MEMORANDUM DECISION
Felix, Judge.
Statement of the Case
[1] In July 2019, Eileen Bennett died in a hospital from bowel necrosis. Two years later, Bennetts daughter Ruby Williams, individually and as personal representative of Bennetts estate, sued several healthcare providers for medical malpractice stemming from Bennetts medical treatment in the days immediately preceding her death. Anonymous Healthcare Provider IV (“Provider IV”) filed a Motion for Preliminary Determination and Motion for Summary Judgment. Shortly thereafter, Anonymous Healthcare Provider V (“Provider V”) and Anonymous Healthcare Provider VI (“Provider VI”) filed their Motion for Preliminary Determination of Law. After briefing and a hearing, the trial court granted summary judgment in favor of Providers IV, V, and VI. Williams now appeals and raises three issues for our review that we revise and restate as the following two issues:
1. Whether Bennett had a physician-patient relationship with Provider IV such that Provider IV owed Bennett a duty of care; and
2. Whether Bennett had a physician-patient relationship with Provider V such that Provider V owed Bennett a duty of care.
[2] Because Williamss significant noncompliance with Indiana Appellate Rule 46 substantially impedes our review of her claims, we hold that she has waived appellate review of all her claims. We affirm.
Facts and Procedural History
[3] On July 8, 2019, Bennett presented to the emergency department of a St. Joseph County hospital complaining of persistent nausea and vomiting with abdominal pain radiating to her back. Bennett had a unique abdominal anatomy due to several prior abdominal surgeries. After Bennett was admitted, Anonymous Healthcare Provider III (“Provider III”) diagnosed her with high-grade small bowel obstruction. Believing Bennett likely needed surgery, Provider III called Provider IV, a general surgeon, for a consultation. After reviewing the CT scan of Bennetts abdomen, Provider IV stated he could not perform the necessary operation due to Bennetts abdominal anatomy and recommended Provider III consult with Provider V. Provider III then called Provider V, a bariatric surgeon employed by Provider VI. Provider V stated he was not on call and not available to perform the necessary surgery, but he did recommend transferring Bennett to a tertiary hospital. Provider III contacted a tertiary hospital and had Bennett transferred there. On July 9, 2019, Bennett died at the tertiary hospital from bowel necrosis.
[4] On July 2, 2021, Williams, individually and as personal representative of Bennetts estate, filed a lawsuit against ten individual and institutional healthcare providers, including Providers IV, V, and VI (collectively, the “Providers”), alleging they committed medical malpractice when treating Bennett on July 8, 2019. On January 20, 2023, Provider IV filed a Motion for Preliminary Determination and Motion for Summary Judgment. On March 16, 2023, Providers V and VI filed their Motion for Preliminary Determination of Law. The Providers essentially argued that they did not have a physician-patient relationship with Bennett such that they owed her a duty of care. The trial court ultimately granted summary judgment in favor of the Providers. This appeal ensued.
Discussion and Decision
[5] Williams raises several issues on appeal concerning whether the Providers owed a duty of care to Bennett. However, we cannot address those claims due to Williamss significant noncompliance with Appellate Rule 46. Although we have a well-established preference for deciding cases on their merits rather than on procedural grounds like waiver, Pierce v. State, 29 N.E.3d 1258, 1267 (Ind. 2015) (quoting Roberts v. Cmty. Hosps. of Ind., Inc., 897 N.E.2d 458, 469 (Ind. 2008)), if a partys failure to comply with the Appellate Rules is “sufficiently substantial to impede our consideration of the issue raised,” we will not address the merits of that issue, id. (quoting Guardiola v. State, 375 N.E.2d 1105, 1107 (Ind. 1978)).
[6] The purpose of our appellate rules—especially Appellate Rule 46 governing the content of briefs—“is to aid and expedite review and to relieve the appellate court of the burden of searching the record and briefing the case.” Miller v. Patel, 212 N.E.3d 639, 657 (Ind. 2023) (emphasis added) (quoting Dridi v. Cole Kline LLC, 172 N.E.3d 361, 364 (Ind. Ct. App. 2021)). For instance, a partys analysis of an issue on appeal must be supported in relevant part by citations to the Appendix or parts of the Record on Appeal upon which the party relies. Ind. Appellate Rule 46(A)(8)(a). We will not search the record to find a basis for the partys argument. Carter ex rel. CNO Fin. Grp., Inc. v. Hilliard, 970 N.E.2d 735, 755 (Ind. Ct. App. 2012) (citing Nealy v. Am. Family Mut. Ins., 910 N.E.2d 842, 845 n.2 (Ind. Ct. App. 2009), trans. denied). Moreover, a partys arguments must be supported by cogent reasoning and citations to relevant authorities. App. R. 46(A)(8)(a). “We will not step in the shoes of the advocate and fashion arguments on his behalf, ‘nor will we address arguments’ that are ‘too poorly developed or improperly expressed to be understood.’ ” Miller, 212 N.E.3d at 657 (quoting Dridi, 172 N.E.3d at 364).
[7] At no point in her opening brief does Williams provide the applicable standard of review as required by Appellate Rule 46(A)(8)(b). See Appellants Am. Br. at 11–13; see generally id. at 11–34. Williams fails to support all the statements of fact in the Statement of Case section of her opening brief with citations to the record as required by Appellate Rule 46(A)(5). Appellants Am. Br. at 5–6. Williams fails to support more than half of the statements of fact in the Statement of Facts section of her opening brief with citations to the record as required by Appellate Rule 46(A)(6)(a). Appellants Am. Br. at 7–9. For the statements of fact that Williams does support with citations to the record, those citations do not substantially conform to the requirements of Appellate Rule 22(C), as required by Appellate Rule 46(A)(6)(a). Appellants Am. Br. at 7–9. Williams also fails to support with citations to the record almost all the factual statements in the argument section of both her opening brief and reply brief as required by Appellate Rule 46(A)(8)(a). Appellants Am. Br. at 12–25, 27–33; Appellants Reply Br. at 6–11, 13–14, 16–19.
[8] Providers V and VI devote the first three and a half pages of their Argument, Providers V & VIs Br. at 8–11, to pointing out some of Williamss record citation errors and alleged “factual inaccuracies,” id. at 8. The Providers also point out that Williams fails to include a statement of the applicable standard of review.
1
Provider IVs Br. at 13 n. 6; Providers V & VIs Br. at 7. Provider IV also claims that Williams “relies on selective and sometimes altered quotations” from the case law she uses. Provider IVs Br. at 17. Our review of Williamss briefing lends credence to this claim.
[9] Several of Williamss case citations include incorrect information or do not include key information such as the deciding court or a pinpoint citation. For example, in support of quoted material, Williams cites “Mills v. Barrios, 859 N.E.2d 1066, 1070 (In. Ct. App. 2006),”
2
Appellants Am. Br. at 11; the correct citation is Mills v. Berrios, 851 N.E.2d 1066, 1070 (Ind. Ct. App. 2006). Similarly, Williams cites to “Kuester v. Inman, 715 N.E.2d 96, 104 (In. Ct. App. 2001),”
3
Appellants Am. Br. at 11, but the correct citation is Kuester v. Inman, 758 N.E.2d 96, 101–02 (Ind. Ct. App. 2001). At one point, Williams states that the court in Kuester cited “Dixon v. Siwy, 661 N.E.2d 600, 601 (1996),” Appellants Am. Br. at 13, but the court in Kuester, 758 N.E.2d at 101, provided the following citation: Dixon v. Siwy, 661 N.E.2d 600, 607 (Ind. Ct. App. 1996).
[10] Williams also misquotes several cases. For instance, she cites to “Walters v. Rinker, 520 N.E.2d 468 (In. 1988)” for the following quotation: “It is not necessary that a physician physically examine, treat or prescribe medication for another person in order for a physician-patient relationship to exist.” Appellants Am. Br. at 11. A review of our Supreme Courts decision in Walters v. Rinker reveals that the quotation is actually as follows: “We have discovered no medical malpractice cases which hold that a physician must physically examine, treat or prescribe medication for another person in order for a physician-patient relationship to exist.” 520 N.E.2d 468, 471 (Ind. 1988).
[11] These are just a few examples out of many of Williamss noncompliance with Appellate Rule 46. These errors alone substantially impede our review of Williamss claims; however, her briefing is replete with such errors.
4
Consequently, Williams has waived all her claims on appeal, and we will not exercise our discretion to address the merits thereof. We therefore affirm the trial court on all issues raised.
[12] Affirmed.
FOOTNOTES
1
. Not to be one-sided, we note the Providers also have examples of failing to comply with Appellate Rule 46.
2
. This citation leads to Flynn v. Henkel, 859 N.E.2d 1063 (Ill. App. Ct. 2006), revd, 880 N.E.2d 166 (Ill. 2007).
3
. This citation leads to Woodson v. City of New York, 715 N.E.2d 96 (N.Y. 1999). Furthermore, it is unclear what Williams is attempting to pinpoint in the Kuester decision, see Appellants Am. Br. at 11, because that case spans only pages 96 through 103 of Volume 758 of Northeastern Reporter Second, yet Williams specifically cites to page 104, on which Zakutansky v. Board of Tax Commissioners, 758 N.E.2d 103 (Ind. T.C. 2001), appears.
4
. In addition to her violations of Appellate Rule 46, Williams also fails to recognize that some of the authority upon which she relies has been disapproved of or reversed. For instance, Williams analyzes her claims under Webb v. Jarvis, 575 N.E.2d 992 (Ind. 1991), but our Supreme Court disapproved of Webb’s holding regarding foreseeability in the duty context in Goodwin v. Yeakles Sports Bar & Grill, Inc., 62 N.E.3d 384, 390–91 (Ind. 2016). Similarly, Williams relies on the causation analysis set forth in Hiser v. Randolph, 617 P.2d 774 (Ariz. Ct. App. 1980), but the Arizona Supreme Court disapproved of that analysis in Thompson v. Sun City Community Hospital, Inc., 688 P.2d 605, 612–16 (Ariz. 1984). Williams also relies on the Court of Appeals of Oregons decision in Mead v. Legacy Health System, 220 P.3d 118 (Or. Ct. App. 2009), but the Oregon Supreme Court reversed that decision in part in Mead v. Legacy Health Sys., 283 P.3d 904, 915 (Or. 2012), en banc.
Memorandum Decision by Judge Felix
Chief Judge Altice and Judge Bradford concur.
Altice, C.J., and Bradford, J., concur.