Full Opinion

Pursuant to Ind. Appellate Rule 65(E), the trial court and parties shall not take any action in reliance upon this Opinion until it is certified. FILED Oct 26 2026, 9:15 am CLERK Indiana Supreme Court Court of Appeals and Tax Court IN THE Court of Appeals of Indiana Anonymous Healthcare Provider 1, Anonymous Healthcare Provider 2, and Anonymous Healthcare Provider 3, Appellants-Defendants v. Diana Foust, Appellee-Plaintiff and Indiana Lions Eye Bank Inc. d/b/a VisionFirst Indiana Lions Eye Bank, and Holly Williams Lambert, Commissioner of the Indiana Department of Insurance Parties of Interest October 26, 2026 Court of Appeals Case No. 25A-CT-3212 Court of Appeals of Indiana | Opinion 25A-CT-3212 | October 26, 2026 Page 1 of 16 Appeal from the Hamilton Superior Court The Honorable P. Chadwick Hill, Magistrate Trial Court Cause No. 29D05-2302-CT-1125 Opinion by Judge Weissmann Judges Altice and Foley concur. Weissmann, Judge. [1] Sixty-five-year-old Russell A. Foust was dying in an Indiana hospital when an employee of an organ procurement organization searched the Indiana donor registry and erroneously identified Russell as a registered organ and tissue donor. Russell was soon deemed medically eligible for corneal tissue donation, and after his death, an eye bank removed his corneal tissue for donation to an unspecified recipient. Russell’s surviving spouse, Diana Foust, later sued everyone involved for negligence and moved for a preliminary determination that Indiana’s Medical Malpractice Act (MMA) does not apply to her claims. [2] In her motion, Diana specified that her negligence claims are based on the defendants’ acts or omissions in searching the donor registry to determine Russell’s donor status. The organ procurement organization, its employee, and the hospital opposed Diana’s motion, arguing that the MMA applied to her claims. The hospital also cross-moved for summary judgment, emphasizing that it did not search the donor registry and claiming it did not owe Russell a duty to Court of Appeals of Indiana | Opinion 25A-CT-3212 | October 26, 2026 Page 2 of 16 do so under Section 15(a) of Indiana’s Revised Uniform Anatomical Gift Act (RUAGA). [3] The trial court determined that the MMA does not apply to Diana’s negligence claims, denied the hospital’s motion for summary judgment, and certified both decisions for this now-consolidated interlocutory appeal. On de novo review, we conclude the MMA does not apply to Diana’s claims because the challenged conduct—searching the donor registry—was not curative, salutary, or otherwise intended to benefit Russell’s health. We also conclude that the hospital did not owe Russell a duty to search the registry under RUAGA § 15(a). Accordingly, we affirm the trial court’s determination that the MMA is inapplicable, reverse the court’s denial of the hospital’s motion for summary judgment, and remand for the court to enter summary judgment in the hospital’s favor.1 Facts [4] The defendants in this case are Indiana Lions Eye Bank Inc. d/b/a VisionFirst Indiana Lions Eye Bank (hereinafter, “Eye Bank”) and three anonymous healthcare providers.2 Anonymous Healthcare Provider 1 (hereinafter, “Donor Organization”) is an organ procurement organization. Anonymous Healthcare 1 We conducted oral argument in this case on September 1, 2026, at DePauw University. We thank the University’s administration and students for their generosity in hosting the argument. We also thank the parties’ counsel for their participation and advocacy. 2 Holly Williams Lambert, Commissioner of the Indiana Department of Insurance, was named as a defendant but is simply a party of interest due to the case’s potential effect on the Indiana Patient’s Compensation Fund. Court of Appeals of Indiana | Opinion 25A-CT-3212 | October 26, 2026 Page 3 of 16 Provider 2 (hereinafter, “Coordinator”) is a Donor Organization employee. And Anonymous Healthcare Provider 3 (hereinafter, “Hospital”) is a hospital. [5] On September 11, 2021, Russell was admitted to Hospital’s facility with septic shock following a prosthetic knee infection. He was placed on a ventilator in the facility’s intensive care unit (ICU), where he ultimately died from sepsis ten days later. On the morning of his death, at 8:46 a.m., a Hospital ICU nurse called Donor Organization to report Russell’s impending death and refer him for potential organ and tissue donation. Donor Organization, in turn, assigned Coordinator to determine whether Russell was registered as a donor. [6] Though the Hospital ICU nurse correctly relayed Russell’s name and date of birth (Russell A. Foust, born December 28, 1955), Coordinator searched the Indiana Donor Registry and matched him to a different person (Russell N. Foust, born June 1, 1954). Because of this mismatch, Coordinator erroneously recorded Russell’s donor designation as “Registered Yes.” App. Vol. II, p. 103. She, along with other Donor Organization personnel, then proceeded with an evaluation of Russell’s medical eligibility to donate. Coordinator determined that Russell was ineligible for organ donation but eligible to donate corneal tissue. Coordinator advised the Hospital ICU nurse of these determinations at 10:31 a.m. [7] Russell died at 11:07 a.m. Shortly thereafter, the Hospital ICU nurse notified Coordinator of Russell’s death. Coordinator then contacted Eye Bank and advised that Russell was a registered organ and tissue donor and medically Court of Appeals of Indiana | Opinion 25A-CT-3212 | October 26, 2026 Page 4 of 16 eligible for corneal tissue donation. Eye Bank, in turn, contacted Russell’s surviving spouse, Diana, and advised her of the same. Diana was surprised to learn that Russell was a registered organ and tissue donor because anatomical gifts are against the family’s religion. But she felt bound to honor what she was told were Russell’s wishes and, therefore, provided Eye Bank with oral consent to remove his corneal tissue. [8] At 3:30 p.m., an Eye Bank representative arrived at Hospital’s facility and conducted an independent evaluation of Russell’s medical eligibility for corneal tissue donation. Concluding Russell was eligible, the representative performed a corneal excision on Russell at 5:00 p.m., removing his corneal tissue. The record does not reveal what happened to the tissue after its removal. [9] The day after Russell’s corneal tissue was removed, Eye Bank discovered the registry mismatch: Russell A. Foust (born December 28, 1955) was not a registered organ and tissue donor. That same day, an Eye Bank representative contacted Diana and explained to her that Russell’s corneal tissue had been removed in error. The representative also seems to have obtained Diana’s after- the-fact consent to the anatomical gift despite the error. [10] Diana thereafter initiated medical malpractice proceedings against Hospital, Donor Organization, Coordinator, and Eye Bank. But after filing a proposed complaint for medical malpractice with the Indiana Department of Insurance, she reversed course and sued the same four parties directly in civil court for negligent infliction of emotional distress. That is, she sought damages for Court of Appeals of Indiana | Opinion 25A-CT-3212 | October 26, 2026 Page 5 of 16 emotional distress she allegedly suffered because of the defendants’ negligence acts or omissions against Russell. [11] Eventually, Diana moved for a preliminary determination that the MMA did not apply to her negligence claims, such that she could pursue them in court without first going through medical malpractice proceedings. See infra ¶ 15. In her motion, Diana articulated her claims as follows: “[Defendants] had a duty to check the donor registry to determine if Russell was an organ donor,” and “[r]ather than perform their duties, they instead failed to carefully verify if Russell’s personal identifying information matched the details of the person on their registry.” App. Vol. II, p. 24. [12] Hospital, Donor Organization, and Coordinator (collectively, “Providers”) opposed Diana’s motion, arguing that the MMA applied to her negligence claims. Hospital also cross-moved for summary judgment, emphasizing that it did not search the donor registry and claiming it did not owe Russell a duty to do so under RUAGA § 15(a). Alternatively, Hospital claimed it is immune from civil liability under RUAGA § 17. Diana did not file a written response to Hospital’s motion for summary judgment, and at a hearing on the motion, her counsel argued only that Hospital was not entitled to judgment as a matter of law on its immunity claim. [13] The trial court ultimately issued its preliminary determination that the MMA did not apply to Diana’s negligence claims. The court also denied Hospital’s motion for summary judgment. Afterward, Hospital moved the court to certify Court of Appeals of Indiana | Opinion 25A-CT-3212 | October 26, 2026 Page 6 of 16 both rulings for interlocutory appeal, and Donor Organization and Coordinator jointly did the same as to the preliminary determination only. The trial court granted both motions to certify, and this Court accepted appellate jurisdiction of the two appeals that followed—one filed by Hospital, and the other jointly filed by Donor Organization and Coordinator. This Court also ordered the appeals consolidated under Indiana Appellate Rule 38. Discussion and Decision [14] This appeal presents two general issues for our review: (1) whether the MMA applies to Diana’s negligence claims; and (2) whether Hospital was entitled to summary judgment. We review both issues de novo. See Ind. Dep’t of Ins. v. Doe, 247 N.E.3d 1204, 1210 (Ind. 2024) (hereinafter, “Doe 2024”). In the end, we conclude that the MMA does not apply to Diana’s negligence claims because the challenged conduct—searching the donor registry—was not curative, salutary, or otherwise intended to benefit Russell’s health. We also conclude that Hospital was entitled to summary judgment because it did not search the donor registry and did not owe Russell a duty to do so under RUAGA § 15(a). I. The MMA Does Not Apply to Diana’s Claims [15] The MMA was enacted in 1975 in response to a healthcare crisis: a “growth in [medical malpractice] litigation, combined with a ballooning of damage awards and a corresponding rise in malpractice-insurance premiums, [had] prompted many doctors to reduce the services they offered, refuse to perform high-risk procedures, or leave their profession altogether.” Gierek v. Anonymous 1, 250 Court of Appeals of Indiana | Opinion 25A-CT-3212 | October 26, 2026 Page 7 of 16 N.E.3d 378, 391 (Ind. 2025). “To reverse this trend, the MMA created measures to mitigate the cost of insuring and defending malpractice claims.” Id. Among other things, the MMA “grants preliminary authority over medical malpractice actions to a medical review panel, which must render an opinion on a proposed complaint before a claimant can sue a healthcare provider in court.” Bojko v. Anonymous Physician, 232 N.E.3d 1155, 1158 (Ind. 2024) (citing Ind. Code § 34-18-8-4). A. Medical Malpractice, Generally [16] “The MMA is not all-inclusive for claims by patients against healthcare providers nor is it intended to extend to cases of ordinary negligence.” Doe v. Ind. Dep’t of Ins., 194 N.E.3d 1197, 1200 (Ind. Ct. App. 2022) (hereinafter, “Doe 2022”). It applies only to claims of “malpractice,” which it defines as “a tort or breach of contract based on health care or professional services that were provided, or that should have been provided, by a health care provider, to a patient.” Ind. Code § 34-18-2-18. [17] To determine whether a claim sounds in malpractice, “[c]ourts look to the substance of [the] claim, not the manner in which the conduct is framed in a pleading by the claimant.” G.F. v. St. Catherine Hosp., Inc., 124 N.E.3d 76, 85 (Ind. Ct. App. 2019) (citing Doe ex rel. Roe v. Madison Ctr. Hosp., 652 N.E.2d 101, 104 (Ind. Ct. App. 1995)). This inquiry is guided by the following principles: • The MMA defines “health care” as “an act or treatment performed or furnished, or that should have been performed or furnished, by a health Court of Appeals of Indiana | Opinion 25A-CT-3212 | October 26, 2026 Page 8 of 16 care provider for, to, or on behalf of a patient during the patient’s medical care, treatment, or confinement.” Ind. Code § 34-18-2-13. • The MMA defines “patient,” in pertinent part, as “an individual who receives or should have received health care from a health care provider, under a contract, express or implied, and includes a person having a claim of any kind, whether derivative or otherwise, as a result of alleged malpractice on the part of a health care provider.” Id. § 22. • “Indiana courts understand the [MMA] to cover curative or salutary conduct of a health care provider acting within his or her professional capacity, . . . but not conduct unrelated to the promotion of a patient’s health or the provider’s exercise of professional expertise, skill, or judgment.” Howard Reg’l Health Sys. v. Gordon, 952 N.E.2d 182, 185 (Ind. 2011) (internal quotation marks omitted). • “[A] claim falls within the MMA when there is a causal connection between the conduct complained of and the nature of the patient-health care provider relationship.” Doe 2024, 247 N.E.3d at 1214-15 (internal quotation marks omitted); see also Cmty. Health Network, Inc. v. McKenzie, 185 N.E.3d 368, 376 (Ind. 2022) (describing the connection as “temporal” because the challenged conduct must occur “during” the patient’s medical care). • “A case sounds in ordinary negligence [rather than medical malpractice] where the factual issues are capable of resolution by a jury without application of the standard of care prevalent in the local medical community.” B.R. ex rel. Todd v. State, 1 N.E.3d 708, 714 (Ind. Ct. App. 2013); see Doe 2024, 247 N.E.3d at 1216 (stating “the quintessence of a malpractice case” is conduct “implicat[ing] the professional standard of care”). B. Diana’s Negligence Claims [18] Diana’s negligence claims do not sound in medical malpractice. As clarified in her motion for preliminary determination, the conduct underlying the claims is Court of Appeals of Indiana | Opinion 25A-CT-3212 | October 26, 2026 Page 9 of 16 Providers’ alleged acts or omissions in searching the donor registry to determine Russell’s donor status. This conduct does not qualify as “health care” under the MMA because it was not curative, salutary, or otherwise intended to benefit Russell’s health. See Ind. Code § 34-18-2-13; Gordon, 952 N.E.2d at 185. [19] In reaching this conclusion, we find instructive this Court’s decision in Weldon v. Universal Reagents, Inc., 714 N.E.2d 1104 (Ind. Ct. App. 1999). There, a healthy blood donor allegedly became ill after letting a blood bank inject her with red blood cell antigens to increase the level of Rho(D) antibody in her blood. Id. at 1105. As part of a blood bank program, “Rho(D) antibody [was] used to produce a medical product called . . . RhoGam,” which in turn, was “used to help Rh negative pregnant women with Rh positive babies.” Id. at 1105-06. The donor sued the blood bank for negligence, and this Court ruled that the MMA did not apply to her claim. Id. at 1111. The Court reasoned that the donor was not a traditional “patient,” as defined by the act,3 because the injections were not intended to benefit the donor’s health but, instead, were performed for the sole benefit of third parties—unidentified pregnant women. 3 The MMA’s definition of “patient” contemplates two co-equal classes that can be referred to as “traditional patients” and “derivative patients.” See Ind. Code § 34-18-2-22. A traditional patient is an “individual who receives or should have received health care from a health care provider, under a contract, express or implied.” Id. A derivative patient is a person who otherwise has a claim “as a result of alleged malpractice on the part of a health care provider.” Id. “‘Derivative’ claims ‘include the claim of a parent or parents, guardian, trustee, child, relative, attorney, or any other representative of the patient,’ and include ‘claims for loss of services, loss of consortium, expenses, and other similar claims.’” Goleski v. Fritz, 768 N.E.2d 889, 891 (Ind. 2002) (quoting Ind. Code § 34-18-2-22). Court of Appeals of Indiana | Opinion 25A-CT-3212 | October 26, 2026 Page 10 of 16 Id. at 1109-10. In other words, the donor was not a traditional patient because the injections were not “health care,” as defined by the act. [20] As Weldon’s rationale subtly illustrates, the MMA’s definitions of “health care” and “patient” are, at least in part, codependent and circular. To qualify as health care, conduct must be performed for a traditional patient; and to qualify as a traditional patient, a person must receive health care. But only a patient can bring a claim to which the act applies. Ind. Code § 34-18-8-1 (authorizing “a patient or the representative of a patient” to file a malpractice complaint). Thus, even when conduct is curative, salutary, or otherwise intended to benefit a person, the MMA does not apply unless that person is the one either bringing the claim or giving rise to another’s derivative claim. See supra n.3. [21] Like the injections in Weldon, which were not intended to benefit the blood donor, searching the donor registry to determine Russell’s donor status was not intended to benefit Russell’s health. The search was done for the sole benefit of the would-be recipient of any organ or tissue Russell would have donated had he been a registered organ and tissue donor and been deemed medically eligible to donate. The search, therefore, does not qualify as “health care” under the MMA. See Weldon, 714 N.E.2d at 1110. [22] Providers claim, without citation to authority, that the health benefits to the would-be recipient of any organ or tissue Russell might have donated are sufficient to qualify the registry search as “health care” under the MMA. Weldon, however, instructs otherwise. As discussed above, a non-claimant third Court of Appeals of Indiana | Opinion 25A-CT-3212 | October 26, 2026 Page 11 of 16 party does not qualify as a traditional “patient” under the act. Thus, any health benefit such a person receives from the challenged conduct does not qualify as “health care.” See supra ¶ 20. [23] Providers also urge us to consider the registry search as benefiting Russell because, without it, his desire to be an organ and tissue donor might have gone undiscovered. We are not persuaded. Nothing in the record suggests that Russell wanted to be a donor, the registry search resulted in him being mismatched to a different person, and Diana claims donation was against his religion. Providers cannot claim the search benefited Russell by uncovering a wish the record does not show he held. And even assuming he held it, Providers do not explain how honoring a person’s premortem decision to make postmortem anatomical gifts can be considered curative, salutary, or otherwise intended to benefit that person’s health. [24] For these reasons, we affirm the trial court’s preliminary determination that the MMA does not apply to Diana’s negligence claims. 4 II. Hospital Is Entitled to Summary Judgment [25] “Summary judgment is appropriate only ‘if the designated evidentiary matter shows that there is no genuine issue as to any material fact and that the moving 4 Donor Organization and Coordinator jointly moved to strike a portion of Diana’s appellate brief, in which she argues that the mere existence of the RUAGA supports the conclusion that the MMA does not apply to her negligence claims. We do not consider Diana’s argument in reaching our decision on this issue and, therefore, deny the motion to strike as moot. Court of Appeals of Indiana | Opinion 25A-CT-3212 | October 26, 2026 Page 12 of 16 party is entitled to a judgment as a matter of law.’” Doe 2024, 247 N.E.3d at 1210 (quoting Ind. Trial Rule 56(C)). Hospital contends there are no genuine issues of material fact and that it was entitled to judgment as a matter of law because it: (1) did not search the donor registry and did not have a duty to do so under RUAGA § 15(a); and (2) is immune from civil liability under RUAGA § 17. We find the duty issue dispositive and, therefore, do not address the immunity issue. [26] It is undisputed that Coordinator—a Donor Organization employee—searched the donor registry and erroneously determined that Russell was a registered organ and tissue donor. Therefore, in moving for summary judgment, Hospital reasonably interpreted Diana’s negligence claim as alleging Hospital owed Russell a duty to conduct its own independent search of the registry. Hospital argued it did not owe Russell that duty under RUAGA § 15(a), which states: When a hospital refers an individual at or near death to a procurement organization, the organization shall make a reasonable search of . . . the Indiana donor registry . . . to ascertain whether the individual has made an anatomical gift. Ind. Code § 29-2-16.1-15(a)(3); see generally Ind. Code § 29-2-16.1-1(22) (defining “procurement organization” to mean “an eye bank, organ procurement organization, or tissue bank”). [27] Diana did not file a written response to Hospital’s motion for summary judgment, and she did not argue the duty issue at the hearing thereon. Thus, she did not assert that Hospital’s alleged duty to search the donor registry was Court of Appeals of Indiana | Opinion 25A-CT-3212 | October 26, 2026 Page 13 of 16 based on something other than RUAGA § 15(a). She also did not assert that her negligence claims were based on a different alleged duty. Accordingly, summary judgment in Hospital’s favor is appropriate if RUAGA § 15(a) did not impose on Hospital a duty to search the donor registry. See Goodwin v. Yeakle’s Sports Bar & Grill, Inc., 62 N.E.3d 384, 386 (Ind. 2016) (“Absent a duty there can be no negligence or liability based upon the breach.”). [28] “When reviewing a statute, our primary goal is to determine and follow the legislature’s intent.” Lake Imaging, LLC v. Franciscan All., Inc., 182 N.E.3d 203, 207 (Ind. 2022). “The best evidence of this intent is the statutory language itself, which, when given its plain and ordinary meaning, should apply ‘in a logical manner consistent with the statute’s underlying policy and goals.’” Id. (quoting Matter of Supervised Estate of Kent, 99 N.E.3d 634, 638 (Ind. 2018)). [29] We have little trouble concluding that RUAGA § 15(a) did not impose on Hospital a duty to search the donor registry. The statute’s plain language states that “the [organ procurement] organization,” not the referring hospital, “shall make a reasonable search of . . . the Indiana donor registry . . . to ascertain whether the individual has made an anatomical gift.” Ind. Code § 29-2-16.1- 15(a)(3). Because Hospital did not owe Russell the duty on which Diana’s negligence claims are based, it is entitled to judgment as a matter of law. See Goodwin, 62 N.E.3d at 386. Court of Appeals of Indiana | Opinion 25A-CT-3212 | October 26, 2026 Page 14 of 16 [30] For these reasons, we reverse the trial court’s denial of Hospital’s motion for summary judgment and remand for the trial court to enter summary judgment in Hospital’s favor.5 Conclusion [31] We affirm the trial court’s preliminary determination that the MMA does not apply to Diana’s negligence claims. However, we reverse the trial court’s denial of Hospital’s motion for summary judgment and remand for the court to enter summary judgment in Hospital’s favor. Altice, J., and Foley, J., concur. ATTORNEYS FOR APPELLANTS ANONYMOUS HEALTHCARE PROVIDER 1 AND ANONYMOUS HEALTHCARE PROVIDER 2 Inge Verstraeten Porter Ronald A. Mingus Reminger Co., L.P.A. Indianapolis, Indiana ATTORNEYS FOR APPELLANT ANONYMOUS HEALTHCARE PROVIDER 3 Stacey L. Hanefeld Melanie A. Kalmbach Drewry Simmons Vornehm, LLP Carmel, Indiana 5 Hospital moved to strike a portion of Diana’s appellate brief, in which she argues against Hospital’s claimed immunity as a basis for summary judgment. As we rule in Hospital’s favor without considering the immunity issue, we deny the motion to strike as moot. Court of Appeals of Indiana | Opinion 25A-CT-3212 | October 26, 2026 Page 15 of 16 ATTORNEYS FOR APPELLEE Katherine A. Piscione Ann Marie Waldron Waldron Tate Land, LLC Indianapolis, Indiana Court of Appeals of Indiana | Opinion 25A-CT-3212 | October 26, 2026 Page 16 of 16