Court Opinion

ID: 9716241
Source: CourtListenerOpinion
Date Created: 2023-08-26 06:31:56.738871+00
Date Added: 2024-06-11T09:59:04.604284
License: Public Domain

BAILEY, Judge,
concurring in result.
I agree with the majority's analysis of the dispositive issue; namely, whether Lusk timely filed her complaint. As such, I concur with the majority's affirmance of the trial court's grant of summary judgment in favor of Dr. Swanson. However, I write separately to respond to the dicta that arose from the majority's decision to further address whether Lusk presented a prima facie case of negligence against Dr. Swanson.
In regards to the sufficiency of Lusk's negligence claim, she presents a two-part argument to avoid summary judgment. First, she argues that Dr. Swanson's negli-genee was capable of being understood by a layperson without expert testimony; see-ondly, she contends that her expert witness did not need to specifically state that he was familiar with the requisite standard of care. Lusk contends that either her affidavit, which described her interactions with Dr. Swanson following her injury, or that of her expert, Dr. Gaither, was sufficient to establish a genuine issue of material fact. I agree.
Expert medical testimony is usually required to determine whether a physician's conduct fell below the applicable standard of care. Bader v. Johnson, 732 N.E.2d 1212, 1217 (Ind.2000). Generally, this is because of the technical and complicated nature of the medical treatment, which makes it impossible for a trier of fact to apply the standard of care without the benefit of expert opinion on the ultimate question of breach of duty. Id. at 1217-18. However, "not all medical malpractice cases are so technical 'that they require expert testimony." Harris v. Raymond, 715 N.E.2d 388, 394 (Ind.1999) reh'g denied. Where the failure is such that lay people could comprehend that a failure had occurred without needing expert opinion, *755none is required. Bowman v. Beghin, 713 N.E.2d 913, 916 (Ind.Ct.App.1999).
To assess whether a lay person could appreciate the significance of Dr. Swanson's failure to diagnose Lusk's broken bone in her wrist, one must first consider the facts of the alleged negligence, as put forth by the parties in their designated affidavits, in support of, and in opposition to, summary judgment. In pertinent part, those affidavits provide as follows:
AFFIDAVIT OF JIMMY D. SWANSON, M.D.
Jimmy D. Swanson, M.D., being first duly sworn upon his oath, deposes and states:
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6. I met the appropriate standard of care of a physician practicing under same or similar cireumstances in rendering treatment to Martia [sic] Lusk.
(R. 36-37.)
AFFIDAVIT OF MARITA LUSK
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8. That I was informed by medical staff, that I had sustained a fracture of my right upper arm, on said occasion, and the following day, August 19, 1995, on or near the facility, named above, an additional examination occurred, James D. Swanson, M.D., the attending staff physician conducting said examination, who confirmed the diagnosis of an upper arm fracture, and thereafter authorized my admittance in Dearborn County Hospital, as a patient, after reviewing my chart and the X-ray photographs obtained of my upper arm, the previous day. On said occasion, Dr. Swanson did not diagnose, nor direct that additional X-ray photographs, more complete, and including pictures of my lower wrist hand and arm, be obtained, nor indicated concern that any wrist fracture was present or possible, as a result of my fall, though I complained of pain that day, throughout the limb.
4. That from the date of said occasion, until an occasion on or about November 11, 1996, no further X-ray photographs were directed to be taken of my right wrist area, though I met with James D. Swanson, M.D., on several occasions, in the months subsequent, to his initial examination of me and continued, on said occasions, to attempt to convey orally to him, my experience of extreme pain and tenderness, asso-clated with my right wrist area.
5. That pursuant to James D. Swanson's directives, in follow up treatment, prescribed by him, I undertook physical rehabilitation, at an associated out patient facility, specializing in assisting in such physical rehabilitation ..., requiring me to manipulate, lift and maneuver weights, with my right wrist.
(R. 67-68.)
AFFIDAVIT OF JAMES M. GAITHER, M.D.
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3. That the failure to order additional x-ray photographs of Marita Lusk, to include x-rays of her wrist, upon said admitting physician's examination of Marita Lusk,; said day subsequent to the fall, and to the emergency x-ray photographs taken of her upper arm, revealing a fracture, assuming the truthfulness and quality of any communication of pain and tenderness of said wrist *756condition, being conveyed to said admitting physician, James D. Swanson, by Marita Lust [sic], upon the occasion of said admitting examination, is more likely than not, an example of below standard treatment, care, and medical practice, as would be observed by physicians similarly situated.
4. That, continued efforts, by Marita Lusk, in follow-up visits with said admitting physician, James D. Swanson, in scheduled visits, over the course of the months subsequent to the occasion of her fall, to convey to James D. Swanson, her experienced pain and tenderness, in said wrist, assuming the truthfulness of said allegations of her attempts to so convey, not prompting and [sic] order by Dr. Swanson to x-ray the wrist, constitutes, more likely than not, further additional examples of below standard medical practice.
5, That any physical rehabilitation orders, prescribed to Marita Lusk, by James D. Swanson, M.D., directing her to attempt wrist maneuvers and mobility weight tests, stressing her wrist, prior to any diagnosis of the fracture in her wrist, after her initial examination by Dr. Swanson, constituted, more likely than not, a further and additional example of below standard medical practice.
(R. 65-66.) From these designations, it is clear that a doctor-patient relationship existed, thus invoking a duty on the part of Dr. Swanson to Lusk. It is also sufficiently alleged that Dr. Swanson failed to diagnose Lusk with a broken bone in her wrist and recommended physical therapy that caused Lusk to suffer additionally. Thus, as focused upon by the majority, the critical issue which remains is whether Lusk has sufficiently asserted claims from which it could be determined that Dr. Swanson failed "to conform to the requisite standard of care required by the relationship[.]" See Oelling, 593 N.E.2d at 190.
As noted by the majority, "[clases which do not require expert testimony generally involve the physician's failure to remove surgical implements or foreign object's from the patient's body." Simms, 651 N.E.2d at 350; see e.g. Burke v. Capello, 520 N.E.2d 439, 441 (Ind.1988) (involving surgical cement left inside a patient after hip surgery), overruled on other grounds by Vergara by Vergara v. Doan, 593 N.E.2d 185, 186 (Ind.1992); Funk v. Bonham, 204 Ind. 170, 180, 183 N.E. 312, 316 (1932) (addressing a surgical sponge left inside a patient's abdomen). However, this exception is not strictly limited to the foregoing fact patterns. See e.g. Gold v. Ishak, 720 N.E.2d 1175, 1183-84 (Ind.Ct.App.1999) (holding that "[alithough we have typically limited the use of common knowledge to cases involving the physician's failure to remove an object, that does not preclude the use of the res ipsa loquitur or common knowledge exception in other cases, such as this one.") In Gold, we held that "expert testimony is not required because a fire occurring during surgery where an instrument that emits a spark is used near a source of oxygen is not beyond the realm of the lay person to understand." Underlying each of the foregoing judgments was a determination that the jury was able to understand the doctor's conduct without extensive technical input.
Here, as averred in her Complaint and affidavit, Lusk presented to Dr. Swanson as a patient who had sustained an upper arm fracture as the result of a fall, and who, on multiple subsequent visits, continued to express pain in her wrist Dr. Swanson did not order an X-ray of Lusk's *757wrist. Rather, the eventual x-ray that revealed the broken bone in Lusk's wrist was the result of a referral from her outpatient rehabilitation clinic. As such, the averred facts are plain; namely, a fall, a fractured upper right arm, persistent pain in the right wrist, and failure to diagnose. The diagnostic tool necessary to detect the broken bone in Lusk's right wrist was rudimentary-an X-ray. Given these facts, I fail to see how extensive technical input was necessary to raise a genuine issue of material fact regarding whether Dr. Swanson conformed to his requisite standard of care. Lay people could appreciate whether these facts amounted to a failure to diagnose. Accordingly, I would find that Lusk's affidavit created a genuine issue of fact regarding the element of whether Dr. Swanson conformed to his requisite standard of care.
Moreover, while the inclusion of Dr. Gaither's affidavit could be considered superfluous in light of Lusk's affidavit, Lusk could have supported her motion in opposition solely with Dr. Gaither's affidavit in that his affidavit also raised a genuine issue of material fact precluding summary judgment. Dr. Gaither's affidavit indicates that he is a "board certified physician, a graduate of a certified and fully accredited medical school, ...". (R. 65.) Thus, under the simple fact pattern of this case, he possesses more than the requisite knowledge, skill, experience, training and education to give an opinion as to whether Dr. Swanson failed to render the appropriate standard of care by failing to diagnose the fractured wrist.