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Riley v. St. Mary's Medical Center of Evansville, Inc.

Court of Appeals of Indiana

October 29, 2019

Nataomi Riley and Frank Riley, Appellants-Plaintiffs,
v.
St. Mary's Medical Center of Evansville, Inc., Appellee-Defendant

          Appeal from the Vanderburgh Circuit Court The Honorable David D. Kiely, Judge Trial Court Cause No. 82C01-1809-CT-4911

          ATTORNEYS FOR APPELLANTS Arthur R. Baxter, Jr. Cynthia S. Rose Baxter Rose & Schrager LLP Indianapolis, Indiana

          ATTORNEYS FOR APPELLEE Michele S. Bryant Lauren E. Dimmitt Wooden McLaughlin LLP Evansville, Indiana

          CRONE, JUDGE.

         Case Summary

         [¶1] Nataomi Riley and her husband, Frank Riley, filed a medical malpractice complaint against St. Mary's Medical Center of Evansville, Inc. ("the Hospital"), alleging that a Hospital radiologic technologist ("RT") was negligent in injecting contrast dye into Nataomi's arm in preparation for a CT scan and that the negligence proximately caused various injuries. The Hospital moved for summary judgment. In response, the Rileys designated an affidavit from another RT who opined that the Hospital's RT breached the applicable standard of care and that this negligence proximately caused Nataomi's injuries. The Hospital conceded that the RT's affidavit established a genuine issue of material fact regarding a breach of the standard of care, but argued that the RT was not qualified to render an expert opinion on proximate causation. The trial court granted the Hospital's summary judgment motion. On appeal, the Rileys argue that their RT is qualified to render an expert opinion on proximate causation and that a genuine issue of material fact exists regarding that issue. We agree and therefore reverse and remand for further proceedings.

         Facts and Procedural History

         [¶2] The designated evidence most favorable to the Rileys as the summary judgment opponents indicates that at approximately 3:00 p.m. on June 8, 2015, sixty-eight-year-old Nataomi arrived at the Hospital for a CT scan with contrast dye to rule out a pulmonary embolism. According to Nataomi's affidavit, she had had "the same test done before and never had any problems." Appellants' App. Vol. 2 at 50. When Hospital employee RT Karen Osborne "came into the room to insert the dye [Nataomi] told her that [she had] always been a 'hard stick', and [Osborne's] reply was 'Don't worry this is not my first rodeo. I've been doing this for over 25 years.'" Id. Osborne inserted an IV into Nataomi's right forearm, went behind a barrier to avoid radiation exposure from the CT scan, and used a remote control to inject a thirty-milliliter pressurized "smart prep" test dose of dye into Nataomi's arm at four milliliters per second. Id. at 152. "As the dye was going into [Nataomi's] arm it was so painful [she] kept telling [Osborne], 'it hurts, it hurts'." Id. at 50. "With the intense pain [Nataomi] was having [she] just knew it was going into the tissue and [she] told [Osborne] that." Id. Once the entire test dose was injected, Osborne put Nataomi "into the [x]-ray machine. After a few seconds [Nataomi] was screaming to get [her] out of the machine because the pain went from [her] whole arm up to [her] shoulder." Id. When Osborne came to get Nataomi out of the machine, Osborne said, "'I knew there was a problem when looking at your x-ray.'" Id. According to Osborne's affidavit, she "fail[ed] to visualize the contrast in [Nataomi's] chest [on the machine's monitor] within 5 to 6 seconds of the injection[.]" Id. at 54.

         [¶3] "Another technician then inserted a needle in [Nataomi's] left arm and there was no pain when the dye went in [her] left arm." Id. at 50. Nataomi received a thirty-milliliter test dose and an additional seventy milliliters of dye in her left arm, for a total of 100 milliliters. Id. at 167-69. "The technicians put [her] back in the x-ray machine and it seemed like just a few minutes went by and [her] x-ray was finished." Id. at 50. Osborne "observed swelling that resembled a small egg [on Nataomi's right arm] and [Nataomi] complained of some pain." Id. at 54. Osborne "concluded an infiltration had occurred" and "applied compresses, massaged the area, and elevated [Nataomi's] right arm." Id.[1]According to Nataomi, Osborne "wrapped a dressing around [her] right arm and said, you might have a little bruising and swelling within an hour or after coming home and she left the room." Id. at 50. Osborne did not notify the Hospital's radiologist, Dr. Tony Findley, about the infiltration.

         [¶4] Nataomi got home between 6:30 and 7:30 p.m., and "[s]oon after" her "arm continued to swell so bad that the flesh broke open on [her] right hand and fluid was running out." Id. She called the "x-ray department and spoke to a technician and explained what was going on." Id. The technician told Nataomi "to apply alternating cold and hot compresses on [her] arm" and "that if it got too bad to go to the emergency room." Id. at 50-51. Around 10:00 p.m., "the pain became so unbearable and the swelling so bad that [Frank] took [Nataomi] to the Emergency Room. The ER doctor gave [her] morphine for the pain and ordered an [x]-ray for [her] right arm." Id. at 51. "When they moved [her] arm it was so painful that [she] was screaming and thought [she] would pass out from the pain." Id. "A short time later a trauma surgeon [Dr. Todd Burry] came in and commented that he had hardly ever seen a case like this and he was going to have to do surgery." Id. Nataomi was diagnosed with "[r]ight arm IV contrast extravasation." Id. at 72.[2]

         [¶5] Nataomi went into surgery at about 5:30 a.m. Dr. Burry's notes indicate that Nataomi was administered general anesthesia and preoperative antibiotics. "The hematoma/fluid collection was then identified. A linear incision was made approximately 2 inches in length parallel with the radius.… Immediately the hematoma was entered and fluid was drained. Hematoma was debrided and this hematoma was approximately 5 inches in length overall." Id. A "wound VAC [vacuum-assisted closure] was cut to the appropriate size … and then covered with appropriate dressing." Id. Nataomi was discharged "on June 12, 2015 and then had weeks of home health care with the wound [VAC]." Id. at 51.

         [¶6] According to Nataomi, who is right-handed, "[t]he skin is tight over the healed wound and pulls. The surgeon said that there is nothing he can do for that." Id. "Ever since the surgery, on average of two to three times a day, [she gets] a sharp electrical shock running from [her] wrist down into [her] fingers." Id. "The surgeon told [her] that [she has] nerve damage. [Her] grip is not as secure. [She] will be holding something in the right hand and all of a sudden it will just drop out of [her] hand." Id. "While writing [her] fingers will start to curl and [she has] to stop and take [her] left hand and uncurl them." Id.

         [¶7] In January 2016, the Rileys filed a proposed medical malpractice complaint against the Hospital with the Indiana Department of Insurance, alleging that as a result of medical negligence Nataomi "developed compartment syndrome of the right arm requiring emergency surgery and prolonged wound care" and "suffered permanent neurological and muscular damage to [her] right arm[, ]" among other injuries, and that Frank suffered a loss of consortium. Id. at 22. In June 2018, the medical review panel unanimously opined that the evidence submitted by the parties did not support the conclusion that the Hospital "failed to comply with the appropriate standard of care" and that the Hospital's conduct "was not a factor in the injuries and damages of which [the Rileys] complained." Id. at 28, 31, 34.

         [¶8] In September 2018, the Rileys filed a medical malpractice complaint against the Hospital in the trial court. The Hospital filed a motion for summary judgment and designated the medical review panel's opinion. In response, the Rileys designated Nataomi's medical records, Osborne's deposition, Dr. Findley's answers to interrogatories, [3] and affidavits from Nataomi, Osborne, and RT Barry Southers, who opined that Osborne "did not follow the standard of care in these circumstances and that conduct was a factor in the resultant injury to [Nataomi]." Id. at 57. In its reply to the Rileys' response, the Hospital argued that Southers was "not qualified to render an expert opinion as to medical causation" and cited cases to support its argument. Appellants' App. Vol. 3 at 9.[4] At the summary judgment hearing, the Hospital conceded that Southers's affidavit established a genuine issue of material fact regarding a breach of the standard of care, but reiterated its argument that Southers was not qualified to render an expert opinion on causation. In March 2019, the trial court issued an order summarily granting the Hospital's summary judgment motion. The Rileys now appeal. Additional facts will be provided below.

         Discussion and Decision

         [¶9] The Rileys argue that the trial court erred in granting the Hospital's summary judgment motion. "We review a summary judgment ruling by applying the same standard as the trial court: if the evidence shows there are no genuine issues of material fact and the moving party is entitled to judgment as a matter of law, summary judgment is appropriate." Lorenz v. Anonymous Physician #1, 51 N.E.3d 391, 397 (Ind.Ct.App. 2016). Just as the trial court does, we resolve all questions and view all evidence in the light most favorable to the non-moving party, so as to not improperly deny that party its day in court. Sorrells v. Reid-Renner, 49 N.E.3d 647, 650 (Ind.Ct.App. 2016) (quoting Alldredge v. Good Samaritan Home, Inc., 9 N.E.3d 1257, 1259 (Ind. 2014)). "Evidence sufficient to support a verdict is not required" to establish a genuine issue of material fact. Siner v. Kindred Hosp. L.P., 51 N.E.3d 1184, 1189 (Ind. 2016).

         [¶10] "Indiana's distinctive summary judgment standard imposes a heavy factual burden on the movant to demonstrate the absence of any genuine issue of material fact on at least one element of the claim." Id. at 1187. For a medical malpractice claim, those elements are (1) that the defendant owed a duty to the plaintiff; (2) that the defendant breached that duty; and (3) that the breach proximately caused the plaintiff's injuries. Id. "A 'unanimous opinion of the medical review panel' in favor of the movant is 'ordinarily sufficient' to meet [the movant's] initial burden, requiring the non-movant to rebut the medical panel opinion with expert medical testimony." Id. (quoting ...


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