 1997) (treatment without informed consent may be negligence); Ind.Code § 16-36-1-3(a)(1) (2008) (adult patients presumed capable of directing their own healthcare). While the parties and the trial court have analyzed this aspect of the case through debate over extent of duty, it might just as well be analyzed by asking whether the hospital, construing the facts favorably to McSwane, has succeeded in demonstrating that it did not breach its duty, a burden rarely but occasionally met as a matter of law. Considered as whether the hospital's duty extended to off-premises activities or as whether it breached its duty by assenting to Malia's insistence on departing, the trial court was correct to grant judgment for the hospital. [1]