St. Anthony Medical Center, Inc. v. Smith

• Decision Date: 28 May 1992
• Docket Number: No. 37A04-9010-CV-460,37A04-9010-CV-460
• Citation: 592 N.E.2d 732
• Parties: ST. ANTHONY MEDICAL CENTER, INC., Appellant-Defendant-Cross-Appellee, v. Betty SMITH, Personally and as Administratrix of the Estate of John F. Smith, Deceased, Appellee-Plaintiff-Cross-Appellant. 1
• Court: Indiana Appellate Court

Page 732

592 N.E.2d 732

ST. ANTHONY MEDICAL CENTER, INC., Appellant-Defendant-Cross-Appellee, v. Betty SMITH, Personally and as Administratrix of the Estate

of John F. Smith, Deceased,

Appellee-Plaintiff-Cross-Appellant.

No. 37A04-9010-CV-460. ¹

Court of Appeals of Indiana,

First District.

May 28, 1992.

Timothy F. Kelly, Law Offices of Timothy F. Kelly and Associates, Munster, for appellant-defendant-cross-appellee.

Catherine A. Kling, Indiana Dept. of Ins., Indianapolis, for amicus curiae.

Timothy S. Schafer, Schafer and Schafer, Professional Corporation, Merrillville, for appellee-plaintiff-cross-appellant.

RATLIFF, Chief Judge.

STATEMENT OF THE CASE

St. Anthony Medical Center, Inc. ("SAMC") appeals from a judgment in favor of Betty Smith, personally and as administratrix the estate of John F. Smith, decedent ("Betty"), in a wrongful death action. Betty cross-appeals challenging both the reduction of the jury's award of damages from $937,000 to $500,000 and the constitutionality of the Indiana Medical Malpractice Act. We affirm.

ISSUES

1. Did the trial court have subject matter jurisdiction over this claim when Betty's original complaint was filed before the medical review panel had issued its opinion?

2. Did the trial court err in admitting evidence regarding the dependency of John's adult child and giving instructions on damages the adult child incurred?

3. Did the trial court err in failing to admonish the jury regarding a statement made by plaintiff's counsel?

4. Did the trial court err in restricting defense counsel's cross-examination of a witness?

5. Is the Indiana Medical Malpractice Act constitutional and did the trial court err in reducing the jury's award of damages?

FACTS

John Smith was scheduled to undergo prostate surgery. On July 18, 1986, John underwent a pre-admission intravenous pyelogram test ² ("IVP") at SAMC. Prior to the IVP, John was placed on a restrictive diet and instructed to take four laxatives. John reported to the radiology department at SAMC and began the IVP at 9:45 a.m.; the IVP was completed at approximately 11:15 a.m. Upon completion of the IVP, John was discharged to the dressing room located within the radiology department. At approximately 1:15 p.m., nurses' aide Patricia Howe knocked on the door and asked John if he was all right, Howe believed that John had said "yep." Record at 482. Thereafter, John remained in the dressing room until 3:45 p.m. when a nurses' aide discovered him lying on the floor. John had suffered an ischemic infarct ³ The X-ray technician at SAMC was aware that John was on a restricted diet, had taken laxatives prior to the IVP test, and that this, combined with the stress of the test itself, can lower an individual's blood pressure causing a hypotensive condition. If a person is left in a hypotensive condition for a prolonged period of time, a stroke, caused by a lack of blood supply to the brain, can result. Moreover, the dye injected into a person's veins during the administration of an IVP, can also lower blood pressure by dilating veins and arteries in the body.

commonly known as a stroke, due to a lack of blood supply to his brain.

John was hospitalized at SAMC after his July 18 stroke. On July 27, 1986, a nurse at SAMC administered to John three times the dosage of Heparin that he was prescribed. On August 12, 1986, while still a patient at SAMC, John died.

Betty initiated this case by filing a complaint entitled "MALPRACTICE CLAIM PROPOSED COMPLAINT" against SAMC in the Lake Circuit Court on July 8, 1987. One day later, Betty filed an identical complaint with the Indiana Insurance Commissioner ("Review Panel"). The Review Panel issued its opinion on February 23, 1989, concluding that SAMC "failed to comply with the appropriate standard of care as charged in the Complaint. However the [Review] Panel was unable to determine whether the defendant's [SAMC's] failure to comply with the appropriate standard of care was a factor of the resultant damages." Record at 33. On March 8, 1989, Betty filed a motion to reinstate her complaint with the trial court. Thereafter, SAMC filed a motion to dismiss the complaint or in the alternative for a change of venue. The court denied the dismissal. On September 11, 1989, this case was assigned to the Jasper Circuit Court.

Trial commenced on August 6, 1990. On August 8, 1990, the jury returned a general verdict in favor of Betty "... as Administratrix of the Estate of John F. Smith, deceased," and awarded damages in the amount of $937,000. Subsequently, SAMC filed its motion to reduce the judgment to the cap provided under the Indiana Medical Malpractice Act. On October 9, 1990, the court granted SAMC's motion to reduce the judgment to $500,000.

SAMC appeals the judgment and Betty cross-appeals the reduction of the damages award. Other relevant facts will be presented in our discussion.

DISCUSSION AND DECISION

Issue One

SAMC asserts that the trial court lacked subject matter jurisdiction because Betty's complaint did not comply with the procedural requirements of the Indiana Medical Malpractice Act ("Act"), in that the complaint was filed before the Review Panel had issued its opinion. Thus, SAMC contends the trial court was required to grant its motion to dismiss the complaint.

The Act provides:

"Except as provided in subsection (b) and in section 3.5 of this chapter, no action against a health care provider may be commenced in any court of this state before the claimant's proposed complaint has been presented to a medical review panel established pursuant to this chapter and an opinion is rendered by the panel."

IND.CODE Sec. 16-9.5-9-2. Thus, if the defendant is a qualified health care provider under the Act, a proposed complaint submitted to the medical review panel and a decision by the medical review panel upon the complaint is required prior to instituting an action in an Indiana state court of general jurisdiction. State Ex Rel. Hiland v. Fountain Circuit Court (1987), Ind., 516 N.E.2d 50, 51. Submission of a proposed complaint to the medical review panel is a condition precedent to filing a medical malpractice claim in Indiana. Knoblett v. Kinman (S.D.Ind.1985), 623 F.Supp. 805, 807. The Act grants subject matter jurisdiction of medical malpractice actions first to the medical review panel, and then to the trial court. Cha v. Warnick (1983), Ind.App., 455 N.E.2d 1165, 1166-67, trans denied. The Act does, however, provide for limited subject matter jurisdiction by a court of general jurisdiction, prior to the time the review panel renders an opinion, in certain circumstances. See IND.CODE Sec. 16-9.5-10-1 (before opinion is rendered, court has limited jurisdiction to determine preliminarily an affirmative defense, or issue of law or fact not reserved by Act for written opinion by medical review panel); Id. (limited jurisdiction to compel discovery); IND.CODE Sec. 16-9.5-10-2 (party or chairman of medical review panel may invoke jurisdiction of court by paying filing fee and filing copy of proposed complaint for limited purpose "... including the taxation and assessment of costs or the allowance of expenses, including reasonable attorney fees, or both"); Hiland, 516 N.E.2d at 52 (in multiple defendant action, where one of the defendants is qualified health care provider, change of venue from county or judge is among issues that may be determined preliminarily); see also I.C. Sec. 16-9.5-9-2(b) (may commence an action in court without first submitting claim to medical review panel if all parties agree).

The proper course of action when a plaintiff fails to comply with the Act is for the trial court to dismiss the complaint without prejudice, thereby allowing the plaintiff to refile after the medical review panel has issued its opinion. Castelli v. Steele (S.D.Ind.1988), 700 F.Supp. 449, 455; Johnson v. Methodist Hospital of Gary, Ind. (N.D.Ind.1982), 547 F.Supp. 780, 781-82; Cha, 455 N.E.2d at 1167. In the case at bar, Betty filed her medical malpractice complaint against SAMC in the trial court on July 8, 1987. One day later she filed an identical complaint with the Indiana Insurance Commissioner and the complaint was submitted to the Review Panel for it to render an opinion. Since the original complaint was filed before a proposed complaint was filed with the Review Panel and before it rendered an opinion, the trial court originally lacked subject matter jurisdiction over these proceedings. See Castelli, 700 F.Supp. at 455 (subject matter jurisdiction is determined as of the date a complaint is filed). Therefore, had SAMC filed an Ind.Trial Rule 12(b)(1) motion when the trial court lacked subject matter jurisdiction over the complaint, the court would have been required to dismiss the cause of action without prejudice. This would have permitted Betty to refile her medical malpractice complaint after the Review Panel rendered its opinion. However, prior to the time that the Review Panel entered its opinion, the record reflects that the only action instituted by either party was on July 22, 1987, when SAMC's counsel entered an appearance and moved for additional time to respond.

It was not until August 29, 1989, that SAMC filed a motion to dismiss Betty's complaint for lack of subject matter jurisdiction. By this point in time, the Review Panel had rendered its opinion. More importantly, on March 8, 1989, after the proposed complaint had been filed with the Indiana Insurance Commission and the Review Panel had rendered its opinion, Betty filed a "MOTION TO REINSTATE" the original complaint with the trial court. SAMC concedes that once the opinion of the Review Panel was issued, the trial court would have had subject matter jurisdiction to accept the filing of Betty's complaint. Appellant's Brief at 12. However, SAMC argues that Betty's motion to reinstate was ineffective because the first complaint was a nullity; therefore, there was no complaint to "reinstate". SAMC...