Appeal Rules that Chiropractors Not Qualified to Proffer Opinions on ‘Complex’ Causation Questions
A medical malpractice case against a Franklin County chiropractor can proceed to trial after the Indiana Court of Appeals held Wednesday that chiropractors, including those on medical review panels, are not qualified to render opinions on the cause of injuries when a case involves a “complex” causation issue.
Craig Totton broke multiple ribs and his ankle in a motorcycle accident in September 2009. He immediately sought treatment for his injuries from Dr. Daniel Bukofchan, a chiropractor, at Franklin County Chiropractic Clinic. There were several treatment sessions Totton went to. During one of these visits Bukofchan “snapped” Totton’s neck, and thereafter Totton said he experienced sharp pain and a progressive weakening in his left arm.
In December of 2010, an MRI showed a herniated disc in Totton’s neck, which required surgery. He filed a proposed medical malpractice complaint against Bukofchan and the clinic, alleging Bukofchan had “carelessly, negligently, and unskillfully examined and treated Totton and that as a direct and proximate result, he suffered personal injuries and an aggravation of a preexisting injury.”
Shortly after Totton filed his lawsuit, a medical review panel consisting of three chiropractors reviewed Totton’s case as part of the malpractice proceeding. The panel issued an opinion in 2015 finding Bukofchan’s treatment did not fail to meet the applicable standard of care and “was not a factor of the resultant damages.” Undeterred, Totton filed a complaint alleging medical malpractice in Franklin Circuit Court, and Bukofchan moved for summary judgment.
In response to Bukofchan’s motion to set aside the case, Totton hired Guy DiMartino, a chiropractor who stated that Bukofchan failed to meet the applicable standard of care and caused or substantially contributed to Totton’s injuries. Bukofchan argued to the Franklin Circuit Court that DiMartino was not qualified to provide expert testimony on the causation of Totton’s injuries. The trial court agreed, stating “chiropractors are more akin to nurses in that they receive limited medical licenses and are therefore not qualified to offer expert testimony as to the medical cause of injuries.” Bukofchan’s motion for summary judgment was granted.
Totton appealed to the Indiana Court of Appeals and argued that non-physician health care providers can give a causation opinion under Indiana Evidence Rule 702. The Indiana Court of Appeals agreed and reversed the motion for summary judgment. The Court reasoned that “non-physician health care providers can give a causation opinion if the issue is not complex and if the issue is complex and a chiropractor cannot render an opinion, then chiropractors sitting on medical review panels are likewise unqualified.”
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