Vaidik, C.J.
Case Summary
In this medical-malpractice case against a chiropractor, the medical review panel, which consisted of three chiropractors, found that the defendant chiropractor met the applicable standard of care and did not cause the plaintiff’s injuries. The defendant-chiropractor moved for summary judgment, and in opposition the plaintiff designated an affidavit from his own chiropractor, who opined that the defendant-chiropractor did not meet the applicable standard of care and caused the plaintiff’s injuries. The trial court entered summary judgment in favor of the defendant-chiropractor because it found that chiropractors are not qualified to give expert opinions as to the medical cause of injuries.
A non-physician healthcare provider, such as a chiropractor, may qualify under Indiana Evidence Rule 702 to render an opinion as to medical causation if the causation issue is not complex. But the medical-causation issue in this case is complex. Accordingly, if a non-physician healthcare provider is not qualified under Evidence Rule 702 to render an opinion as to medical causation because the causation issue is complex, then chiropractors sitting on medical review panels are likewise not qualified to render opinions as to medical causation when the causation issue is complex. Thus, the opinion of the all-chiropractor medical review panel in this case can only be used as evidence that the defendant-chiropractor met the applicable standard of care. Because there is a genuine issue of material fact on this issue, we reverse the entry of summary judgment in favor of the defendant-chiropractor and remand this case for trial.
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The general rule is that non-physician healthcare providers are not qualified under Evidence Rule 702 to render opinions as to medical causation. See Nasser v. St. Vincent Hosp. & Health Servs., 926 N.E.2d 43 (Ind. Ct. App. 2010), trans. denied; Long v. Methodist Hosp. of Ind., Inc., 699 N.E.2d 1164 (Ind. Ct. App. 1998), trans. denied; Stryczek v. The Methodist Hosps., 694 N.E.2d 1186 (Ind. Ct. App. 1998), trans. denied. The rationale for this general rule is that there is a significant difference in the education, training, and authority to diagnose and treat diseases between physicians and non-physician healthcare providers. Cf. Ind. Code § 25-22.5-1-1.1 (physicians) with Ind. Code § 25-23-1-1.1 (registered nurses) & Ind. Code § 25-10-1-1 (chiropractors). In short, physicians have unlimited licenses, while registered nurses and chiropractors have limited licenses.
However, there is not a blanket rule that prohibits non-physician healthcare providers from qualifying as expert witnesses as to medical causation under Evidence Rule 702. In Curts v. Miller’s Health Systems, 972 N.E.2d 966 (Ind. Ct. App. 2012), we held that a non-physician healthcare provider may qualify under Evidence Rule 702 to render an opinion as to medical causation if the causation issue is not complex. “The determinative question is whether [the non-physician healthcare provider] has sufficient expertise, as provided in Rule 702(a), with the factual circumstances giving rise to the claim and the patient’s injuries.” Id. at 971.
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That being said, if a non-physician healthcare provider, such as a chiropractor, is not qualified under Evidence Rule 702 to render an opinion as to medical causation because the causation issue is complex, then chiropractors sitting on medical review panels are likewise not qualified to render opinions as to medical causation when the causation issue is complex. The rationale for this flows from our holding in Nasser. There, we held that a nurse who served on a medical review panel consisting of two physicians and one nurse was not qualified under Evidence Rule 702 to give her expert opinion as to medical causation (because it was beyond the scope of her professional expertise), either to create a genuine issue of material fact on summary judgment or to serve as substantive evidence at trial. Nasser, 926 N.E.2d at 52. In reaching this holding, we noted that there was a conflict between Indiana Code section 34- 18-10-23, which provides that the “report of the expert opinion reached by the medical review panel is admissible as evidence in any action subsequently brought by the claimant in a court of law,” and Evidence Rule 702. In the face of this conflict, we found that Evidence Rule 702 “prevail[ed]” and that the nurse’s opinion was inadmissible. Nasser, 926 N.E.2d at 52. Because the requirements of Evidence Rule 702 have not been met given the complex causation issues present in this case, the unanimous opinion of the all chiropractor medical review panel cannot be used as evidence that Dr. Bukofchan did not cause Totton’s injuries. Rather, the opinion can only be used as evidence that Dr. Bukofchan met the applicable standard of care, which squarely falls within the chiropractors’ area of expertise. Totton, however, created a genuine issue of material fact on this issue by designating the affidavit of Dr. DiMartino, who opined that Dr. Bukofchan failed to meet the applicable standard of care. See Hughley, 15 N.E.3d at 1003. We therefore reverse the entry of summary judgment in favor of Dr. Bukofchan and remand this case for trial.
Reversed and remanded.
Bailey, J., and Robb, J., concur.