United States District Court, S.D. Indiana, Indianapolis Division
ENTRY ON DEFENDANT TOULOUKIAN'S MOTION FOR SUMMARY JUDGMENT
RICHARD L. YOUNG, Chief District Judge.
Plaintiff, Debra Swain, filed suit against Defendants, Covidien, Inc., Tyco Healthcare Group, LP, and Dr. Christopher Touloukian, M.D., for damages sustained as a result of a medical procedure. The case was removed from state court based upon diversity jurisdiction pursuant to 28 U.S.C. § 1332. Dr. Touloukian now moves for summary judgment on the claim asserted against him. For the reasons set forth below, the motion for summary judgment is GRANTED.
Swain suffered from perforated sigmoid colon diverticulitis. On December 24, 2009, she underwent surgery to have part of her colon resected. Dr. Touloukian, Swain's surgeon, successfully completed the resection, but when he attempted to anastomose (i.e. connect the two resultant ends) the colon with a DST Series EEA 28mm Stapler ("the stapler"), the surgery went terribly wrong.
The stapler used on Swain is no ordinary desk stapler. It consists of two principal parts-the main stapling device and the anvil. In very simple terms, the anvil enters the bowel from the abdominal cavity and is placed in the proximal end of the bowel. The stapler is passed through the rectum to the stump of the sigmoid colon, at which point a protruding part of the stapler punctures the end of the stump and then meets with the anvil. With some finesse and the use of various sutures and clamps, the surgeon then connects the anvil and stapler to bring the two ends of the colon together. Once the anvil and stapler are engaged, the instrument is ready to fire, anastomosing the two ends of the colon. After the stapler fires, it should release from the tissue upon two counterclockwise motions, allowing the surgeon to safely slide the stapler out of the rectum.
Dr. Touloukian reported that he had successfully engaged and fired the stapler, but that the stapler failed to release from the tissue. For approximately 20 or 30 minutes, Dr. Touloukian employed various maneuvers to release the stapler. During this process, Swain's rectal stump tore, resulting in a significant amount of feces spilling into her abdomen. Due to the tear and fecal contamination, Dr. Touloukian decided to abort the anastomosis and instead perform a colostomy.
Swain argues that Dr. Touloukian failed to exercise the "applicable standards of care" while treating her and thus caused her significant harm. A unanimous Medical Review Panel found otherwise, stating that "[t]he evidence does not support the conclusion that the Defendant failed to meet the appropriate standard of care as charged in the complaint and the conduct complained of was not a factor of the resultant damages." (Filing No. 48-1).
Under the Erie doctrine, federal courts exercising diversity jurisdiction apply state substantive law and federal procedural law. Gasperini v. Ctr. for Humanities, Inc., 518 U.S. 415, 428, 116 S.Ct. 2211, 135 L.Ed.2d 659 (1996). Therefore, the court applies the federal standard for summary judgment and Indiana substantive law with respect to the medical malpractice claim. Id.
Summary judgment is appropriate when a movant shows that no genuine dispute as to any material fact exists and the movant is entitled to judgment as a matter of law. Fed.R.Civ.P. 56(a). The burden rests with the movant to demonstrate an absence of evidence to support the nonmoving party's case. Higgins v. Koch Development Corp., 997 F.Supp.2d 924, 927 (S.D. Ind. 2014) (citing Celotex Corp. v. Catrett, 477 U.S. 313, 325, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986)). Once the movant meets this burden, the responsibility shifts to the non-movant to "go beyond the pleadings" and point to evidence that establishes the existence of a genuine dispute of material fact. Id. at 928. The court construes the evidence and all inferences reasonably drawn therefrom in the light most favorable to the nonmoving party. Washington v. Haupert, 481 F.3d 543, 547 (7th Cir. 2007) (citing Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 255, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986)).
In a case such as this, where the doctor charged with malpractice receives a certified Opinion of a Medical Review Panel finding that the evidence does not support the conclusion that the physician failed to exercise the appropriate standard of care, the plaintiff must generally present expert testimony to demonstrate the existence of a genuine issue of fact. Ziobron v. Squires, 907 N.E.2d 118, 122 (Ind.Ct.App. 2008); see also Syfu v. Quinn, 826 N.E.2d 699, 704 (Ind.Ct.App. 2005) (stating that a unanimous opinion of a medical review panel finding no breach of the applicable standard of care is generally sufficient to negate the existence of a genuine issue of fact). In support of the motion, Dr. Touloukian argues that Swain's failure to present expert testimony on the applicable standard of care, breach of that standard, or proximate cause entitles him to summary judgment. (Filing No. 47 at 2). Swain counters that she need not present expert testimony because her case falls within the res ipsa loquitur exception. (Filing No. 64 at 1-3).
A medical malpractice plaintiff must ordinarily "present expert opinion that a defendant health care provider's conduct fell below the applicable standard of care, " unless res ipsa loquitur applies. Chi Yun Ho v. Frye, 880 N.E.2d 1192, 1201 (Ind. 2008). This doctrine permits the trier of fact to infer negligence where:
(1) the injuring instrumentality is shown to be under the management or exclusive control of the defendant or his servants, and (2) the accident is such as in the ordinary course of things does not happen if those who have ...