Marigold Overshiner and Earl Overshiner, Individually and as Parents and Guardians of their Minor Daughter, Kaitlyn Overshiner v. Hendricks Regional Health and Ian Johnston, M.D. , 119 N.E.3d 1124 ( 2019 )


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  • ATTORNEYS FOR APPELLANTS                                     ATTORNEYS FOR APPELLEE
    John Morris                                                  HENDRICKS REGIONAL
    Stan Brown                                                   HEALTH
    Morris Law Firm                                              Ronald A. Mingus
    Lafayette, Indiana
    FILED
    Nicholas G. Brunette
    Feb 21 2019, 5:26 am
    Katherine M. Haire
    Reminger Co., LPA                   CLERK
    Indiana Supreme Court
    Indianapolis, Indiana              Court of Appeals
    and Tax Court
    ATTORNEY FOR APPELLEE
    IAN JOHNSTON, M.D.
    James W. Brauer
    Katz Korin Cunningham PC
    Indianapolis, Indiana
    IN THE
    COURT OF APPEALS OF INDIANA
    Marigold Overshiner and Earl                                 February 21, 2019
    Overshiner, Individually and as                              Court of Appeals Case No.
    Parents and Guardians of their                               18A-CT-582
    Minor Daughter, Kaitlyn                                      Appeal from the Putnam Circuit
    Overshiner, and Kaitlyn                                      Court
    Overshiner,                                                  The Honorable Matthew L.
    Appellants-Plaintiffs,                                       Headley, Judge
    Trial Court Cause No.
    v.                                                   67C01-0610-CT-321
    Hendricks Regional Health and
    Ian Johnston, M.D.,
    Appellees-Defendants.
    Brown, Judge.
    Court of Appeals of Indiana | Opinion 18A-CT-582 | February 21, 2019                     Page 1 of 18
    [1]   Marigold Overshiner and Earl Overshiner, Individually and as Parents and
    Guardians of their Minor Daughter, Kaitlyn Overshiner, and Kaitlyn Overshiner
    (collectively, the “Overshiners”) appeal the trial court’s directed verdict in favor
    of Hendricks Regional Health (“Hendricks Regional”) and Ian Johnston, M.D.
    (“Dr. Johnston” and together with Hendricks Regional, “Providers”). We
    affirm. 1
    Facts and Procedural History
    [2]   On September 27, 2006, the Overshiners filed a complaint for damages against
    Providers and other defendants in the Putnam Circuit Court, after having filed a
    proposed complaint with the Indiana Department of Insurance pursuant to the
    Indiana Medical Malpractice Act. The medical review panel, consisting of a
    board-certified pediatrician, a board-certified obstetrician-gynecologist, and a
    neonatologist, unanimously decided that Providers and other defendants did not
    breach the standard of care or cause the claimed injuries. The complaint alleged
    that Marigold presented in active labor on October 26, 2004, at Hendricks
    Regional Hospital in Danville, Indiana, that “Marigold was admitted to the
    hospital under the care, treatment and supervision of [Dr. Johnston],” and that
    Dr. Johnston “was Marigold’s obstetrician during this pregnancy, beginning on
    or about March 11, 2004” and “[k]new that Marigold was blood type O negative
    and anti-D positive” early on in her pregnancy and prior to October 26, 2004.
    1
    We heard oral argument in this case on January 23, 2019, in Indianapolis, and thank counsel for their oral
    advocacy and written presentations in this matter.
    Court of Appeals of Indiana | Opinion 18A-CT-582 | February 21, 2019                            Page 2 of 18
    Appellee Hendricks Regional’s Appendix Volume II at 5. It stated that, within
    the first twenty-four hours following her birth the night of October 26, 2004,
    Kaitlyn’s cord blood indicated that she was RH positive, which was indicative of
    hemolytic disease of the newborn; that on the morning of October 27, 2004, 2
    Kaitlyn’s newborn Total Serum Bilirubin (“TSB”) was 9.2; and that she
    developed jaundice and was treated with phototherapy on the same day. The
    complaint further alleged that Kaitlyn’s risk factors for severe neonatal
    hyperbilirubinemia were present prior to, during, and after her birth, and that she
    suffered hyperbilirubinemia and other medical conditions and physical injuries,
    including, but not limited to, blindness.
    [3]   On November 27, 2017, an eight-day jury trial commenced. On November 30,
    2017, the Overshiners began four days of testimony by Dr. Robert Shuman, a
    retired neuropathologist who currently provides “mostly medical-legal
    consultations.” 3 Transcript Volume II at 39. He testified that he decided to be a
    pediatric neuropathologist and “wanted to be a person who looked at the brains
    of children we lost and reason, or figure out, or explore, or determine why we
    lost those children” in medical school. Id. at 10. He indicated that, when he
    started his pediatric neuropathology training, he “changed from the bedside to
    2
    The complaint states that Kaitlyn was born on October 26, 2004, but then alleges events involving her
    “newborn” Total Serum Bilirubin to have occurred in October 2006. Appellee Hendricks Regional’s
    Appendix Volume II at 5. This appears to be a scrivener’s error.
    3
    When prompted, Dr. Shuman testified that all of the charges in this case to date for his services as an expert
    witness for the Overshiners amounted to $120,900.
    Court of Appeals of Indiana | Opinion 18A-CT-582 | February 21, 2019                               Page 3 of 18
    the autopsy room” and from 1971 to 1975 autopsied “4,300 brains, of which
    1,500 were infants and children.” Id. at 13-14. He testified he did not engage in
    direct patient practice from the period of 1970 through 1975 “when we still had
    Rh disease.” Id. at 15.
    [4]   Dr. Shuman stated that he has a board certification in neuropathology and that
    he was “board-certified in neurology with special competence in neurology.” Id.
    at 30. He later indicated he was not, nor eligible to be, a member of the
    American Academy of Pediatrics and that he was “not an active member but . . .
    retired” from the American Academy of Neurology. Supplemental Transcript
    Volume II at 103. He testified that he had been licensed to practice medicine
    “[s]ince 1990, or 1991” and, from 1991 until 2014, was in South Bend, Indiana,
    where he “practiced child neurology, founding a . . . clinical practice of child
    neurology . . . which [he] then maintained until [his] retirement in 2006,” 4 and
    he later testified that upon retiring he moved to California. Transcript Volume II
    at 4, 26.
    [5]   At a later point during cross-examination, Dr. Shuman answered affirmatively
    when he was asked “we’ve already gone over that you’re not a pediatrician and
    not an obstetrician, correct[?]” Supplemental Transcript Volume II at 130. He
    4
    Dr. Shuman later stated that, at his clinic, he developed a close relationship with his pediatricians, who he
    “trained for a number of emergency situations, and . . . when to call” him. Transcript Volume II at 38. He
    explained further that he “could even go out of town for a week every six months, and if they were in trouble,
    they called me, and the mothers would call me, and I’d be able to take care of the issue over the telephone, or
    tell them where to go, when to go, where to go, very important.” Id.
    Court of Appeals of Indiana | Opinion 18A-CT-582 | February 21, 2019                              Page 4 of 18
    answered affirmatively when he was asked whether the guidelines of the
    American Academy of Neurology provided “[i]f a medical expert is not in active
    clinical practice when offering an expert opinion,” the expert “should be
    prepared to demonstrate competence to provide such an opinion,” and that
    evidence of competence may include “active clinical practice,” “relevant
    publications in medical or scientific journals,” and “active teaching or
    supervision of medical students, residents, or fellows in an area relevant to the
    expertise opinion . . . .” Id. at 104. Dr. Shuman agreed that he did not meet the
    American Academy of Neurology’s guidelines for testifying because he was not
    in active clinical practice, did not teach, and had no publications “since you
    returned.” Id. at 104-105. He also indicated that he had never been involved in
    the handover between the obstetrician and the pediatrician after a child is born,
    “[e]xcept in [his] training as a pediatrician,” which he subsequently admitted he
    did not complete. Id. at 130.
    [6]   When counsel for the Overshiners moved to submit Dr. Shuman “as qualified to
    be an expert,” the following exchange occurred:
    THE COURT: Any statement from the defense? I thought we –
    [Counsel for Hendricks Regional]: Your Honor, I’m sorry. Don’t
    we have a motion in limine already –
    THE COURT: Right.
    [Counsel for Hendricks Regional]: – that the Court has already
    addressed.
    THE COURT: Right. Ladies and gentlemen, we’ll show that the
    doctor – it [sic] obviously is a doctor. You’ll hear from a lot of
    Court of Appeals of Indiana | Opinion 18A-CT-582 | February 21, 2019       Page 5 of 18
    doctors here the next few days, okay? And we’ve already heard
    what his areas of his practice were in.
    Transcript Volume II at 40.
    [7]   Dr. Shuman indicated that he “really [thought] that there’s a tremendous
    amount of variability” to dealing with Rh disease with respect to the standards of
    practice. Id. at 114. In comparing himself to a typical practitioner, he testified:
    I am less aggressive than neonatologists. I am as aggressive as
    those whom I consider to be very good pediatricians. I am much
    more aggressive than many pediatricians. And then, I qualify that
    by telling you that I’ve only known good pediatricians.
    I’m terribly proactive. Aggressive has a bad connotation. I’m
    terribly proactive in my practice of pediatric neurology. I would
    rather prevent seizures than treat seizures.
    Id. at 114. In explaining the standard of care when dealing with an Rh baby, he
    stated that “from the moment of first visit to the obstetrician, the obstetrician’s
    standard of care is one of hypervigilance and diligence.” Id. at 201.
    [8]   He indicated that the obstetrician must consult a fellow physician in hematology
    to ensure coverage on the anti-Rh antibody and its course, that “you really have
    to recruit a fetal and maternal medicine person,” and that “you’re going to need
    sophisticated nursing care.” Id. at 202. When asked to address the care
    provided by Dr. Johnston, Dr. Shuman testified in part that there was no
    evidence that a pediatric team was contacted or formed and that Kaitlyn was
    delivered into a hospital “where the blood bank was not prepared, where the
    Court of Appeals of Indiana | Opinion 18A-CT-582 | February 21, 2019        Page 6 of 18
    pediatric staff were not informed, a team had not been made, and the resources
    were not available to take care of her in crisis.” Id. at 212. At a later point,
    during cross-examination, Dr. Shuman acknowledged that Dr. Johnston had
    recommended to Marigold that a high-risk specialist should be brought on
    board, and that she had refused, which Dr. Shuman characterized as “wrong-
    headed”; that Marigold should have accepted Dr. Johnston’s advice; that Dr.
    Johnston’s recommendation to involve a high-risk specialist was “the start of
    putting together a team”; and that a high-risk specialist could be a maternal fetal
    specialist or a neonatologist or both. Supplemental Transcript Volume II at 150.
    [9]   Concerning the nursing staff’s performance following Kaitlyn’s birth, Dr.
    Shuman stated in part:
    I certainly object to the nurses’ lack of education[ 5] about the
    treatment of hyperbilirubinemia and the influence of breastfeeding
    on hyperbilirubinemia in the neonate and blaming mother for
    being a bad mother because she refused to breastfeed. That
    certainly falls below my standard of nursing care.
    Id. at 146. He testified that the normal newborn nursing staff behaved
    as casually about this normal newborn delivery which is not of
    course a normal newborn delivery, but instead a high risk . . . a
    delivery of a high risk infant with hemolytic disease of the
    newborn. And off she goes to the nursery without any warning
    5
    During cross-examination, Dr. Shuman testified that he had not met any of the Hendricks County nurses or
    been to Hendricks County Hospital.
    Court of Appeals of Indiana | Opinion 18A-CT-582 | February 21, 2019                         Page 7 of 18
    signs posted – without any communication given to tighten
    observation.
    In fact, she really should not have gone to the normal newborn
    nursery. She really should have gone to the special care nursery
    where the observation could be closer and perhaps where the
    pediatric nurses are more pediatrically oriented and more
    experienced.
    Transcript Volume II at 212. When counsel for the Overshiners stated, “in your
    opinion, you know, we have here a child in the 21st century who is suffering –
    who was suffering from Rh disease, and now has been diagnosed with
    kernicterus, kernicteric CP” and asked “[s]hould this have happened,” Dr.
    Shuman answered in the negative and testified that: “This is a disease which is
    preventable by diligent attention to the bilirubin levels”; that there is no
    acceptable reason for bilirubin to approach the probability of kernicterus and
    “[i]f it does, it’s a violation of the standard of care, because the levels are
    available”; that “if it does, you’ve failed in preventing a preventable injury”; and
    “it’s an event that shouldn’t have happened. It’s an error that shouldn’t have
    happened. It’s a violation of the standard of care.” Transcript Volume III at 25-
    26.
    [10]   On December 5, 2017, the following exchange occurred between Dr. Shuman
    and counsel for Dr. Johnston:
    [Counsel for Dr. Johnston]: As a pediatric neurologist, would you
    have treated [Marigold’s] pregnancy with Kaitlyn?
    [Dr. Shuman]: As a pediatric neurologist or as a – if I were an
    obstetrician or a neonatologist?
    Court of Appeals of Indiana | Opinion 18A-CT-582 | February 21, 2019         Page 8 of 18
    [Counsel for Dr. Johnston]: No. I’m saying, as in your specialty,
    would you be the right person to treat [Marigold’s] pregnancy?
    [Dr. Shuman]: Absolutely not.
    Supplemental Transcript Volume II at 151.
    [11]   The Overshiners rested their case, and counsel for Hendricks Regional moved
    for a directed verdict with respect to the claims against it, arguing in part that Dr.
    Shuman did not articulate at any time that he was familiar with the standard of
    care “for the care and treatment of a board certified pediatrician,” the standard
    of care “for a hospital; specifically, . . . relevant to a community hospital
    setting,” or “the nursing standard of care required in 2004,” which “would give
    this Court the ability to allow the jury to decide the issue of whether or not it can
    believe the things that Dr. Shuman has to say.” Transcript Volume III at 73. He
    further argued that Dr. Shuman explained the standard of care “but . . . never
    told us that he’s familiar with the standard of care. Importantly, the standard of
    care is not what Dr. Shuman thinks it is.” Id. He explained that Dr. Shuman
    has been putting a different standard of care in this case. That
    being said, things such as, “I’m over-vigilant” or “hypervigilant,”
    which he testified to – that this is his standard of care. Dr.
    Shuman doesn’t get to sit around his pool in California, not
    practicing medicine, and get to tell this Court or your residents of
    Putnam County what the standard of care is.
    There is a standard in Indiana that requires him to come in here
    and demonstrate that he has an accurate understanding of what
    that standard of care is. That question was never asked by
    [counsel for the Overshiners]. It’s a fundamental flaw . . . .
    Court of Appeals of Indiana | Opinion 18A-CT-582 | February 21, 2019       Page 9 of 18
    Id. at 74. Dr. Johnston’s counsel integrated Hendricks Regional’s arguments
    into its own, and stated “I feel that it’s well established in the State of Indiana
    that a testifying expert for the plaintiff must . . . set forth a familiarity with the
    standard of care” in the same or similar circumstance, and argued that:
    what’s really instructive in this case is the failure to solicit from
    [Dr. Shuman] testimony that he was familiar with the standard of
    care. And the reason why I’m convinced that the plaintiffs have
    known about this is because [Dr. Shuman’s] affidavit that was
    used to defeat the summary judgment motions filed by the
    defendants after the 3-0 panel opinion . . . started with the first
    paragraph stating, I am familiar with the standard of care
    applicable to obstetricians and pediatricians. . . .
    [T]hat affidavit was never made evidence in this trial. He had to
    give that testimony from the stand and he did not.
    Id. at 77-79. After additional discussion, counsel for the Overshiners requested
    an opportunity to prepare a brief on the law, which the court granted.
    [12]   On December 6, 2017, the court indicated that the standard of care in Indiana
    “was never described” by Dr. Shuman, who “said what he would have done.”
    Id. at 93. After some discussion, the court dismissed the jury. On December 13,
    2017, the court issued an order which granted Providers’ motion, directed a
    verdict in favor of Providers, and stated in part:
    [The parties’ cited] cases stand for the proposition that an expert
    must know what the standard of care is, and at least in McIntosh
    [v. Cummins, 
    759 N.E.2d 1180
     (Ind. Ct. App. 2011), trans. denied,]
    that she/he is familiar with that standard.
    Court of Appeals of Indiana | Opinion 18A-CT-582 | February 21, 2019         Page 10 of 18
    [Dr. Shuman] was critical of the OB/GYN care, the Pediatrician’s
    care and the nurse[s’] care. However, at no time did he tell the
    jury what the applicable standard of care was. Court finds that
    Plaintiff [sic] cannot expect a jury to know what the applicable
    standard of care is. In a medical malpractice case, that is exactly
    why an expert is required – to tell the jury what the standard of
    care is and how the standard was breached. The jury cannot
    speculate what the standard is. The Court cannot instruct when
    evidence was not produced.
    The Plaintiff [sic] cannot just tell the jury what her/his
    procedure/standards are – the standard must be, at least, told to the
    jury by the Plaintiff. And the only person able to do that in this trial
    was Dr. Shuman. As the Court foud [sic], he did not do so.
    Appellants’ Appendix Volume II at 49-50. The Overshiners filed a motion to
    correct error, which the court denied.
    Discussion
    [13]   The issue is whether the trial court erred or abused its discretion in granting a
    directed verdict in favor of Providers and denying the Overshiners’ motion to
    correct error. The Overshiners contend that “[t]here is no requirement for a
    medical expert to testify he is familiar with the standard of care” and that,
    instead, if the expert does so testify, that statement provides a safe harbor against
    a challenge of unfamiliarity. Appellant’s Brief at 22. The Overshiners further
    argue that Dr. Shuman testified multiple times to what the standard of care was,
    that it was violated, and that Kaitlyn was damaged as a result. They contend
    that he testified very specifically to what the proper treatment for a child in
    Kaitlyn’s situation was, what the treatments actually given were, and what the
    Court of Appeals of Indiana | Opinion 18A-CT-582 | February 21, 2019        Page 11 of 18
    consequences of those treatments were; and that he thus illustrated on a practical
    basis what the standard of care meant when applied to Kaitlyn’s situation.
    [14]   Hendricks Regional maintains that, in his four days of testimony, Dr. Shuman
    testified “regarding his personal preferences and how he believed that Katilyn
    should have received different treatment,” which “does not equate to evidence
    that he was familiar with the standard of care, as to what the standard of care
    was, or that the standard of care was breached,” and argues that he did not
    articulate what the standard of care actually required of it and its staff or how the
    standard of care was breached. Appellee Hendricks Regional’s Brief at 19. Dr.
    Johnston contends in part that Dr. Shuman’s training and experience in pediatric
    neurology and neuropathology did not qualify him to offer opinions in the
    specialty of obstetrics; that Dr. Shuman admitted he had no practice experience,
    training, or education in obstetrics; and that an expert must show a level of
    competence in a specialty that is not his or her own specialty to offer opinions in
    that specialty, i.e., Dr. Shuman was to “provide the jury with testimony . . . that
    he had sufficient skill and experience in the specialty of obstetrics before he could
    support his criticisms” of Dr. Johnston’s care. Appellee Dr. Johnston’s Brief at
    14.
    [15]   Ind. Trial Rule 50 provides that a motion for judgment on the evidence shall be
    granted “[w]here all or some of the issues in a case tried before a jury . . . are not
    supported by sufficient evidence or a verdict thereon is clearly erroneous as
    contrary to the evidence because the evidence is insufficient to support it . . . .”
    Ind. Trial Rule 50(A). The purpose of a Trial Rule 50(A) motion for judgment
    Court of Appeals of Indiana | Opinion 18A-CT-582 | February 21, 2019       Page 12 of 18
    on the evidence is to test the sufficiency of the evidence presented by the non-
    movant. Stewart v. Alunday, 
    53 N.E.3d 562
    , 568 (Ind. Ct. App. 2016) (citing
    Purcell v. Old Nat’l Bank, 
    972 N.E.2d 835
    , 839 (Ind. 2012)). The grant or denial
    of a motion for judgment on the evidence is within the broad discretion of the
    trial court and will be reversed only for an abuse of that discretion. Hill v.
    Rhinehart, 
    45 N.E.3d 427
    , 435 (Ind. Ct. App. 2015) (citing Levee v. Beeching, 
    729 N.E.2d 215
    , 223 (Ind. Ct. App. 2000)), trans. denied. Upon appellate review of a
    trial court’s ruling on such a motion, the reviewing court must consider only the
    evidence and reasonable inferences most favorable to the nonmoving party.
    Belork v. Latimer, 
    54 N.E.3d 388
    , 394-395 (Ind. Ct. App. 2016). A motion for
    judgment on the evidence should be granted “only when there is a complete
    failure of proof because there is no substantial evidence or reasonable inference
    supporting an essential element of the claim.” Stewart, 53 N.E.3d at 568
    (quoting Raess v. Doescher, 
    883 N.E.2d 790
    , 793 (Ind. 2008) (quotation omitted),
    reh’g denied). Likewise, judgment on the evidence is proper if the inference
    intended to be proven by the evidence cannot logically be drawn from the
    proffered evidence without undue speculation. Hill, 45 N.E.3d at 435 (citing
    Levee, 
    729 N.E.2d at 223
    . Also, we review rulings on motions to correct error for
    an abuse of discretion. Speedway SuperAmerica, LLC v. Holmes, 
    885 N.E.2d 1265
    ,
    1270 (Ind. 2008), reh’g denied.
    [16]   In general, “[t]o prevail in a medical malpractice action, the plaintiff
    must prove three elements: ‘(1) a duty on the part of the defendant in relation to
    the plaintiff; (2) failure to conform his conduct to the requisite standard of care
    Court of Appeals of Indiana | Opinion 18A-CT-582 | February 21, 2019       Page 13 of 18
    required by the relationship; and (3) an injury to the plaintiff resulting from that
    failure.’” Whitfield v. Wren, 
    14 N.E.3d 792
    , 797 (Ind. Ct. App. 2014) (quoting
    Blaker v. Young, 
    911 N.E.2d 648
    , 651 (Ind. Ct. App. 2009) (quoting Oelling v.
    Rao, 
    593 N.E.2d 189
    , 190 (Ind. 1992)), reh’g denied, trans. denied). “Physicians are
    not held to a duty of perfect care.” Syfu v. Quinn, 
    826 N.E.2d 699
    , 703 (Ind. Ct.
    App. 2005) (citing Slease v. Hughbanks, 
    684 N.E.2d 496
    , 498 (Ind. Ct. App. 1997)).
    Rather, health care providers in malpractice cases must exercise that degree of
    care, skill, and proficiency exercised by reasonably careful, skillful, and prudent
    practitioners in the same class acting under the same or similar circumstances. See
    Dughaish ex rel. Dughaish v. Cobb, 
    729 N.E.2d 159
    , 164 (Ind. Ct. App. 2000) (citing
    Vergara v. Doan, 
    593 N.E.2d 185
    , 187 (Ind. 1992)), trans. denied. See also Thomson v.
    Saint Joseph Reg’l Med. Ctr., 
    26 N.E.3d 89
    , 93 (Ind. Ct. App. 2015) (observing that
    “[h]ealth care providers must ‘possess and exercise that degree of skill and care
    ordinarily possessed and exercised by a reasonably careful, skillful, and prudent
    practitioner in the same class to which [they] belong [ ] treating such maladies
    under the same or similar circumstances.’”) (quoting Vogler v. Dominguez, 
    624 N.E.2d 56
    , 59 (Ind. Ct. App. 1993), reh’g denied, trans. denied).
    [17]   Unless satisfied by the rule of res ipsa loquitur, a medical malpractice plaintiff is
    ordinarily required to present expert opinion that a defendant health care
    provider’s conduct fell below the applicable standard of care. Chi Yun Ho v. Frye,
    
    880 N.E.2d 1192
    , 1201 (Ind. 2008) (citing Perry, 808 N.E.2d at 768). “This is
    generally so because the technical and complicated nature of medical treatment
    makes it impossible for a trier of fact to apply the standard of care without the
    Court of Appeals of Indiana | Opinion 18A-CT-582 | February 21, 2019        Page 14 of 18
    benefit of expert opinion on the ultimate question of breach of duty.” Bader v.
    Johnson, 
    732 N.E.2d 1212
    , 1217-1218 (Ind. 2000). “Medical negligence is thus
    not generally a conclusion that may be reached by a jury without such an expert
    opinion among the evidence presented.” Chi Yun Ho, 880 N.E.2d at 1201. Such
    expert opinion takes on the character of an evidentiary fact in medical
    malpractice cases. Id.
    [18]   In a medical malpractice claim, a medical review panel initially determines
    whether the defendant has met the applicable standard of care. See Thomson, 26
    N.E.3d at 93 (citing 
    Ind. Code § 34-18-8-4
    ). Here it does not appear that the
    report of the medical review panel was admitted as evidence. See 
    Ind. Code § 34-18-10-23
     (providing that a “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”). To the extent that the medical
    review panel report unanimously found that Providers did not breach the
    standard of care or cause the injuries being claimed, we find cases involving the
    summary judgment context instructive on this point and observe that in that
    context, this Court has found “[w]hen a medical review panel renders an opinion
    in favor of the physician, the plaintiff must come forward with expert medical
    testimony to rebut the panel’s opinion,” Robertson v. Bond, 
    779 N.E.2d 1245
    ,
    1249 (Ind. Ct. App. 2002), trans. denied, and that the Indiana Supreme Court has
    found that an affidavit which “states only that [the expert witness] would have
    treated [the plaintiff] differently, not that the [the defendant physician’s]
    Court of Appeals of Indiana | Opinion 18A-CT-582 | February 21, 2019       Page 15 of 18
    treatment fell below the applicable standard” did not meet the burden to
    overcome summary judgment. Oelling, 593 N.E.2d at 190.
    [19]   As the Overshiners acknowledge in their brief, Dr. Shuman “never specifically
    stated ‘I am familiar with the standard of care.’” Appellants’ Brief at 7. To the
    extent the Overshiners argue that Dr. Shuman was qualified to testify to the
    standard of care and contend specifically that “the foundation for a medical
    expert to testify to the standard of care is that he must state his credentials and
    that he has reviewed the relevant medical records,” Appellants’ Brief at 25, they
    cite to an excerpt of this Court’s decision in Aldrich v. Coda, a case concerning the
    standard of care for podiatrists at the summary judgment stage. 
    732 N.E.2d 243
    ,
    244-245 (Ind. Ct. App. 2000). We note that Aldrich involved an affidavit and
    letter of opinion by Dr. Shea, a “licensed, board certified orthopedic surgeon,”
    and that, in holding that the affidavit was sufficient to establish a genuine issue
    of fact and preclude summary judgment, this Court stated:
    It would have been preferable if Dr. Shea had stated in his
    affidavit that he was familiar with the applicable standard of care
    for podiatrists. Be that as it may, it is evident from the content of
    the opinion letter that Dr. Shea, as an orthopedic surgeon, was
    indeed familiar with the standard of care required of [defendant
    physician,] Dr. Coda, as a podiatrist.
    
    Id. at 245-246
    . We find Aldrich distinguishable and, instead, find instructive this
    Court’s observation in Lusk v. Swanson:
    While it was reasonable in Aldrich to conclude that an orthopedic
    surgeon who diagnoses and corrects skeletal deformities may be
    Court of Appeals of Indiana | Opinion 18A-CT-582 | February 21, 2019       Page 16 of 18
    qualified to render an opinion on the standard of care of a
    podiatrist in such matters, it is not similarly reasonable to
    conclude that a pulmonologist is familiar with the standard of care
    required of an orthopedic surgeon.
    
    753 N.E.2d 748
    , 754 (Ind. Ct. App 2001), trans. denied.
    [20]   Here, we find on the facts presented to the trial court that the Overshiners did
    not provide testimony that allowed the trier of fact to apply the appropriate
    standard of care. Dr. Shuman, a neuropathologist who had never been involved
    in the handover between the obstetrician and the pediatrician after a child is born
    and who at the time of trial was retired and provided mostly medical-legal
    consultations, did not testify to the standard of care required of Providers – i.e.,
    the standard of care applicable to obstetricians, pediatricians, and the nursing
    staff of a community hospital treating a child like Kaitlyn under the same or
    similar circumstances – but rather to his “terribly proactive . . . practice of
    pediatric neurology.” Transcript Volume II at 114. He acknowledged that, with
    regard to his specialty, he would “[a]bsolutely not” be the right person to treat
    Marigold’s pregnancy, and that he was not, nor eligible to be, a member of the
    American Academy of Pediatrics. Supplemental Transcript Volume II at 151.
    Our review of the record and Dr. Shuman’s testimony makes clear that any
    inference intended to be proven by the evidence, as pointed to by the
    Overshiners, cannot logically be drawn without undue speculation as to the
    applicable standard of care. Thus, we conclude that the trial court did not err or
    abuse its discretion in granting a directed verdict in favor of Providers and
    denying the Overshiners’ motion to correct error.
    Court of Appeals of Indiana | Opinion 18A-CT-582 | February 21, 2019       Page 17 of 18
    [21]   For the foregoing reasons, we affirm the entry of the directed verdict.
    Affirmed.
    Altice, J., and Tavitas, J., concur.
    Court of Appeals of Indiana | Opinion 18A-CT-582 | February 21, 2019      Page 18 of 18