Goff, J.
Hetep Bilal “Franklyn” Neter-Nu stopped at Methodist Hospital complaining of nausea and vomiting. He ended up with an amputated foot three weeks later. Neter-Nu sued the hospital, Dr. Zainab Abbas, and Nurse Morgan Mittler (collectively “Health Care Providers” or “Providers”). A jury returned a verdict in favor of Neter-Nu. Providers raise several claims related to certain evidentiary issues and jury instructions, among others. We hold that the trial court erred when it denied Methodist’s Trial Rule 50(A) motion for partial judgment on the evidence and when it calculated prejudgment interest. But the trial court did not abuse its discretion in declining to give Providers’ proposed jury instructions and excluding certain evidence. Therefore, we affirm the jury verdict but reverse and remand with instructions to grant Methodist’s Rule 50(A) motion and recalculate prejudgment interest based on the Providers’ statutory liability.
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In resolving this case, our opinion first addresses whether the trial court erred in inviting the jury to find Methodist liable independent of its vicarious liability for Dr. Abbas and Nurse Mittler. See infra Section I.A. Though we conclude that it did, it does not require reversing the jury verdict. See infra Section I.B. Next, we address whether the trial court abused its discretion in refusing to give the Providers’ proposed instructions on superseding cause and use of hindsight in evaluating the standard of care. We hold that it did not because the instructions given effectively covered these issues. See infra Sections II.A–B. We then address whether the trial court abused its discretion by preventing the Providers from using certain medical records from Neter-Nu’s prior hospitalizations and by preventing them from using an email intended to refresh the recollection of Neter-Nu’s expert. Because the medical records amounted to impermissible character evidence, and because the Providers failed to lay the necessary foundation for refreshing recollection, we hold that the trial court did not abuse its discretion. See infra Sections III.A–B. Finally, the trial court’s error in denying Methodist’s Rule 50(A) motion requires recalculating prejudgment interest. See infra Section IV.
I. The trial court erred by inviting the jury to find Methodist liable independent of its vicarious liability for Dr. Abbas and Nurse Mittler, but joint-and-several liability precludes the need for reversal.
In malpractice cases, like other kinds of negligence actions, the plaintiff must prove (1) the defendant owed the plaintiff a duty of care, (2) the defendant breached its duty by allowing its conduct to fall below the applicable standard of care, and (3) a compensable injury proximately caused by the defendant’s breach of duty. Methodist Hosps., Inc. v. Johnson, 856 N.E.2d 718, 720–21 (Ind. Ct. App. 2006). Although hospitals do not “practice” medicine, they can be directly liable to a plaintiff for negligent supervision, training, or retention of personnel who do practice medicine on their behalf. Cmty. Health Network, Inc., v. McKenzie, 185 N.E.3d 368, 375 (Ind. 2022). Hospitals may also face vicarious liability for the negligence of their agents, such as the doctors and nurses they employ. See id. at 375, 379. In many cases, to establish the applicable standard of care for a health-care provider and to prove that a health-care provider’s negligence caused their injury, the plaintiff must provide expert opinion. Simmons v. Egwu, 662 N.E.2d 657, 658 (Ind. Ct. App. 1996), trans. denied; Harris v. Jones, 143 N.E.3d 1012, 1017 (Ind. Ct. App. 2020).
A. The trial court erred when it denied Methodist’s Trial Rule 50(A) motion and gave instructions inviting the jury to find Methodist liable independent of its vicarious liability for Dr. Abbas and Nurse Mittler.
At trial, Methodist moved unsuccessfully for judgment on the evidence on the limited issue of its direct liability or vicarious liability for an agent other than Dr. Abbas and Nurse Mittler. Similarly, Methodist objected to the court’s instructions inviting the jury to find Methodist liable for the liability of “any other” agent of Methodist.1 Appellant’s App. Vol. 4, pp. 88, 96; Tr. Vol. 9, pp. 195, 196. Methodist argues that, while evidence established its vicarious liability for Dr. Abbas and Nurse Mittler, Neter-Nu presented no evidence showing Methodist’s direct liability or vicarious liability for another agent. We agree.
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Neter-Nu also argues Methodist is vicariously liable for the negligent acts of other agents besides Dr. Abbas and Nurse Mittler. Neter-Nu presented evidence of conflicting entries in Methodist’s records by nonparty nurses, and evidence that non-party employee and hospitalist Dr. Clive Alonzo approved the placement of the IV in Neter-Nu’s foot. But Neter-Nu provided no expert testimony on how these specific actions fell below the applicable standard of care. See Tr. Vol. 3, pp. 88–89, 118, 197 (Nurse Lisa Stringer testifying only about how inconsistent documentation by Nurse Mittler breached the standard of care); Tr. Vol. 4, pp. 164, 168 (Dr. Ahmet Gurbuz declining to opine on chart entries and limiting his expert opinion to Dr. Abbas only); Tr. Vol. 5, pp. 15–16, 76 (Dr. Tripp testifying to the standard of care required of Dr. Abbas “or any of the Methodist hospitalists” but then clarifying that his opinion relates only to Dr. Abbas). Unless the physician’s conduct is so obviously substandard that negligence is within the common knowledge of lay people, Syfu v. Quinn, 826 N.E.2d 699, 703 (Ind. Ct. App. 2005), “[e]xpert opinion is indispensable to an evaluation of a particular defendant’s conduct within the framework of the duty imposed by law,” Bonnes v. Feldner, 642 N.E.2d 217, 220 n.1 (Ind. 1994) (quoting Stumph v. Foster, 524 N.E.2d 812, 814 (Ind. Ct. App. 1988)). Absent such testimony, the trial court should have granted Methodist’s Rule 50(A) motion and should not have instructed the jury inviting them to find Methodist liable independent of its vicarious liability for Dr. Abbas and Nurse Mittler. [Footnote omitted.
B. There is no need to reverse the jury verdict given the application of joint-and-several liability.
To the extent the trial court erred by denying Methodist’s Rule 50(A) motion and inviting the jury in its instructions to find Methodist liable independent of its vicarious liability for Dr. Abbas and Nurse Mittler, the errors do not require reversal. Joint-and-several liability applies to negligent defendants in medical-malpractice suits. Ind. Dep’t of Ins. v. Everhart, 960 N.E.2d 129, 138 (Ind. 2012). Under joint-and-several liability, each defendant is liable for the entire damages award, regardless of the degree of the defendant’s negligence. See id. at 137. The trial court instructed the jury that, “regardless of [a defendant’s] degree of negligence, they are jointly liable for the entire amount of Franklyn NeterNu’s damages,” and that the jury “must return a verdict against all negligent defendants in a single amount for the total damages” without considering “the amount that any individual defendant will pay toward [the] verdict.” Appellant’s App. Vol. 4, p. 96. Because joint-and-several liability applies in medical-malpractice cases, the jury did not award damages based on each liable defendant’s individual degree of negligence. Instead, it awarded damages based on Neter-Nu’s injury. Therefore, the error in inviting the jury to find Methodist negligent for the actions of agents besides Dr. Abbas and Nurse Mittler did not impact the damages amount. Instead, the error impacts who pays the damages before the Patient’s Compensation Fund pays the balance.
…Since Methodist is solely liable by reason of Dr. Abbas’s and Nurse Mittler’s negligence, then NeterNu can recover a total of $500,000—$250,000 on behalf of Dr. Abbas and Methodist and $250,000 on behalf of Nurse Mittler and Methodist—before the Patient’s Compensation Fund pays the balance.
II. The trial court did not abuse its discretion in refusing to give the Providers’ proposed jury instructions.
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A. Even if Providers’ proposed instruction on superseding cause were proper, the trial court’s instructions on causation covered the issue.
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Finally, even if the proposed instruction were proper, the trial court’s model instruction on causation essentially covered the issue of superseding cause. See Bouras, 423 N.E.2d at 744 (concluding the trial court is not required to give an instruction when another “instruction covers that area of the law”). In Control Techniques, Inc. v. Johnson, this Court held that refusing to instruct the jury on superseding cause was not reversible error because the doctrines of causation and foreseeability—set forth in separate instructions—impose the same limitations on liability as the superseding-cause doctrine. 762 N.E.2d 104, 108 (Ind. 2002). We reasoned that causation limits a defendant’s liability to foreseeable consequences, but a superseding cause is, by definition, one that is not foreseeable. Id. So, the superseding-cause “doctrine in today’s world adds nothing to the requirement of foreseeability that is not already inherent in the requirement of causation.” Id.
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In sum, given the lack of evidence that getting follow-up care sooner would have saved Neter-Nu’s foot, the trial court did not abuse its discretion in declining to give the Providers’ proffered jury instruction on superseding cause. And the jury instructions essentially covered superseding cause when the trial court properly instructed the jury on proximate cause.
B. Providers’ proposed instruction on avoiding hindsight as a basis for its standard-of-care determination was effectively covered by other jury instructions.
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But a trial court is not required to give a jury instruction where another instruction covers that area of law. See Bouras, 423 N.E.2d at 744. In Carter v. Robinson, the Court of Appeals held that when a trial court instructed a jury that a practitioner must use the degree of care a reasonable practitioner would use “under the same or similar circumstances,” there was no need for an instruction that a “determination should not be based on hindsight.” 977 N.E.2d 448, 457, 458 (Ind. Ct. App. 2012), trans. denied. Here, the trial court provided a similar instruction stating that, when determining whether the Providers exercised reasonable care, the jury should consider “the degree of care and skill that a reasonably careful, skillful, and prudent physician and/or nurse would use under the same or similar circumstances.” Appellant’s App. Vol. 4, p. 89 (emphasis added). By instructing the jury to evaluate the Providers based on what a reasonable provider would do in those same circumstances, the trial court effectively instructed the jury not to use hindsight. Therefore, there was no error in failing to provide the instruction against using hindsight.
III. The trial court did not abuse its discretion by precluding Providers from using certain medical records and emails.
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Here, Providers argue that the trial court improperly excluded (A) medical records documenting Neter-Nu’s disruptive behavior during prior hospitalizations and (B) certain emails from Neter-Nu’s expert witness.
A. The trial court properly excluded records of Neter-Nu’s medical history.
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Instead, the trial court properly excluded the medical records as impermissible evidence of other acts to prove character. Indiana Evidence Rule 404(b)(1) prohibits evidence of other acts “to prove a person’s character in order to show that on a particular occasion the person acted in accordance with the character.”…
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Second, the Providers argue they could use the medical records as the basis of an expert’s opinion testimony under Indiana Evidence Rule 703. Specifically, they argue that the experts could have referenced those records as the basis of their opinions on whether Nurse Mittler met the applicable standard of care when placing the IV in Neter-Nu’s foot… Providers were able to present evidence that Nurse Mittler thought the IVs kept coming out of Neter-Nu’s arms, making it appropriate for her to place the IV in NeterNu’s foot. And Nurse Mittler was unaware of Neter-Nu’s history of pulling IVs at the time, so the medical records did not affect Nurse Mittler’s decision to place the IV in his foot. Therefore, any error in preventing Providers from referring to the medical records was harmless.
Finally, the Providers argue that the evidence of Neter-Nu’s history of removing his IVs and failing to take blood-pressure medication could be used to impeach Neter-Nu’s testimony that he’s a “compliant patient.” Appellant’s Br. at 49 (quoting Tr. Vol. 6, pp. 48–49). But the Providers didn’t raise this argument at trial, effectively waiving it for appellate review….
B. The trial court properly excluded emails from Neter-Nu’s expert witness.
After Neter-Nu’s expert, Dr. Tripp, testified at trial to Neter-Nu’s injury and symptoms, Providers on cross-examination sought to use a previous email Dr. Tripp sent to Neter-Nu’s counsel to (1) refresh Dr. Tripp’s recollection, and (2) impeach him. Though the trial court excluded this evidence on hearsay and relevance grounds, we find no abuse of discretion.
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IV. Though we affirm the jury verdict and damages award, the trial court’s error in denying Providers’ Rule 50(A) motion still requires recalculation of prejudgment interest.
The trial court awarded prejudgment interest to Neter-Nu in the amount of 8% of $250,000 for 48 months. Neter-Nu argues that the trial court should have awarded prejudgment interest in the amount of each defendant’s liability. We agree.
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Conclusion
Our courts promise litigants a fair trial, not necessarily a perfect one. And Neter-Nu and the Providers received a fair trial here. We affirm the jury verdict but reverse and remand for the trial court to enter Methodist’s Rule 50(A) motion and recalculate prejudgment interest based on the Providers’ statutory liability under the MMA. [Footnote omitted.]
Rush, C.J., and Massa, Slaughter, and Molter, JJ., concur