Court Opinion

ID: 9963423
Source: CourtListenerOpinion
Date Created: 2024-04-25 15:42:33.341286+00
Date Added: 2024-06-11T08:24:48.898852
License: Public Domain

FILED
                                                                       Apr 25 2024, 8:57 am

                                                                           CLERK
                                                                       Indiana Supreme Court
                                                                          Court of Appeals
                                                                            and Tax Court

                                             IN THE

            Court of Appeals of Indiana
                                     Kenneth Kesler, M.D.,
                                          Appellant-Plaintiff,

                                                     v.

            Indiana University Health Care Associates, Inc., d/b/a/
                 Indiana University Health Physicians (IUHP),
                                          Appellee-Defendant.

                                             April 25, 2024

                                     Court of Appeals Case No.
                                           23A-PL-2111

                                          Appeal from the
                                        Marion Superior Court

                                          The Honorable
                                      Heather A. Welch, Judge

                                        Trial Court Cause No.
                                        49D01-2307-PL-27885

Court of Appeals of Indiana | Opinion 23A-PL-2111 | April 25, 2024    Page 1 of 19
                                      Opinion by Senior Judge Baker
                                       Judges Pyle and Felix concur.

      Baker, Senior Judge.

      Statement of the Case
[1]   Kenneth Kesler, M.D. sought a declaratory judgment, seeking relief from the

      restraints contained in a noncompetition clause of the Employment Agreement

      he entered into with Indiana University Health Care Associates, Inc. d/b/a

      Indiana University Health Physicians (IUHP). IUHP responded by filing its

      answer, verified counterclaim for declaratory judgment, and a request for a

      temporary restraining order (TRO), preliminary injunction, and permanent

      injunction. After a hearing, the trial court issued its order granting IUHP’s

      request for a preliminary injunction and enjoined Dr. Kesler from treating

      patients within the geographically restricted area provided in the

      noncompetition clause in his Employment Agreement. Dr. Kesler brings this

      interlocutory appeal from the court’s order. Concluding that the court’s order

      did not reflect consideration of all competing interests in support of the result

      reached, we reverse and remand.

      Facts and Procedural History
[2]   Dr. Kesler is a board-certified thoracic surgeon who has developed a surgical

      procedure to remove complex germ cell cancer tumors in the chest area.

      Court of Appeals of Indiana | Opinion 23A-PL-2111 | April 25, 2024        Page 2 of 19
      During his career, he has developed a group of around 156 referring physicians

      who are primarily medical oncologists not employed by IUHP.

[3]   In 2014, Kesler entered into an Employment Agreement with IUHP, which

      took effect on January 1, 2015. The Employment Agreement contained a

      restrictive covenant not to compete for a period of two years after the

      termination of his employment with IUHP and within the defined geographical

      thirty-mile range.

[4]   Dr. Kesler provided IUHP with written notice of his intent to terminate the

      Employment Agreement as of July 14, 2023. After that date, he was employed

      by Community Health Network at Community North Hospital, a hospital

      within the thirty-mile geographically restricted area. Within days of the

      termination of his employment with IUHP, Dr. Kesler filed a declaratory

      judgment action seeking relief from the restrictive covenant not to compete.

      IUHP responded by filing its answer, verified counterclaim for declaratory

      judgment, and a request for a TRO, preliminary injunction, and permanent

      injunction.

[5]   The trial court held a hearing on IUHP’s motion requesting a TRO and

      preliminary injunction. During the hearing, IUHP presented argument and

      relied on the verified pleadings and responses filed in the action. Among other

      things, IUHP argued “it’s actually in the public interest to enforce—uh—the

      contracts between the parties in this way [by enforcing the non-competition

      clause].” Tr. Vol. II, p. 13. IUHP further claimed that “the suggestion that

      Court of Appeals of Indiana | Opinion 23A-PL-2111 | April 25, 2024        Page 3 of 19
      there’s harm to patients is really refuted by–uh—sort of by Dr. Kesler himself.

      Um—you know—subject to his non-solicitate [sic], he agrees that patients can

      and—we agree that patients can continue to treat with him if they choose—

      uh—to relocate their care.” Id.

[6]   Dr. Kesler offered exhibits and testimonial evidence. He testified about his

      education, experience, training, employment, and referral network. He agreed

      with the statement that there was no one at IUHP who performs the same

      surgical procedure he does on the complex germ cell tumors in the chest. Over

      ninety-five percent of his patients are new patients. Dr. Kesler’s counsel argued

      that “there certainly is a strong public interest that Dr. Kesler be able to perform

      these surgeries. At this time, the only place Dr. Kesler has surgical procedures

      [sic]—perform these procedures is at Community Hospital.” Id. at 28. IUHP

      responded that, “[w]e’re not limiting whether patients can treat with Dr. Kesler.

      We are asking that the Court enforce the reasonable restrictive covenant on

      where Dr. Kesler may situate his practice—uh—going forward if he’s providing

      the same medical services.” Id. at 29.

[7]   The trial court entered its order granting a preliminary injunction in favor of

      IUHP, and enjoined Dr. Kesler from treating patients within the restricted

      geographical area set out in the Employment Agreement.

      Court of Appeals of Indiana | Opinion 23A-PL-2111 | April 25, 2024        Page 4 of 19
      Discussion and Decision
      A.      Confusion Apparent in the Record
[8]   Before we address the dispositive issue in this appeal, we pause to note the

      confusion in the record as to what the appealed order really is. The trial court’s

      order setting a hearing says it is considering a “Motion For Temporary

      Restraining Order,” but makes reference in the order to IUHP’s “Motion for

      Temporary Restraining Order and Preliminary Injunction” and concludes by

      setting a “virtual hearing on the Motion for Temporary Restraining Order and

      Preliminary Injunction.” Appellant’s App. Conf. Vol. II, p. 94 (emphasis added).

      The record also shows that the parties believed they were attending a hearing

      solely addressing the request for a temporary restraining order. See Tr. Vol. II,

      p. 6. (“We know that this is a TRO hearing, not the full preliminary injunction

      hearing.”) p. 7 (“TRO is to preserve the status quo until the–the preliminary

      injunction hearing.”). The court announced at the beginning of the hearing that

      “We’re here today on the Defendant’s motion for a temporary restraining

      order.” Id. at 5. And the final line of the trial court’s order reads, “Either

      counsel may petition the Court to schedule a preliminary injunction hearing.”

      Appellant’s App. Conf. Vol. II, p. 22.

[9]   However, immediately preceding that sentence, the trial court’s appealed order

      says, “Based on the foregoing analysis, the Court hereby GRANTS IUHP’s

      Motion for Temporary Restraining Order and Preliminary Injunction. Until this

      controversy is resolved on the merits, Dr. Kesler is enjoined from violating the

      noncompete in the Employment Agreement and treating patients within the 30-
      Court of Appeals of Indiana | Opinion 23A-PL-2111 | April 25, 2024         Page 5 of 19
       mile radius of his Employment Agreement.” Id. (emphasis added). And in

       setting out the “STANDARDS FOR ISSUANCE OF A TRO AND

       PRELIMINARY INJUNCTION,” the trial court’s order mistakenly cites State

       v. Econ. Freedom Fund, 959 N.E.2d 794, 803 (Ind. 2011), to set out the

       requirements for obtaining a TRO. See id at 15. Freedom Fund, however, sets

       out the requirements to obtain a preliminary injunction. 959 N.E.2d at 803. It

       is Indiana Trial Rule 65(B)(1) which governs the requirements for a temporary

       restraining order, namely, that “it clearly appears from specific facts shown by

       affidavit or by the verified complaint that immediate and irreparable injury,

       loss, or damage will result to the applicant before the adverse party or his

       attorney can be heard in opposition.” Additionally, Trial Rule 65(D)

       establishes that the trial court’s order granting a TRO shall include or be

       accompanied by findings under Trial Rule 52.

[10]   And the record is blurred in yet another way. After setting out the court’s

       assessment of the evidence under subheadings that follow the requirements for

       a preliminary injunction, the order also discusses the “Bond Amount” and finds

       that because “no TRO may issue without adequate security. . . . “security should

       be provided” under Trial Rule 65(C) (emphasis added). Trial Rule 65(C) states

       “No restraining order or preliminary injunction shall issue except upon the giving

       of security by the applicant.” (emphasis added).

[11]   We conclude that the trial court’s order should be considered an order granting

       a preliminary injunction. The order says, “[u]ntil this controversy is resolved

       on the merits . . .” Id. at 22. Although, one could argue that “merits” refers to

       Court of Appeals of Indiana | Opinion 23A-PL-2111 | April 25, 2024        Page 6 of 19
       a preliminary injunction hearing, where the likelihood of success on the merits

       would be considered, the parties argued, and the court issued findings on the

       requirements for a preliminary injunction. Additionally, under our case law,

       the court’s issuance of a TRO is not reviewable on appeal, and is superseded

       anyway, by the apparent grant of the preliminary injunction. See Witt v. Jay

       Petroleum, Inc., 964 N.E.2d 198, 203 (Ind. 2012) (entry of TRO is not

       appealable); Vickery v. Ardagh Glass Inc., 85 N.E.3d 852, 857 (Ind. Ct. App.

       2017) (claims arising from the grant of a TRO become moot when superseded

       by a preliminary or a permanent injunction), trans. denied.

       B.      Issue
[12]   The dispositive issue in this appeal is whether the issuance of the preliminary

       injunction was supported by the evidence and was proper. We conclude that it

       was not.

       C.      Standard of Review
[13]   “The grant or denial of a request for a preliminary injunction rests within the

       sound discretion of the trial court, and our review is limited to whether there

       was a clear abuse of that discretion.” Buffkin v. Glacier Group, 997 N.E.2d 1, 9

       (Ind. Ct. App. 2013). “When determining whether to grant a preliminary

       injunction, the trial court is required to make special findings of fact and state

       its conclusions thereon.” Id. “When findings and conclusions thereon are

       made, we must determine if the trial court’s findings support the judgment.” Id.

       “We will reverse the trial court’s judgment only when it is clearly erroneous.”

       Court of Appeals of Indiana | Opinion 23A-PL-2111 | April 25, 2024         Page 7 of 19
       Id. “Findings of fact are clearly erroneous when the record lacks evidence or

       reasonable inferences from the evidence to support them.” Id. “A judgment is

       clearly erroneous when a review of the record leaves us with a firm conviction

       that a mistake has been made.” Id. “We consider the evidence only in the light

       most favorable to the judgment and construe findings together liberally in favor

       of the judgment.” Id. “Also, the power to issue a preliminary injunction

       should be used sparingly, and such relief should not be granted except in rare

       instances in which the law and facts are clearly within the moving party’s

       favor.” Id.

[14]   “To obtain a preliminary injunction, the moving party has the burden of

       showing by a preponderance of the evidence the following: (1) a reasonable

       likelihood of success at trial; (2) the remedies at law are inadequate; (3) the

       threatened injury to the movant outweighs the potential harm to the nonmoving

       party from the granting of an injunction; and (4) the public interest would not

       be disserved by granting the requested injunction.” Id. “If the movant fails to

       prove any of these requirements, the trial court’s grant of an injunction is an

       abuse of discretion.” Id.

       D.      Not All Preliminary Injunction Requirements Met
[15]   We next examine the record to determine whether there is evidence to support

       the trial court’s findings and whether those findings support the trial court’s

       conclusions. See id. Here, we are most concerned with the showing as to (3)

       the threatened injury to the movant outweighs the potential harm to the

       Court of Appeals of Indiana | Opinion 23A-PL-2111 | April 25, 2024         Page 8 of 19
       nonmoving party from the granting of an injunction, and (4) the public interest

       would not be disserved by granting the requested injunction. Concluding that

       the trial court’s order is not supported as to some of the findings leading to the

       ultimate conclusion that a preliminary injunction is warranted, we find the trial

       court erred.

       D.1. Trial Court’s Findings And Evidentiary Support or Lack Thereof

[16]   In its order, the court concluded, in pertinent part, as follows:

               C.       Balance of Harms and Public Interest

                        1.     Dr. Kesler asserts that a TRO in IUHP’s favor
                        would be contrary to the public interest because he has
                        patients who are in need of surgical intervention to protect
                        their health and lives, and the noncompete impairs
                        patients’ legitimate interest in selecting the physician of
                        their choice. Opp., pp. 6-7.
                        2.     However, without an injunction, IUHP would lose
                        the benefit of the non-compete agreement contained in the
                        Employment Agreement, to which Dr. Kesler agreed.
                        IUHP could also lose goodwill if Dr. Kesler is not
                        enjoined from competing with IUHP.
                        3.     Dr. Kesler freely entered the Employment
                        Agreement that contained this non-competition provision.
                        Courts in Indiana have long recognized the freedom of
                        parties to enter into contracts and have presumed that
                        contracts represent the freely bargained agreement of the
                        parties. Trimble v. Ameritech Publ., Inc., 700 N.E.2d 1128,
                        1129 (Ind. 1998). The Indiana Supreme Court has
                        “continue[d] to believe that “it is in the best interest of the
                        public not to restrict unnecessarily persons’ freedom of
                        contract.” This Court further notes there is not evidence
                        of an unequal bargaining power between the parties at this

       Court of Appeals of Indiana | Opinion 23A-PL-2111 | April 25, 2024             Page 9 of 19
                        early stage of the case.
                        4.     Dr. Kesler’s potential harm appears to be that he
                        will have to move his practice more than 30 miles away
                        from IU Health University Hospital and IU Health
                        Methodist Hospital. IUHP notes that Dr. Kesler himself
                        pointed out that numerous Indiana hospitals are equipped
                        with the resources Dr. Kesler needs for his practice.
                        Memo., p. 15.
                         5.    The Court acknowledges that, under the
                        noncompete, Dr. Kesler could still provide treatment
                        outside the Restricted Territory, and it is not uncommon
                        for his patients to willingly travel to him for treatment.
                        6.     The Court finds that the injuries to IUHP outweigh
                        the harm to Dr. Kesler.
                        7.     The Court further finds the best interest of the
                        public would be served in enforcing the Employment
                        Agreement, which appears to be a valid contract.
                        8.     The Court further notes that Ind. Code § 25-22.5-
                        5.5-2.5(b)—providing that a primary care physician and an
                        employer may not enter into a noncompete agreement—
                        would not apply to Dr. Kesler because, admittedly, he is
                        not a primary care physician.

       Appellant’s App. Conf. Vol. II, pp. 11-12.

       D.2. The Parties’ Arguments

[17]   Dr. Kesler’s counsel argued that there are no thoracic surgeons at IUHP

       performing the surgical procedure Dr. Kesler developed to remove complex

       germ cell cancer tumors in the chest area. Counsel further remarked that there

       were “20—some—uh patients on [Exhibit B] who are very sick—who need

       cancer surgery. And there certainly is a strong public interest that Dr. Kesler be

       able to perform these surgeries.” Tr. Vol. II, p. 28. Dr. Kesler testified that

       Court of Appeals of Indiana | Opinion 23A-PL-2111 | April 25, 2024       Page 10 of 19
       “the referring physicians have categorically said no, I want Dr. Kesler to care

       for my patient. Or the patients have done that.” Id. at 22. And in his response

       to IUHP’s request for a TRO, Dr. Kesler argued, “Physician non-competition

       agreements involve other considerations because it impairs ‘[t]he patients’

       legitimate interest in selecting the physician of their choice . . .” Appellant’s

       App. Conf. Vol. II, p. 91 (citing Central Ind. Podiatry, P.C. v. Krueger, 882 N.E.2d

       723, 727 (Ind. 2008)). He further asserted that “[t]he patient’s confidence in

       selecting the physician of their choice” is an important consideration. Id. The

       Krueger decision specifically said, “the confidence of a patient in the physician is

       typically an important factor in the relationship that relocation would displace.”

       882 N.E.2d at 727.

[18]   On the other hand, IUHP argued that it “has a protectible interest in

       maintaining goodwill with patients and its patient base, and the restrictive

       covenant provides a reasonable and necessary means to protect that interest.”

       Appellee’s Conf. Br. p. 11. It also argued that the restrictive covenant was a

       “crucial aspect” of the Employment Agreement and that “approximately 29%

       of Dr. Kesler’s patients reside within the Restricted Territory.” Id. At the

       hearing, IUHP argued that “it’s actually in the public interest to enforce—uh—

       the contracts between the parties in this way.” Tr. Vol. II, p. 13.

[19]   IUHP further argued that “[a]vailable data on Dr. Kesler’s patients confirms

       that Dr. Kesler has had 2270 unique patients from 2019 to present, and 17,371

       encounters. This same data confirms that patients remain as patients for two

       years on average, across IU Health.” Appellant’s App. Conf. Vol. II, p. 80

       Court of Appeals of Indiana | Opinion 23A-PL-2111 | April 25, 2024        Page 11 of 19
       (Counterclaim). IUHP defined its suggested monetary damages based on data

       that Dr. Kesler’s “patients remain as patients for two years on average, across

       IU Health” and that the “total value of all those patients over the next two

       years would have been $2.8 Million.” Appellee’s Conf. Br. p. 21.

[20]   As for the nature of Dr. Kesler’s patients, however, he testified at the hearing

       that over ninety-five percent of his patients are new patients, not repeat patients.

       He also provided Exhibit B, which was a list of referral sources, or referring

       physicians, he developed relationships with prior to entering into the

       Employment Agreement. And he testified that “the vast majority of my referral

       prior to IU Health employment came from outside IU Health Physicians.” Tr.

       Vol. II, p. 20. Exhibit C was identified as a list of patients referred to Dr. Kesler

       since his separation from IUHP and “none of them” are part of “the IUHP

       patient base.” Id. at 22.

       D.3. Analysis

[21]   As for the trial court’s findings in this area, there is no dispute as to Findings

       Number 4, 5, and 8. Dr. Kesler could provide services outside the

       geographically limited area and his patients would travel to receive his services.

       And no one disputes that Dr. Kesler is not a primary care physician. We now

       address the findings which remain.

       Court of Appeals of Indiana | Opinion 23A-PL-2111 | April 25, 2024         Page 12 of 19
       D.3.a.           Public Interest—Contracts or Physician of Choice

[22]   We will address the trial court’s Findings Number 1, 2, 3 and 7 together

       because they each pertain to the various positions about what is in the public’s

       interest.

[23]   Despite Dr. Kesler’s argument that the noncompete impairs patients’ legitimate

       interest in selecting the physician of their choice, IUHP made no showing that

       the public interest would not be disserved by the entry of a preliminary

       injunction. In Fumo v. Medical Group of Michigan City, Inc., 590 N.E.2d 1103,

       1109 (Ind. Ct. App. 1992), we held that:

               the availability of the particular specialty practiced by the
               physician is a matter to be considered by the trial court in looking
               at the totality of the circumstances. Where a specialist offers
               services uniquely or sparsely available in a specified geographical
               area, an injunction may be unwarranted because the movant is
               unable to meet the burden of showing that the public would not
               be disserved.

       And “[t]he effect of the injunction upon the public interest must be weighed

       with the relative potential harms to the parties.” Id. at 1108.

[24]   Additionally, and perhaps more importantly, IUHP has not demonstrated that

       it has suffered any harm. Dr. Kesler’s statement that none of the post-

       separation patients who were referred to him were members of IUHP’s patient

       base is unrefuted. IUHP simply responded that 29 percent of the patients lived

       in the particular restricted area under the noncompetition clause. However,

       had Dr. Kesler moved his practice 30.01 miles from University Hospital and

       Court of Appeals of Indiana | Opinion 23A-PL-2111 | April 25, 2024        Page 13 of 19
       Methodist Hospital, patients from that restricted area could have freely traveled

       to Dr. Kesler’s new location at the same risk of suggested “harm” to IUHP.

       IUHP drafted and negotiated for that provision. Thus, IUHP anticipated the

       loss of future patients upon Dr. Kesler’s departure had he moved his practice

       30.01 miles from downtown Indianapolis and cannot now complain that the

       loss of those same patients constitutes present harm attributable to a geographic

       violation of the restrictive covenant.

[25]   This leads us to the next point which is the unreasonableness or futility of the

       geographic restriction at issue here. Although this also pertains to IUHP’s

       likelihood of success at trial on the merits, IUHP has not demonstrated that the

       geographic limitation here does not disserve the public while providing a benefit

       to IUHP. IUHP has no thoracic surgeons who perform the complex

       procedures Dr. Kesler performs. Therefore, the restriction does nothing more

       than prevent Dr. Kesler from exercising his specific skill set. The record here

       shows there simply are no thoracic surgeons at IUHP with whom Dr. Kesler is

       in direct competition.

[26]   And as for goodwill considerations, IUHP has not made a showing that the

       complex procedures he performs involve trade secrets or confidential

       information. “Indeed, ‘[a]lthough an employer has a protectible property

       interest in the good will of his business (including secret or confidential

       information), the same is not true regarding the general knowledge, information

       or skills gained by the employee in the course of his employment.’” Buffkin, 997

       N.E.2d at 11 (quoting Brunner v. Hand Indus., Inc., 603 N.E.2d 157, 160 (Ind. Ct.

       Court of Appeals of Indiana | Opinion 23A-PL-2111 | April 25, 2024        Page 14 of 19
       App. 1992)). Furthermore, “‘[W]hile an employer, under a proper restrictive

       agreement, can prevent a former employee from using his trade or business

       secrets, and other confidential knowledge gained in the course of the

       employment, and from enticing away old customers, he has no right to

       unnecessarily interfere with the employee’s following any trade or calling for

       which he is fitted and from which he may earn his livelihood and he cannot

       preclude him from exercising the skill and general knowledge he has acquired

       or increased through experience or even instructions while in the

       employment.’” Id. (quoting Donahue v. Permacel Tape Corp., 234 Ind. 398, 411,

       127 N.E.2d 235, 241 (Ind. 1955)) (citation omitted).

[27]   Here, the trial court’s findings “do not reflect consideration of all competing

       interests or disclose the reasons for the result reached[]” regarding whether the

       public interest would be disserved by issuing the preliminary injunction. Id.

       Dr. Kesler provided unrefuted evidence that he was the only thoracic surgeon in

       the particular area who performed the surgical procedure he developed to

       remove complex germ cell cancer tumors in the chest area. IUHP responded by

       making an argument appropriate for the underlying matter, viz., it is in the

       public interest not to restrict unnecessarily persons’ freedom of contract.

[28]   However, IUHP offered no evidence to show that the public would not be

       disserved in the particular area. More recently our supreme court found that a

       preliminary injunction would not disserve the public because the employer

       “provided qualified physicians to meet the needs of all patients who would have

       seen Krueger.” Krueger, 882 N.E.2d at 734. Such is not the case here based on

       Court of Appeals of Indiana | Opinion 23A-PL-2111 | April 25, 2024       Page 15 of 19
       the record before us. And again, importantly, IUHP has not demonstrated any

       harm related to a geographic violation of the restrictive covenant.

[29]   The trial court addressed the public interest in the provision of those services in

       the particular area by reference to the geographic restrictions contained in the

       noncompetition clause. The court found “it is not uncommon for [Dr. Kesler’s]

       patients to willingly travel to him for treatment.” Appellant’s App. Conf. Vol.

       II, p. 21. This highlights, however, that IUHP would “lose” those patients

       whether Dr. Kesler practiced 1 mile, 30.1 miles, or 100 miles away from

       downtown Indianapolis. It is Dr. Kesler’s departure that is the source of

       IUHP’s “loss.” However, the court’s findings do not show that it considered

       whether the public in the particular area would be disserved by the absence of

       Dr. Kesler’s service. And IUHP has not shown that it has other physicians who

       provide the same services in the particular area.

[30]   Almost one third of Dr. Kesler’s patients, who are in poor health, would have

       to travel further to receive his unique medical services. Instead, the court found

       that IUHP’s loss of the benefit of its bargain in terms of the noncompetition

       clause in the Employment Agreement, i.e., the suggested lost revenue in the

       amount of $2.8 million, outweighed the harm to Dr. Kesler by having to move

       his practice out of the geographically restricted area. Yet, IUHP was aware that

       upon Dr. Kesler’s departure, which was allowed under the Employment

       Agreement, it would lose the continued revenue from his patients.

       Consequently, it has not shown any harm beyond that which it anticipated

       anyway under the terms of the Employment Agreement should Dr. Kesler

       Court of Appeals of Indiana | Opinion 23A-PL-2111 | April 25, 2024       Page 16 of 19
       leave. IUHP has not tied its suggested revenue loss to a geographic violation of

       the restrictive noncompetition covenant.

[31]   Although “Indiana courts recognize the freedom of parties to enter into

       contracts,” Fresh Cut, Inc. v. Fazli, 650 N.E.2d 1126, 1129 (Ind. 1995), “Indiana

       courts have long stated that covenants which restrict a person’s employment

       opportunities are strongly disfavored,” see Buffkin, 997 N.E.2d at 9-10, and “‘an

       employer must show some reason why it would be unfair to allow the employee

       to compete with the former employer.’” Clark’s Sales and Serv., Inc. v. Smith, 4

       N.E.3d 772, 780 (Ind. Ct. App. 2014) (quoting Pathfinder Commc’ns Corp. v.

       Macy, 795 N.E.2d 1109, 1110 (Ind. Ct. App. 2003)), trans. denied. Here, IUHP

       has failed to established a valid reason why it would be unfair for Dr. Kesler to

       practice at Community North Hospital.

[32]   The question before us is limited to whether the issuance of the preliminary

       injunction was proper. Here, the trial court’s findings do not show its

       consideration of the risk to the public within the geographic limitation brought

       about by the restriction of Dr. Kesler’s services. And IUHP has not shown

       harm related to the geographic limitation of the noncompetition clause. As

       such, we order that the preliminary injunction be dissolved.

       D.3.b.           Irreparable Harm—Balance of Harms

[33]   The trial court’s Finding Number 6 says that the harm to IUHP outweighs the

       harm to Dr. Kesler. IUHP has advanced the proposition that the loss of the

       patients who would have stayed within the IU Health system for two years

       Court of Appeals of Indiana | Opinion 23A-PL-2111 | April 25, 2024        Page 17 of 19
       would result in a $2.8 million loss due to Dr. Kesler’s employment within the

       Community Health Network. However, it is not the violation of the geographic

       limitation of the noncompetition clause that they would suffer the suggested

       $2.8 million loss; it is Dr. Kesler’s departure itself, which is authorized and was

       contemplated under the Employment Agreement. As such, IUHP has

       demonstrated no harm attributable to a violation of the noncompetition clause.

       And Dr. Kesler could, in theory, move his practice. Yet, the consideration

       missing from the trial court’s consideration is the harm to the public if health

       care services are unavailable due to the grant of injunctive relief. For some of

       these very ill patients, the harm could be irreparable. We conclude that the trial

       court erred by granting the preliminary injunction and the same must be

       dissolved.

       Conclusion
[34]   We conclude that the trial court’s findings do not show a consideration of the

       disservice to the public by enjoining Dr. Kesler’s medical practice. IUHP has

       failed to show it has suffered harm. Dr. Kesler could move his practice. But

       the record shows the public suffers from the injunctive relief granted here.

       Consequently, we conclude that the trial court erred by concluding that IUHP

       was entitled to injunctive relief and by issuing the preliminary injunction.

       Therefore, we reverse and remand this matter to the trial court with instructions

       to dissolve the preliminary injunction.

[35]   Reversed and remanded.

       Court of Appeals of Indiana | Opinion 23A-PL-2111 | April 25, 2024       Page 18 of 19
Pyle, J., and Felix, J., concur.

ATTORNEYS FOR APPELLANT
Robert E Saint
Russell T. Clarke, Jr.
Emswiller, Williams, Noland, & Clarke, LLC
Indianapolis, Indiana

ATTORNEYS FOR APPELLEE
Laurie E. Martin
Gregory A. English
Christopher D. Wagner
Hoover Hull Turner LLP
Indianapolis, Indiana

Court of Appeals of Indiana | Opinion 23A-PL-2111 | April 25, 2024   Page 19 of 19