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Dallas McKain v. Kenneth Bisson, M.D.

Citations: 12 F.3d 692; 1993 U.S. App. LEXIS 33324; 1993 WL 526789Docket: 92-3419

Court: Court of Appeals for the Seventh Circuit; December 21, 1993; Federal Appellate Court

Narrative Opinion Summary

In this case, a plaintiff filed a medical malpractice suit against a physician, alleging negligent misdiagnosis of a myocardial infarction, which purportedly deprived him of treatment opportunities. The case moved to federal court, where a jury ruled in favor of the defendant. On appeal, the plaintiff challenged the rejection of jury instructions on the 'loss of chance' doctrine, which Indiana courts have not definitively adopted. The appeal also contested the refusal to certify a state law question regarding this doctrine. Indiana law requires proof of a breach of standard care and causation for medical malpractice claims, and the court found no basis for the 'loss of chance' instruction, as proximate cause must be more than a mere possibility of a better outcome. Jury instructions included avoidable consequences, which were justified by evidence of the plaintiff's failure to follow discharge advice, and contributory negligence, which was later dismissed. The appellate court affirmed the lower court's rulings, emphasizing the lack of evidence to support the plaintiff's claims under the proposed legal theories.

Legal Issues Addressed

Avoidable Consequences Doctrine

Application: The jury was instructed on avoidable consequences, requiring the defendant to prove that the plaintiff's failure to follow medical advice resulted in avoidable damages.

Reasoning: Regarding the avoidable consequences instruction, the jury was instructed that the defendant must prove that McKain’s failure to follow discharge instructions proximately resulted in damages that could have been avoided.

Contributory Negligence Defense

Application: The defense of contributory negligence was initially presented but later dismissed, as no evidence showed it proximately caused the plaintiff's injuries.

Reasoning: At the close of evidence, the magistrate judge granted McKain's motion for judgment as a matter of law regarding contributory negligence, instructing the jury to disregard this issue during deliberations.

Jury Instructions and Proximate Cause

Application: Proximate cause is established when an act or omission significantly contributes to an injury, and the jury must determine if negligence was a substantial factor.

Reasoning: The magistrate judge instructed that proximate cause is established when an act or omission significantly contributes to an injury or damage, which must be a direct result or a likely consequence of that act or omission.

Loss of Chance Doctrine

Application: The court declined to adopt the 'loss of chance' doctrine, which would alter causation requirements by allowing compensation for reduced chances of a favorable outcome due to negligence.

Reasoning: Adopting the 'loss of chance' doctrine would significantly alter Indiana's causation requirements, and the court found no error in refusing to instruct on this doctrine.

Medical Malpractice and Standard of Care

Application: In Indiana, establishing medical malpractice requires proving a breach of the standard of care and a compensable injury directly caused by that breach.

Reasoning: The legal framework for proving negligence in Indiana requires establishing the standard of care owed by the doctor, a breach of that standard, and a compensable injury caused by the breach.