How Does an IHS Medical Malpractice Claim Work?

Malpractice at an Indian Health Service hospital or clinic is not an ordinary lawsuit against a doctor. It is a claim against the United States under the Federal Tort Claims Act. That means a required administrative claim within two years, a six-month agency review, and then a lawsuit in federal court in Albuquerque, with no jury. Miss the first step and there is no case.

Step by step

  1. Presentment. A written claim, usually on Standard Form 95, stating what happened and a specific dollar amount, is delivered to the Department of Health and Human Services. 28 U.S.C. 2401(b) gives two years from when the claim accrued. The dollar figure matters: you generally cannot ask a court for more later.
  2. Agency review. Under 28 U.S.C. 2675, the agency has six months to admit, deny, or offer. Silence after six months counts as a denial.
  3. Lawsuit. Suit is filed in the United States District Court for the District of New Mexico under 28 U.S.C. 1346(b) within six months of a denial. A federal judge, not a jury, decides the case. New Mexico substantive law governs what counts as malpractice and how damages are measured.

Which facilities are covered

FacilityLocationNote
Gallup Indian Medical CenterGallup, NMFederal IHS hospital
Northern Navajo Medical CenterShiprock, NMFederal IHS hospital
Crownpoint Health Care FacilityCrownpoint, NMFederal IHS
Zuni Comprehensive Community Health CenterZuni, NMFederal IHS
Chinle Comprehensive Health Care FacilityChinle, AZFederal IHS
Tribally operated 638 facilities (for example Tséhootsooí Medical Center, Fort Defiance)VariousUsually covered by the FTCA under the Indian Self-Determination Act; confirm early

Care from a private contractor working inside a federal facility may fall outside the FTCA and instead be a New Mexico Medical Malpractice Act claim with its own three-year rule and review panel. Sorting out who employed the provider is one of the first tasks.

What you must prove

The same things as any malpractice case: a provider-patient relationship, a departure from the standard of care, and harm caused by that departure, established through expert testimony. In Haceesa v. United States, a Tenth Circuit case that began at an IHS facility in this region, the court addressed how responsibility is divided when a federal hospital misdiagnoses a condition and a later provider misses it again.

Common mistakes

  • Waiting for the hospital's internal review before filing the SF-95. The two years run regardless.
  • Filing the SF-95 without a dollar amount, or with a low one.
  • Suing in state court. The case will be dismissed and the clock may have run.
  • Assuming a tribal or 638 clinic is not federal for these purposes. Many are.

Where we come in

Keeler & Keeler has handled Federal Tort Claims Act cases arising from IHS and tribal facilities across the Four Corners for more than twenty years, from our office in Gallup a few blocks from Gallup Indian Medical Center. Our IHS malpractice page covers what the claim can recover. Call (505) 722-5608 for a free, confidential review; the deadline may be closer than you think.

General information about federal and New Mexico law, not legal advice. FTCA deadlines depend on when a claim accrued, which is a legal question.

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