Court Opinion

ID: 9897347
Source: CourtListenerOpinion
Date Created: 2023-11-14 19:10:27.583575+00
Date Added: 2024-06-11T09:15:42.704681
License: Public Domain

FILED
                                                                            Jul 10 2023, 8:37 am

                                                                                CLERK
                                                                            Indiana Supreme Court
                                                                               Court of Appeals
                                                                                 and Tax Court

ATTORNEYS FOR APPELLANT                                     ATTORNEY FOR APPELLEE
Margaret M. Christensen                                     Andrew T. Shupp
Moncerrat Z. Alvarez                                        Hoeppner Wagner & Evans, LLP
Dentons Bingham Greenebaum LLP                              Valparaiso, Indiana
Indianapolis, Indiana
Gregory Allen Crisman
Allison Elizabeth Pulliam
Eichhorn & Eichhorn
Hammond, Indiana

                                             IN THE
    COURT OF APPEALS OF INDIANA

Jatinder K. Kansal, M.D., P.C.,                             July 10, 2023
Appellant-Defendant,                                        Court of Appeals Case No.
                                                            22A-CT-2646
        v.                                                  Appeal from the
                                                            Lake Superior Court
Taylor Krieter,                                             The Honorable
Appellee-Plaintiff                                          Stephen E. Scheele, Judge
                                                            Trial Court Cause No.
                                                            45D05-1905-CT-564

                                  Opinion by Judge Vaidik
                               Judges Tavitas and Foley concur.

Court of Appeals of Indiana | Opinion 22A-CT-2646 | July 10, 2023                                   Page 1 of 10
      Vaidik, Judge.

      Case Summary
[1]   Taylor Krieter has sued Dr. Jatinder Kansal for battery and intentional

      infliction of emotional distress, alleging that he touched her inappropriately

      when she was seeing him for allergies and eczema. Taking the position that her

      claims are not medical-malpractice claims, Krieter did not present a proposed

      complaint to a medical-review panel before going to court, as would be required

      under Indiana’s Medical Malpractice Act, Ind. Code art. 34-18. Dr. Kansal

      moved to dismiss for lack of subject-matter jurisdiction, arguing that the Act

      applies because any sexual misconduct (he denies there was any) occurred

      during medical appointments where Dr. Kansal examined and treated Krieter.

      The trial court denied Dr. Kansal’s motion. We affirm. The issue isn’t whether

      the alleged tortious conduct occurred during the provision of medical care but

      whether the conduct itself was part of the provision of medical care. Assuming

      sexual misconduct occurred, as we must at this early stage of the case, it was

      wholly unrelated to the provision of medical care. Therefore, Krieter is not

      claiming medical malpractice, the Medical Malpractice Act doesn’t apply, and

      the trial court has subject-matter jurisdiction.

      Facts and Procedural History
[2]   Dr. Kansal is a board-certified Asthma, Allergy, and Immunology specialist. In

      2016 and 2017, Krieter saw him several times for allergies and eczema. In 2019,

      Court of Appeals of Indiana | Opinion 22A-CT-2646 | July 10, 2023         Page 2 of 10
      Krieter sued Dr. Kansal for battery and intentional infliction of emotional

      distress, alleging that Dr. Kansal “did inappropriately touch and/or molest” her

      while she was his patient. Appellant’s App. Vol. II p. 12.

[3]   At her deposition, Krieter offered specifics, including the following. Krieter

      went to see Dr. Kansal for treatment of her seasonal allergies, and it was Dr.

      Kansal who brought up her eczema and said he needed to examine her skin.

      Krieter’s mother was with her at the early appointments, but when her mother

      stopped accompanying her, Dr. Kansal’s demeanor and conduct changed. At

      various appointments in 2017, Dr. Kansal “cupped” Krieter’s breasts, “rubbed”

      her nipples with his fingers, and “rubbed” her buttocks and thighs for fifteen to

      twenty seconds. Id. at 125-38. Krieter didn’t always wear a bra, but when she

      did, Dr. Kansal sometimes lifted it and touched her breasts. Dr. Kansal always

      told Krieter he needed to “check everywhere,” id. at 122, 124, 138, and she

      initially took his word for it, but she eventually realized he was touching her in

      a sexual way that had nothing to do with medical treatment. During one of the

      last visits, Dr. Kansal lifted Krieter’s bra and felt her breasts but didn’t touch her

      anywhere else. When Dr. Kansal was alone with Krieter, he spoke to her in a

      sexual way and in a different voice than the one he used when others were in

      the room. For example, he told her she was a “very pretty girl,” told her she

      should shave her legs because men prefer smooth legs, and asked her questions

      about her boyfriend, including whether he cared that she worked at Hooters. Id.

      at 117, 135, 142.

      Court of Appeals of Indiana | Opinion 22A-CT-2646 | July 10, 2023           Page 3 of 10
[4]   After Krieter’s deposition, Dr. Kansal moved to dismiss her complaint for lack

      of subject-matter jurisdiction under Trial Rule 12(B)(1). He denied any

      inappropriate conduct or statements, explained that “[t]horough and complete

      whole body skin examinations” were necessary because of Krieter’s severe skin

      conditions, and framed Krieter’s claims as complaints about the scope of those

      examinations. Id. at 26-48. He argued that such claims are subject to the

      Medical Malpractice Act, which provides that a malpractice claim cannot be

      commenced in court until the claimant has presented a proposed complaint to a

      medical-review panel and the panel has given an opinion. Ind. Code § 34-18-8-

      4. Because Krieter did not present her claims to a medical-review panel before

      going to court, Dr. Kansal asserted that the trial court lacks subject-matter

      jurisdiction. See, e.g., Rossner v. Take Care Health Sys., LLC, 172 N.E.3d 1248,

      1255 (Ind. Ct. App. 2021) (noting that a trial court lacks subject-matter

      jurisdiction over a malpractice claim that has not been through a medical-

      review panel), trans. denied.1

[5]   Following briefing and oral argument, the trial court denied Dr. Kansal’s

      motion without explanation. Dr. Kansal then sought and received permission

      to bring this interlocutory appeal.2

      1
       In support of his motion, Dr. Kansal submitted an affidavit from Dr. Laura Rogers, who opined that
      everything Dr. Kansal did with Krieter was medically appropriate. However, Dr. Rogers’s opinion was based
      entirely on Dr. Kansal’s version of events. She did not consider Krieter’s deposition testimony. Therefore, the
      affidavit is largely unhelpful in determining whether Krieter’s claims are subject to the Medical Malpractice
      Act.
      2
          We held oral argument on May 31, 2023. We thank counsel for their helpful advocacy.

      Court of Appeals of Indiana | Opinion 22A-CT-2646 | July 10, 2023                                 Page 4 of 10
      Discussion and Decision
[6]   Where, as here, a trial court rules on a Trial Rule 12(B)(1) motion to dismiss for

      lack of subject-matter jurisdiction based on a paper record and oral argument,

      with no evidentiary hearing, our review is de novo. GKN Co. v. Magness, 744

      N.E.2d 397, 401 (Ind. 2001). While a court deciding a motion to dismiss for

      failure to state a claim under Trial Rule 12(B)(6) can consider only the

      allegations in the plaintiff’s complaint, a court deciding a 12(B)(1) motion “may

      consider not only the complaint, but also any affidavits or other evidence

      presented and submitted on the issue of subject matter jurisdiction.” Martinez v.

      Oaklawn Psychiatric Ctr., Inc., 128 N.E.3d 549, 555 (Ind. Ct. App. 2019), clarified

      on reh’g, 131 N.E.3d 777, trans. denied.

[7]   Dr. Kansal renews his argument that Krieter’s claims are medical-malpractice

      claims subject to the Medical Malpractice Act, that she was therefore required

      to present a proposed complaint to a medical-review panel before going to

      court, and that because she failed to do so the trial court lacks subject-matter

      jurisdiction. The Act defines “malpractice” as “a tort or breach of contract

      based on health care or professional services that were provided, or that should

      have been provided, by a health care provider, to a patient.” I.C. § 34-18-2-18.

      We must decide, then, whether Krieter’s claims are “based on health care or

      professional services that were provided, or that should have been provided, by

      a health care provider, to a patient.” We hold they are not.

      Court of Appeals of Indiana | Opinion 22A-CT-2646 | July 10, 2023          Page 5 of 10
[8]   As Dr. Kansal notes, we have held that a claim is subject to the Medical

      Malpractice Act if (1) the alleged tortious conduct “involves provision of

      medical services” and (2) “the rendering of medical services is to the plaintiff

      for the plaintiff’s benefit.” Anonymous Hosp., Inc. v. Doe, 996 N.E.2d 329, 334

      (Ind. Ct. App. 2013), trans. denied. Dr. Kansal argues both prongs are satisfied

      here because the conduct at issue occurred “during the provision of medical

      services” and “in the course of scheduled medical appointments” meant to

      benefit Krieter. Appellant’s Br. pp. 26-31. But the question isn’t whether the

      alleged conduct occurred “during” the provision of medical services. The

      question is whether the alleged tortious conduct itself “involves” the provision

      of medical services. Krieter claims that she went to see Dr. Kansal for medical

      treatment and that at some point during the appointments Dr. Kansal’s conduct

      would transition from examination for medical purposes to groping for sexual

      purposes. This detour to sexual groping, if it occurred, was not medical care

      and did not “involve” medical care.

[9]   This conclusion is consistent with other well-established principles in this area.

      As we recently explained:

              The MMA is not all-inclusive for claims by patients against
              healthcare providers nor is it intended to extend to cases of
              ordinary negligence. Rather, it covers only curative or salutary
              conduct of a health care provider acting within his or her
              professional capacity and not conduct unrelated to the promotion
              of a patient’s health or the provider’s exercise of professional
              expertise, skill, or judgment. The fact that the alleged misconduct
              occurred in a healthcare facility, or that the injured party was a
              patient at the facility, is not dispositive of whether the MMA
      Court of Appeals of Indiana | Opinion 22A-CT-2646 | July 10, 2023         Page 6 of 10
               applies. Instead, we must look to the substance of the claim and
               determine whether it is based on the provider’s behavior or
               practices while acting in his or her professional capacity as a
               provider of medical services.

               A case sounds in ordinary negligence where the factual issues are
               capable of resolution by a jury without application of the
               standard of care prevalent in the local medical community. By
               contrast, a claim falls under the MMA where there is a causal
               connection between the conduct complained of and the nature of
               the patient-health care provider relationship. Thus, acts or
               omissions of a health care provider unrelated or outside the
               provider’s role as a health care professional are outside the reach
               of the MMA.

       Doe v. Ind. Dep’t of Ins., 194 N.E.3d 1197, 1200-01 (Ind. Ct. App. 2022) (cleaned

       up), trans. denied. Sexual groping is not “curative or salutary conduct.” It is

       “conduct unrelated to the promotion of a patient’s health or the provider’s

       exercise of professional expertise, skill, or judgment.”

[10]   Our holding is also consistent with this Court’s other decisions addressing

       sexual-misconduct claims against healthcare providers. We have repeatedly

       held that such claims are not subject to the Medical Malpractice Act. See Ind.

       Dep’t of Ins. v. Doe, --- N.E.3d ---, No. 22A-CT-1276, 2023 WL 3768429 (Ind. Ct.

       App. June 2, 2023); Doe, 194 N.E.3d 1197; Fairbanks Hosp. v. Harrold, 895

       N.E.2d 732 (Ind. Ct. App. 2008), trans. denied; Grzan v. Charter Hosp. of Nw. Ind.,

       702 N.E.2d 786, 792 (Ind. Ct. App. 1998); Murphy v. Mortell, 684 N.E.2d 1185

       Court of Appeals of Indiana | Opinion 22A-CT-2646 | July 10, 2023          Page 7 of 10
       (Ind. Ct. App. 1997), trans. denied; Doe by Roe v. Madison Ctr. Hosp., 652 N.E.2d

       101 (Ind. Ct. App. 1995), reh’g denied.3

[11]   Dr. Kansal contends this case is like Popovich v. Danielson, 896 N.E.2d 1196

       (Ind. Ct. App. 2008), trans. denied, a case that didn’t involve claims of sexual

       misconduct. There, the plaintiff sued a doctor for battery, claiming he was

       rough with her at the hospital after a car accident, apparently because he

       believed she was drunk. Specifically, the plaintiff alleged that the doctor spoke

       rudely to her, refused her pain medication, and then “grabbed [her] by her ankle

       and in a quick, jerky and rough manner lifted her leg straight in the air over her

       body and pierced the open flesh with a needle causing excruciating pain from

       her broken ribs, the embedded glass cuts and bruises to her chest and

       abdomen[.]” Id. at 1199. We held that, notwithstanding the plaintiff’s allegation

       that the doctor acted maliciously, the claim was covered by the Medical

       Malpractice Act because the doctor’s alleged battery “occurred while he was

       evaluating [the plaintiff’s] injuries, as he had been called to the hospital to do,

       and thus is based on the provider’s behavior or practices while acting in his

       professional capacity as a provider of medical services.” Id. at 1202 (cleaned

       up). In a footnote, we added that the plaintiff’s description of the doctor’s

       3
         In some of these cases, the patients argued that their sexual-misconduct claims were covered by the
       Medical Malpractice Act, hoping to access the Patient’s Compensation Fund established by the Act. See Doe,
       --- N.E.3d ---, No. 22A-CT-1276, 2023 WL 3768429; Doe, 194 N.E.3d 1197; Murphy, 684 N.E.2d 1185. We
       have rejected the argument regardless of who was making it. The only exception we have recognized is when
       a psychologist, psychiatrist, or other mental-health professional mishandles the “transference phenomenon”
       and has a sexual relationship with a patient. See, e.g., Dillon v. Callaway, 609 N.E.2d 424 (Ind. Ct. App. 1993),
       trans. denied. Dr. Kansal does not argue that exception applies here.

       Court of Appeals of Indiana | Opinion 22A-CT-2646 | July 10, 2023                                   Page 8 of 10
       conduct “suggests he displayed ‘poor bedside manner’ or was insensitive in his

       treatment of [the plaintiff]—the reasonableness of which is to be determined by

       the medical review panel; however, we cannot say his conduct was so ‘wanton

       and gratuitous’ as to fall outside the Malpractice Act.” Id. at 1202 n.2.

[12]   We find Popovich distinguishable. There, the patient alleged that the actual

       examination and treatment were too rough. As Krieter puts it, “The substance

       of the allegations was that [the doctor] inappropriately treated Popovich’s

       injuries – in short, classic medical malpractice allegations.” Appellee’s Br. p. 20.

       Here, on the other hand, Krieter alleges that Dr. Kansal ceased treatment all

       together and shifted to groping her for his own sexual gratification. If true, that

       conduct went far beyond “poor bedside manner” or mere insensitivity.

[13]   We add a caveat. At oral argument, Dr. Kansal’s attorney told us that Dr.

       Kansal denies the alleged touching at the core of Krieter’s claims—cupping her

       breasts, rubbing her nipples, and rubbing her buttocks for fifteen to twenty

       seconds at a time. But if he was admitting that touching and arguing it was

       medically appropriate, the Medical Malpractice Act might apply. Krieter

       conceded as much at the hearing on the motion to dismiss. Tr. pp. 25, 29, 35-

       36. With certain medical specialties, the line between medical touching and

       sexual touching can be blurry. Doctors often have to touch patients in sensitive

       areas and in uncomfortable ways, and a patient could misinterpret proper

       medical touching as inappropriate sexual touching. In a case where the doctor

       and the patient agree as to the touching that occurred but disagree as to the

       purpose of the touching, application of the Act and presentation to a medical-

       Court of Appeals of Indiana | Opinion 22A-CT-2646 | July 10, 2023           Page 9 of 10
       review panel might be appropriate. But this isn’t such a case, so we leave that

       issue for another day.

[14]   Ultimately, we agree with Krieter’s characterization of this case:

               The question for the jury is [] straightforward and purely factual –
               did Kansal grope [Krieter’s] breasts and buttocks as she describes
               or not? If he did, this was a sexual assault, not the provision of
               medical services. If he did not, then [Krieter’s] claim fails
               regardless of whether Kansal’s conduct met the standard of care
               for eczema treatment.

       Appellee’s Br. pp. 20-21. This is a “he said, she said” credibility fight that

       would not benefit from consideration by a medical-review panel. The factual

       issue is “capable of resolution by a jury without application of the standard of

       care prevalent in the local medical community.” Doe, 194 N.E.3d at 1200.

       Therefore, Krieter’s claims are not subject to the Medical Malpractice Act, and

       the trial court did not err by denying Dr. Kansal’s motion to dismiss.

[15]   Affirmed.

       Tavitas, J., and Foley, J., concur.

       Court of Appeals of Indiana | Opinion 22A-CT-2646 | July 10, 2023         Page 10 of 10