BlogLine

Indiana high court gives leeway to standard of care opinions

2/12/24

doctor; medical; healthcare; medicine; care

By: Joshua W. Zhao

In Korakis v. Memorial Hospital of South Bend et al., No. 23S-CT-109 (2024), the Indiana Supreme Court considered whether a medical expert must expressly state the applicable standard of care in their affidavit for the purposes of supporting a summary judgment motion. 

On August 3, 2017, Penny Korakis was taken to Memorial Hospital of South Bend (“Memorial Hospital”) due to pain from her left hand to her left shoulder. She was treated by Dr. David A. Halperin. She received x-rays of her left arm and hand. Dr. Halperin diagnosed her with an acute soft tissue injury. Korakis returned to Memorial Hospital a week later where she received treatment from a nurse practitioner who ordered x-rays of Korakis’ left shoulder, elbow, and wrist. She was referred to Dr. Michael R. Messmer for treatment, which she received in August and September. Dr. Messmer ordered more x-rays of Korakis’ wrist and referred Korakis to physical therapy. Korakis still experienced worsening pain after physical therapy so she returned to Dr. Messmer in October. A nurse told Korakis that she could return to physical therapy, wait two weeks to schedule a MRI or see Dr. John Kelbel. Dr. Kelbel saw Korakis and noted that the initial x-rays revealed an occult radial fracture in Korakis’ left elbow, but the injury had time to heal and likely reached maximum improvement. Dr. Kelbel ordered an MRI of Korakis’ left elbow along with her right ankle. Korakis returned to Dr. Messmer to discuss the results of the MRIs and Dr. Messmer did not find any concerns in the results but reported a fracture after Korakis told him about the x-ray results. 

Korakis filed a proposed complaint with the Indiana Department of Insurance against Memorial Hospital, Dr. Halperin and Dr. Messmer, alleging that her treatment was negligent and fell below the standard of care. Korakis alleged that both doctors failed to identify and diagnose the true extent of Korakis’ injuries. The Medical Review Panel used by the Department of Insurance found in Defendants’ favor. Korakis then filed suit against Memorial Hospital, Dr. Halperin and Dr. Messmer, alleging again that her treatment was negligent and fell below the standard of care and resulted in her needing corrective surgery. All defendants moved for summary judgment based on the Medical Review Panel’s findings that defendants did not fail to meet the applicable standard of care. Korakis argued that Dr. Halperin and Dr. Messmer’s failure to identify the fracture presented a genuine issue of material fact that precluded summary judgment. Korakis supported her response by including the affidavit of Dr. James E. Kemmler. The affidavit did not state the standard of care but concluded that Dr. Messmer had failed to meet the standard of care. The affidavit did not state that Dr. Halperin or Memorial Hospital failed to meet the standard of care. Dr. Messmer and Memorial Hospital argued that Dr. Kemmler’s affidavit was insufficient because it never stated the applicable standard of care. The trial court granted summary judgment in favor of defendants which was affirmed on appeal. Korakis then sought transfer to the Indiana Supreme Court, which was granted. 

The Indiana Supreme Court held that the applicable standard of care may be inferred but a doctor must explicitly state in their affidavit that the treatment fell below the standard of care. The Indiana Supreme Court went on to say that Dr. Kemmler’s affidavit created a genuine issue of material fact because Dr. Kemmler’s medical credentials made him qualified to testify and that Dr. Kemmler had made a detailed evaluation of the care that Dr. Messmer had provided to Korakis. The court found this sufficient to infer the standard of care. The Indiana Supreme Court reversed as to Dr. Messmer due to the affidavit but affirmed as to Dr. Halperin and Memorial Hospital as the affidavit did not state that the treatment of Dr. Halperin and Memorial Hospital fell below a standard of care.  

This case highlights that while the affidavits of medical experts are now less restrictive, it is still vitally important that the medical expert explicitly state that treatment fell below a standard of care. 

For more information, please contact Josh Zhao at josh.zhao@fmglaw.com or your local FMG attorney.