## Facts

- Malia Vandeneede went to Bloomington Hospital with her ex-husband, Monty Vandeneede, seeking treatment for lacerations; she reported a horse-related accident.
- A triage nurse suspected domestic violence based on context and Malia’s refusal of parts of the examination; Malia declined help when discreetly directed to domestic-violence information.
- Orthopedic surgeon Jean M. Eelma treated Malia; Monty was present for examination but not during surgery; post-surgery Malia was alert and oriented.
- Malia’s mother, Ava McSwane, told hospital personnel she believed Monty had assaulted Malia and that Malia was in danger.
- Hospital security briefly separated Monty to search him for weapons and conduct a sobriety test.
- During the separation, McSwane and a nurse privately urged Malia not to leave with Monty; Malia became angry, insisted on leaving, and told them to stay out of their business.
- Shortly after leaving the hospital together, Monty shot and killed Malia and then himself.

## Issues

1. Whether the hospital and treating physician owed Malia a legal duty to protect her from Monty’s subsequent criminal act after she elected to leave.
2. Whether Malia’s decision to leave with Monty despite warnings constituted contributory negligence barring recovery as a matter of law.

## Decision

- The Indiana Supreme Court affirmed summary judgment for the hospital and physician.
- The Court held no duty existed to protect Malia from Monty’s later criminal conduct under these circumstances.
- The Court held that, even if a duty existed, Malia’s conduct constituted contributory negligence as a matter of law, independently barring recovery.

## Legal Principles

- A healthcare provider’s duty of reasonable care within a medical relationship does not ordinarily extend to protecting a competent adult patient from third-party criminal acts absent a special relationship or specific undertaking creating such a duty.
- Duty analysis considers relationship/assumption of duty, foreseeability at the duty level (general class of harm and plaintiff), and public policy.
- Public policy favors patient autonomy; courts are reluctant to impose a duty that would effectively require detaining competent adults or making providers insurers against third-party crimes occurring after discharge or voluntary departure.
- Under Indiana contributory negligence doctrine (where applicable), a plaintiff’s negligence that proximately contributes to the injury can bar recovery; undisputed evidence may permit resolution as a matter of law on summary judgment.

## Conclusion

The court refused to extend medical providers’ negligence duty to preventing a third party’s later criminal violence against a competent adult patient who chose to leave despite warnings, and it further held the patient’s voluntary decision to leave with the assailant barred the claim by contributory negligence as a matter of law.


McSwane v. Bloomington Hosp. & Healthcare Sys., 916 N.E.2d 906 (Ind. 2009)