Indiana Supreme Court Hears Arguments In Medical Privacy, Malpractice Cases

By: Casey Smith

Indiana Supreme Court justices heard oral arguments for multiple cases Tuesday, weighing the stakes in a medical privacy case and considering an allegation of medical malpractice at a state prison.

Both cases are among the 10 being heard and weighed by the high court this month. It’s not yet clear when opinions will be issued in either case.

In Z.D. v. Community Health Network Inc., an unnamed woman — identified as “Z.D.” — is suing Community Health Network after her medical diagnosis was mailed to the wrong person and then shared on social media.

After undergoing an examination and medical testing in the emergency department of an Indianapolis Community Health Network facility in 2018, hospital staff were unable to reach Z.D. to deliver her test results.

The lawsuit claims that a Community Health Network employee mailed a letter with Z.D.’s diagnosis and suggested treatment, but the letter was addressed to another person and instead reached a high school classmate of the woman’s daughter, Jonae Kendrick, who then posted it on Facebook.

Multiple people, including Z.D.’s daughter, saw the online post, according to court documents.

Z.D. said in the court challenge that she learned about her own medical diagnosis from her daughter. The woman paid Kendrick a $100 “bribe” in exchange for the letter, which was later removed from Facebook.

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Case plays out in court

In January 2020, Z.D. filed a complaint against Community Health, alleging that hospital staff “distributed (her) extremely sensitive and private health information to unauthorized person(s) and the general public” and that, as a result, she “suffered extensive injuries.”

The lawsuit also maintained that Community Health was negligent in training, supervising and retaining its employees, and that the hospital “owes a non-delegable duty to its patients to protect the privacy and confidentiality of their protected health information” but had “breached its statutory and common law duties of confidentiality and privacy” by having “no warning system” to catch the mistake before it happened.

Community Health pushed back, arguing that the posting of the letter on Facebook was an unforeseeable “criminal act” that broke “the chain of proximate causation.” The hospital held, too, that it could not be liable for negligent training and supervision if its employee was acting within the scope of employment.

The Marion Superior Court ultimately granted summary judgment to Community Health.

The Court of Appeals affirmed part of that ruling, but reversed and remanded for further proceedings on Z.D.’s invasion of privacy claim. The court additionally found that Z.D. was entitled to a trial on her claims for pecuniary damages resulting from Community Health’s alleged negligence.

Neal Eggeson, an attorney representing Z.D., argued before the justices that Indiana is one of only three states still stipulating that emotional-distress damages can only be recoverable if the plaintiff suffered a physical impact. He said the so-called “modified-impact rule” is “closing the doors” on cases like this.

But attorney Jenny Buchheit, representing Community Health, argued that getting rid of the modified impact rule would make “any type of mishandling of medical information” eligible for legal action.

Buchheit added that — while what happened to Z.D. was “completely unfortunate — the damages alleged by Z.D. stemmed from the posting of the letter to Facebook, not from Community Health sending the letter to the wrong person.

“If we’re thinking about those old cartoons we all watched as children, somebody pulls a lever and the train goes off on the path, and then the train ends up crashing down a ravine and does not go where we intended to go,” Buchheit said. “Miss Kendrick pulled that lever, the train careened off the path, and it crashed.”

Buchheit argued, too, that Kendrick knew she wasn’t the intended recipient of the letter and should have returned it to the post office or Community Health. The hospital also could not have forseen that Kendrick would post the letter to Facebook, she said.

Even so, Indiana Chief Justice Loretta Rush questioned if it was actually Community Health that set the train off-path: “Maybe the lever was pulled earlier,” she said.

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Alleged medical malpractice at Wabash Valley

Separately, in Edward Zaragoza v. Wexford of Indiana LLC; Samuel J. Byrd, M.D.; Naveen Rajoli, M.D.; Jackie L. West-Denning, M.D. , Indiana Supreme Court justices heard arguments in a case involving an inmate who alleged medical malpractice at the Department of Correction facility where he was incarcerated.

Edward Zaragoza filed a complaint in 2019 against Wexford of Indiana LLC, which provided medical care at Wabash Valley Correctional Facility in Terre Haute, where he is being held. He claimed the doctors employed by Wexford denied him treatment in violation of his Eighth Amendment constitutional rights.

Zaragoza, who remains incarcerated, was diagnosed with hypothyroidism, a chronic medical condition, and must take medication daily.

But in court documents, Zaragoza claims he suffers multiple adverse side effects from the prescribed medication — Synthroid — including headaches, muscle pains, neck tightness, cognitive problems, and blurred vision. He said Wexford’s doctors repeatedly denied alternative medications.

One of the defendants, a doctor, claimed that alternative medication was requested, but that after a second opinion from the regional clinical pharmacist, the request was denied, in part because the alternative medication can make Zaragoza’s condition more difficult to manage.

Zaragoza raises a lone issue in his legal challenge: whether the trial court erred in granting summary judgment to Wexford.

In 2021, the Court of Appeals of Indiana affirmed the Marion Superior Court’s ruling granting summary judgment to Wexford.

But Brian Karle, an attorney for Zaragoza, emphasized to Indiana Supreme Court justices Thursday morning that the state’s summary judgment standard “imposes a heavy factual burden” on Wexford.

He noted that Wexford must affirmatively disprove an element of his client’s claim, and only then does the burden shift to Zaragoza “to create a material issue of fact on that particular element.”

In this case, Wexford only sought to disprove a single element of the Eighth Amendment claim — deliberate indifference — and only sought to disprove a single element of the medical malpractice claim — breach of the standard of care — Karle said.

“In this case, the trial court and the court of appeals deviated from Indiana’s well established summary judgment standard and improperly raised the evidentiary bar for expert affidavits,” Karle continued. He said the justices should reverse the trial court’s summary judgment decision and allow that Zaragoza “may have his day in court.”

Rachel Johnson, representing Wexford, said physicians at the prison “all laid out exactly why the treatment was provided” to Zaragoza, and that he “was treated properly.”

In earlier court proceedings, Zaragoza was required to submit evidence showing the existence of a genuine issue of material fact for trial. Zaragoza provided testimony from Dr. Richard Schultheis, a family medicine specialist in Indianapolis, in opposition to Wexford’s motion for summary judgment.

Dr. Schultheis opined in his affidavit, among other things, that Wexford’s doctors had departed from the standard of care in their treatment of Zaragoza.

But Johnson said Dr. Schultheis is not qualified to weigh-in on Zaragoza’s care, given that he only reviewed some of Zaragoza’s medical files and never examined the inmate himself.

“We don’t believe Dr. Schultheis has provided enough information to meet a burden to show he’s an expert, and so we don’t believe the plaintiff has been able to show that there is enough to get over that hurdle to defeat the defendants’ arguments that they made on summary judgment,” Johnson said.

It’s not up to the justices to decide. Rush the panel “will be discussing the case and issuing an opinion in due course.”

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