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Applicability of res ipsa loquitur to Medical Malpractice Cases

Smith v. Dermatology Associates of Fort Wayne, P.C.(Ind. Ct. App. Sept. 7, 2012)

In this case, the Court of Appeals discussed the applicability of res ipsa loquitur to medical malpractice cases.

The plaintiff in this case suffered from psoriasis, a skin condition. The defendant physician prescribed UV treatment administered by a PUVA machine for this condition. Unfortunately, the patient suffered UV burns to 84% of his body. The plaintiff submitted his claims to a medical review panel, which found the health care provider’s care did not breach the standard of care. The plaintiffs then filed a complaint in state court. As part of their claim, they alleged that res ipsa loquitur could be used to support an inference of negligence by the defendants or a machine malfunction. The benefit of res ipsa loquitur for plaintiffs is that if the doctrine applies, they do not need to go to the expense of hiring an expert witness to testify regarding breach and causation.

The trial court, following a bench trial, found that the plaintiffs had failed to establish that the injuries suffered would not have occurred in the absence of negligence.

The Court of Appeals agreed with the trial court and affirmed. The Court of Appeals’ decision was primarily a product of the standard of review following a bench trial. The Court recognized that the trial court had the ability to judge the credibility of witnesses and found that the plaintiffs had failed to meet their burden of persuasion that the defendant had exclusive control of the PUVA machine and that the injuries suffered by the plaintiff do not occur without negligence.

This case demonstrates the importance of a case’s procedural posture. Had this case come to the Court of Appeals in the summary judgment context, the analysis would have been different and the result may have been different. The case also demonstrates the importance of experts in medical malpractice cases and the rarity of situations in which a plaintiff can proceed without expert testimony.


This doctrine allows a plaintiff to avoid proving proximate cause by allowing a jury or court to infer that negligence occurred. For this doctrine to apply, a plaintiff must show: (1) that the injuring instrumentality was within the exclusive management and control of the defendant or its servants, and (2) that the accident is of the type that does not ordinarily happen if those who have the management and control exercise proper care.

In Indiana, medical malpractice plaintiffs usually must submit their claims to a panel of three medical professionals before they may file a lawsuit in state court.

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