Cahoon v. Cummings

Supreme Court of Indiana · Torts

TortsMedical malpracticeWrongful deathSurvival actionsLoss of chancePrejudgment interestSpoliationRestatement (Second) of Torts § 323

Facts

William Cummings presented to his family doctor in December 1991 with heartburn-like symptoms, and x-rays interpreted by Dr. Cahoon led to a diagnosis of hiatal hernia and reflux esophagitis rather than esophageal cancer. Cummings later was diagnosed with esophageal cancer after suffering a perforated, hemorrhaged esophagus; the cancer had spread, and he died in August 1993. The doctors admitted breach of duty but denied causation, and the plaintiff presented expert testimony that although Cummings probably would not have survived even with proper diagnosis, he would have had a statistically significant chance of survival if diagnosed in December 1991. The jury awarded damages, and the trial court instructed that full wrongful death damages could be awarded if defendants' negligence was a substantial factor in death.

Issue

Whether the Mayhue increased-risk causation standard applies in a wrongful death action when the patient probably would have died even absent negligence, and if so, whether damages are the full wrongful death damages or only damages proportional to the increased risk caused by the defendants. The court also addressed whether the plaintiff could pursue both wrongful death and survival theories, whether a survival instruction referencing loss of opportunity was reversible error, whether evidence of altered medical records was admissible, and whether prejudgment interest was available against the health care providers.

Rule

In Indiana, Restatement § 323 as adopted in Mayhue applies in wrongful death actions: the plaintiff may establish causation by showing the defendant's negligence increased the risk of harm and that the increased risk was a substantial factor in the death. But damages in such a case are limited to the proportion of the ultimate damages attributable to the increased risk caused by the defendant, not the full value of the ultimate injury. A plaintiff may pursue both wrongful death and survival theories to verdict under Trial Rule 8(E), provided damages are not awarded on both theories for the same wrong.

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One of 10 multiple-choice questions for this case. Pick an answer to see why.

In Indianapolis, Dr. Lena Morris negligently failed to order follow-up testing for Omar Reed after abnormal findings suggested an aggressive infection. At trial, experts agree Reed more likely than not would have died even with timely treatment, but the plaintiff's expert testifies timely care would have given Reed a 30% chance of survival instead of 5%, and Reed later died from the infection.

Under the governing rule, which is the strongest basis for allowing the wrongful death claim to reach the jury on causation?

Explanation. The majority held that Restatement § 323, as adopted in Mayhue, applies in wrongful death actions. A plaintiff may establish causation by showing the defendant's negligence increased the risk of the ultimate harm and that the increased risk was a substantial factor in the death, even if the patient probably would have died anyway. (Derived from Cahoon v. Cummings (n.d.).)