Court Opinion

ID: 9897371
Source: CourtListenerOpinion
Date Created: 2023-11-14 19:10:44.879409+00
Date Added: 2024-06-11T09:15:44.700415
License: Public Domain

FILED
                                                                      Jun 14 2023, 9:46 am

                                                                           CLERK
                                                                      Indiana Supreme Court
                                                                         Court of Appeals
                                                                           and Tax Court

ATTORNEYS FOR APPELLANT                                    ATTORNEYS FOR APPELLEE
Courtney David Mills                                       Timothy S. Schafer
Alexis R. Jenkins                                          Timothy S. Schafer, II
Riley Bennett Egloff, LLP                                  Todd S. Schafer
Indianapolis, Indiana                                      Merrillville, Indiana

                                            IN THE
    COURT OF APPEALS OF INDIANA

Incremedical, LLC and Annie                                June 14, 2023
Gonzalez,                                                  Court of Appeals Case No.
Appellants-Defendants,                                     22A-CT-2929
                                                           Appeal from the Porter Superior
        v.                                                 Court
                                                           The Honorable Jeffrey Clymer,
Alyssa Kennedy,                                            Judge
Appellee-Plaintiff.                                        Trial Court Cause No.
                                                           64D02-2108-CT-7130

                                  Opinion by Judge Riley
                          Judges Bradford and Weissmann concur.

Riley, Judge.

Court of Appeals of Indiana | Opinion 22A-CT-2929 | June 14, 2023                             Page 1 of 12
      STATEMENT OF THE CASE
[1]   Appellants-Defendants, IncreMedical, LLC (IncreMedical) and Annie

      Gonzalez (Gonzalez) (collectively, Appellants), appeal the trial court’s denial of

      their motion to dismiss Appellee-Plaintiff, Alyssa Kennedy’s (Kennedy),

      Complaint for lack of subject matter jurisdiction.

[2]   We reverse and dismiss.

      ISSUE
[3]   Appellants present this court with one issue on appeal, which we restate as:

      Whether the trial court erred by denying Appellants’ motion to dismiss because

      Appellants are qualified health care providers pursuant to the Medical

      Malpractice Act and Kennedy failed to present her proposed complaint to the

      medical review panel prior to commencing this cause.

      FACTS AND PROCEDURAL HISTORY
[4]   IncreMedical is a rehabilitation management company that employs

      approximately 380 individuals and provides a wide variety of resources and

      personnel in the field of rehabilitation medicine. IncreMedical provides staffing

      and management of rehabilitation facilities in northern Indiana and

      surrounding communities. As part of its business services, IncreMedical

      employs a wide array of health care professionals, including physical therapists

      and occupational therapists. At all times during these events, Gonzalez was an

      employee of IncreMedical and acted in the course and scope of her

      employment with IncreMedical.
      Court of Appeals of Indiana | Opinion 22A-CT-2929 | June 14, 2023        Page 2 of 12
[5]   On August 22, 2019, Kennedy, then a high school student, was playing

      volleyball at Portage High School. During the game, both Kennedy and a

      teammate went for a ball and collided. Kennedy was knocked to the ground

      and her head struck the floor. Kennedy was referred to Athletic Trainer (AT)

      Gonzalez, working as an IncreMedical employee and contracted to work at

      Portage High School. AT Gonzalez advised Kennedy’s mother that “there is

      no use in going to the hospital” because a concussion is not visible on a scan.

      (Appellants’ App. Vol. II, p. 8). The following day, Kennedy informed AT

      Gonzalez that she had a terrible headache. Without doing an impact test as

      required by Portage High School’s safety policies and procedures, AT Gonzalez

      cleared Kennedy for practice. Three days later, Kennedy participated at

      another volleyball game at Portage High School. During the game, Kennedy

      was struck in the head by a ball. She was clearly dazed and confused. Again,

      AT Gonzalez advised Kennedy’s mother “that there was no use in going to the

      ER because there isn’t anything they can do to treat a concussion.”

      (Appellants’ App. Vol. II, p. 20).

[6]   On August 4, 2021, Kennedy filed her Complaint against Portage High School

      and Portage Township Schools (collectively, Portage High School) 1, claiming to

      have sustained a brain injury due to Portage High School’s and its employees’

      negligence in failing to follow its safety rules and procedures. On September

      30, 2021, Portage High School filed its answer, naming AT Gonzalez and

      1
          Portage High School is not part of these appellate proceedings.

      Court of Appeals of Indiana | Opinion 22A-CT-2929 | June 14, 2023       Page 3 of 12
      IncreMedical as non-parties. On January 3, 2022, Kennedy amended her

      Complaint, adding AT Gonzalez and IncreMedical as defendants and alleging

      that AT Gonzalez “failed to recognize [Kennedy’s] brain injury” and “failed to

      perform proper tests regarding concussions and brain injuries.” (Appellants’

      App. Vol. II, p. 20).

[7]   On April 6, 2022, Appellants filed their motion to dismiss Kennedy’s

      Complaint, alleging the trial court lacked subject matter jurisdiction over

      Kennedy’s claims pursuant to Indiana Code section 34-18-8-4 because Kennedy

      had failed to submit a proposed complaint naming Appellants to a medical

      review panel. Together with their motion to dismiss, Appellants provided an

      affidavit from the Indiana Department of Insurance (IDOI) verifying that

      IncreMedical was a qualified health care provider pursuant to Indiana’s

      Medical Malpractice Act (MMA) and an affidavit by Ann Miller (Miller),

      IncreMedical’s Human Resource Manager, averring that AT Gonzalez was an

      employee of IncreMedical acting within the course and scope of her

      employment. On April 13, 2022, Kennedy filed her response. On April 15,

      2022, Appellants filed a reply, including a supplemental affidavit from IDOI,

      verifying that both IncreMedical and AT Gonzalez “were qualified health care

      providers under the [MMA] for the time periods identified in [Kennedy’s]

      Complaint.” (Appellants’ App. Vol. II, p. 69). The affidavit also averred that

      Kennedy “did not file a Proposed Complaint for Damages with the IDOI

      regarding the claims set forth in [Kennedy’s] Complaint.” (Appellants’ App.

      Court of Appeals of Indiana | Opinion 22A-CT-2929 | June 14, 2023        Page 4 of 12
      Vol. II, p. 69). On June 7, 2022, the trial court heard argument on Appellants’

      motion and subsequently denied Appellants’ motion to dismiss.

[8]   Appellants now appeal. Additional facts will be provided as necessary.

      DISCUSSION AND DECISION
      I. Standard of Review

[9]   A trial court’s ruling on a motion to dismiss for lack of subject matter

      jurisdiction under Trial Rule 12(B)(1), unlike a trial court’s ruling on a motion

      to dismiss under Trial Rule 12(B)(6), may consider not only the complaint, but

      also any affidavits or other evidence presented and submitted on the issue of

      subject matter jurisdiction. B.R. ex rel. Todd v. State, 1 N.E.3d 708, 712 (Ind. Ct.

      App. 2013), trans. denied. If such evidence is presented, the trial court may

      weigh the evidence to resolve the jurisdictional issue. Id. On appeal, our

      standard of review depends on what occurred in the trial court, that is, whether

      the trial court resolved disputed facts, and if the trial court resolved disputed

      facts, whether it conducted an evidentiary hearing or ruled on a “paper record.”

      Martinez v. Oaklawn Psychiatric Ctr., Inc., 128 N.E.3d 549, 554-55 (Ind. Ct. App.

      2019), decision clarified on reh’g, 131 N.E.3d 777 (Ind. Ct. App. 2019).

              If the facts before the trial court are not in dispute, then the
              question of subject matter jurisdiction is purely one of law.
              Under those circumstances no deference is afforded to the trial
              court’s conclusion because appellate courts independently, and
              without the slightest deference to trial court determinations,
              evaluate those issues they deem to be questions of law. Thus, we
              review de novo a trial court’s ruling on a motion to dismiss under

      Court of Appeals of Indiana | Opinion 22A-CT-2929 | June 14, 2023          Page 5 of 12
               Trial Rule 12(B)(1) where the facts before the trial court are
               undisputed.

               If the facts before the trial court are in dispute, then our standard
               of review focuses on whether the trial court conducted an
               evidentiary hearing. Under those circumstances, the court
               typically engages in its classic fact-finding function, often
               evaluating the character and credibility of witnesses. Thus,
               where a trial court conducts an evidentiary hearing, we give its
               factual findings and judgment deference. And in reviewing the
               trial court’s factual findings and judgment, we will reverse only if
               they are clearly erroneous. Factual findings are clearly erroneous
               if the evidence does not support them, and a judgment is clearly
               erroneous if it is unsupported by the factual findings or
               conclusions of law.

               However, where the facts are in dispute but the trial court rules
               on a paper record without conducting an evidentiary hearing,
               then no deference is afforded to the trial court’s factual findings
               or judgment because under those circumstances a court of review
               is in as good a position as the trial court to determine whether the
               court has subject matter jurisdiction. Thus, we review de novo a
               trial court’s ruling on a motion to dismiss where the facts before
               the court are disputed and the trial court rules on a paper record.

       GKN Co. v. Magness, 744 N.E.2d 397, 401 (Ind. 2001) (citations and internal

       quotations omitted). In this case, the trial court considered the affidavits

       presented by Appellants.

[10]   The facts set forth above are undisputed. Moreover, although the trial court

       held a hearing on the motion to dismiss, the hearing was simply an oral

       argument, as the parties presented no additional evidence, and no witnesses

       Court of Appeals of Indiana | Opinion 22A-CT-2929 | June 14, 2023           Page 6 of 12
       were sworn. Accordingly, we apply a de novo standard of review based on the

       paper record before us. See B.R. ex rel. Todd, 1 N.E.3d at 713 (applying a de novo

       standard where the trial court held a hearing at which the parties made legal

       arguments but did not present evidence).

       II. Health Care Providers under the MMA

[11]   The MMA governs medical malpractice claims against healthcare providers.

       Ball Mem’l Hosp., Inc. v. Fair, 26 N.E.3d 674, 679 (Ind. Ct. App. 2015), trans.

       denied. To fall within the purview of the MMA, a provider’s conduct must be

       undertaken in the interest of, or for the benefit of, the patient’s health. In other

       words, the conduct must be “curative or salutary in nature or effect” for the

       person claiming patient status under the MMA. Collins v. Thakkar, 552 N.E.2d

       507, 510 (Ind. Ct. App. 1990). The curative or salutary conduct must be

       directed toward the person to whom the provider owes a duty of care. See Peters

       v. Cummins Mental Health, Inc., 790 N.E.2d 572, 577 (Ind. Ct. App. 2003), trans.

       denied. Conversely, the MMA does not apply to conduct “unrelated to the

       promotion of a patient’s health or the provider’s exercise of professional

       expertise, skill, or judgment.” Howard Reg’l Health Sys. v. Gordon, 952 N.E.2d

       182, 185 (Ind. 2011).

[12]   While the parties do not contest the propriety of Appellants’ conduct as falling

       within the parameters of the MMA, Appellants contend that because they are

       qualified health care providers, as statutorily defined, Kennedy should have

       Court of Appeals of Indiana | Opinion 22A-CT-2929 | June 14, 2023          Page 7 of 12
       submitted her proposed complaint to a medical review panel prior to

       commencing an action before the trial court.

[13]   Generally, a medical malpractice action may not be brought against a health

       care provider until a proposed complaint has been filed with the IDOI and an

       opinion has been issued by a medical review panel. Williams v. Adelsperger, 918

       N.E.2d 440, 445 (Ind. Ct. App. 2009), trans. denied. However, a plaintiff may

       bring a medical malpractice claim against a health care provider—without first

       filing a proposed complaint with the IDOI—if the health care provider against

       whom the action is brought is not qualified under the MMA. Rumell v. Osolo

       Emergency Med. Servs., Inc., 88 N.E.3d 1111, 1114 (Ind. Ct. App. 2017), trans.

       denied.

[14]   In deciding the proper forum, our supreme court has explained that the IDOI is

       the appropriate entity to make the “determination” of whether a health care

       provider is qualified under the MMA. Guinn v. Light, 558 N.E.2d 821, 824

       (Ind. 1990). For this reason, the court has noted that it is “prudent for [the

       plaintiff] to commence [a medical malpractice] action by filing [a] proposed

       complaint with the [IDOI].” Miller v. Terre Haute Reg’l Hosp., 603 N.E.2d 861,

       863 (Ind. 1992). This is so regardless of the ultimate qualified status of the

       defendant health care provider. Id. Moreover, in Shenefield v. Barrette, 716

       N.E.2d 1, 4-5 (Ind. Ct. App. 1999), this court indicated that when conflicting

       information is provided to the claimant concerning the qualified status of a

       physician under the Act, there is an affirmative obligation on the part of the

       claimant to determine from the IDOI whether the doctor is qualified.

       Court of Appeals of Indiana | Opinion 22A-CT-2929 | June 14, 2023         Page 8 of 12
[15]   Here, Appellants submitted an affidavit by Mary Wilson (Wilson), the Director

       of Dedicated Funds of the Indiana Patient’s Compensation Fund, Medical

       Malpractice Division. As part of her duties, as Director of Dedicated Funds,

       Wilson is “responsible for maintaining the records of all individuals and entities

       who have applied for and are qualified health care providers under the Indiana

       Medical Malpractice Act, I.C. § 34-18-1-1 et seq.” (Appellants’ App. Vol. II, p.

       68). She affirmed to have “reviewed the IDOI’s records and related documents

       regarding [IncreMedical] and [AT Gonzalez’s] status as qualified health care

       providers under the Act.” (Appellants’ App. Vol. II, p. 68). In her affidavit,

       Wilson concluded that “[IncreMedical] and their employee, [AT Gonzalez][,]

       were qualified health care providers under the Act for the time periods

       identified in [Kennedy’s] Complaint.” (Appellants’ App. Vol. II, p. 69).

[16]   Even without Wilson’s affidavit, we would reach the same conclusion that

       IncreMedical and AT Gonzalez are health care providers, as defined within the

       province of the MMA. Pursuant to the MMA, a “health care provider” is

       defined as:

               An individual, a partnership, a limited liability company, a
               corporation, a professional corporation, a facility, or an
               institution licensed or legally authorized by this state to provide
               health care or professional services as a physician, psychiatric
               hospital, health facility, emergency ambulance service ([I.C. §]
               16-18-2-107), dentist, registered or licensed practical nurse,
               physician assistant, certified nurse midwife, anesthesiologist
               assistant, optometrist, podiatrist, chiropractor, physical therapist,
               respiratory care practitioner, occupational therapist, psychologist,
               paramedic, advanced emergency medical technician, or

       Court of Appeals of Indiana | Opinion 22A-CT-2929 | June 14, 2023          Page 9 of 12
               emergency medical technician, or a person who is an officer,
               employee, or agent of the individual, partnership, corporation,
               professional corporation, facility, or institution acting in the
               course and scope of the person’s employment.

       Ind. Code § 34-18-2-14(1)(a). Not contesting the status of IncreMedical as a

       health care provider under the MMA, Kennedy focuses her argument on AT

       Gonzalez, claiming that because athletic trainers are not specifically listed in

       the statute, AT Gonzalez is not a health care provider and, therefore, not

       subject to the confines of the MMA. In support of her argument, Kennedy

       refers this court to Kroger Company v. Estate of Hinders, 773 N.E.2d 303 (Ind. Ct.

       App. 2002), trans. denied.

[17]   In Kroger, the Kroger court observed, with respect to the grocery store pharmacy

       which was determined to be an unqualified health care provider under the

       MMA:

               The language of Indiana Code section 34-18-2-14 within the
               Medical Malpractice Act has been revised several times since its
               enactment in 1975. The following ten health care providers have
               been added to the definition since 1975: psychiatric hospital,
               health facility, emergency ambulance service, physician assistant,
               midwife, respiratory care practitioner, occupational therapist,
               paramedic, emergency medical technician, and advanced
               emergency medical technician. At no point have pharmacists
               and pharmacies been added to this carefully considered and
               exclusive list of health care providers afforded the protections of
               the Medical Malpractice Act by the General Assembly.

       Court of Appeals of Indiana | Opinion 22A-CT-2929 | June 14, 2023          Page 10 of 12
       Id. at 306. Analogizing to the Kroger court’s determination, Kennedy maintains

       that because athletic trainers have not “been added to this carefully considered

       and exclusive list of health care providers,” the MMA clearly does not protect

       AT Gonzalez. (Appellee’s Br. p. 9).

[18]   Even though Kroger was decided within the context of statute of limitation

       provisions and represented dicta with respect to its interpretation of statutorily

       defined health care providers, we find Kroger to be unavailing to the situation

       before us for another reason. Unlike the enumerated and exclusive list which

       the Kroger court relied on to exclude pharmacists from the application of the

       MMA, Appellants posit the argument—and we agree—that AT Gonzalez is

       protected under the MMA pursuant to the catch-all provision included in

       Indiana Code section 34-18-2-14. Specifically, the MMA is applicable to AT

       Gonzalez by virtue of being “a person who is an [] employee [] of the []

       professional corporation, facility, or institution [and who was] acting in the

       course and scope of the person’s employment.” See I.C. § 34-18-2-14. In their

       affidavits, Wilson confirmed that IncreMedical and AT Gonzalez were

       qualified health care providers under the MMA, and Miller averred AT

       Gonzalez was an employee of IncreMedical and was acting within the course

       and scope of her employment at the time of the incident.

[19]   Accordingly, as IncreMedical and AT Gonzalez are qualified health care

       providers under the MMA, Kennedy must present her proposed complaint to a

       medical review panel prior to commencing an action in the trial court. I.C. §

       34-18-8-4. Kennedy failed to do so. Because the trial court lacked subject

       Court of Appeals of Indiana | Opinion 22A-CT-2929 | June 14, 2023        Page 11 of 12
       matter jurisdiction, we reverse the trial court’s denial of Appellants’ motion to

       dismiss. 2

       CONCLUSION
[20]   Based on the foregoing, we hold that the trial court erred by denying

       Appellants’ motion to dismiss because IncreMedical and AT Gonzalez are

       qualified health care providers pursuant to the MMA and Kennedy failed to

       present her proposed complaint to the medical review panel prior to

       commencing this cause before the trial court.

[21]   Reversed and dismissed.

[22]   Bradford, J. and Weissmann, J. concur

       2
        Kennedy also claims that AT Gonzalez was not covered by the MMA pursuant to Indiana Code section 34-
       18-3-3. Kennedy failed to raise this argument before the trial court, therefore, we find the issue waived.
       Nance v. Miami Sand & Gravel, LLC, 825 N.E.2d 826, 834 (Ind. Ct. App. 2005), trans. denied (“A party
       generally waives appellate review of an issue or argument unless that party presented that issue or argument
       before the trial court.”).

       Court of Appeals of Indiana | Opinion 22A-CT-2929 | June 14, 2023                             Page 12 of 12