Expert Report Required In Hip Fracture Wrongful Death Case: The Court of Appeals of Iowa (“Iowa Appellate Court”) held in its opinion dated August 17, 2022 in a case involving a nursing home resident who suffered a hip fracture while being transferred into her wheelchair, “We do not believe that understanding the causation behind a subtrochanteric intertrochanteric hip fracture, an ischial pressure injury, or the death of a woman with a myriad of underlying health conditions is within the common knowledge of a non-medically trained person. Therefore, expert witness testimony was needed with respect to the element of causation, which triggers the statutory requirement for a certificate of merit affidavit.”
Underlying Facts
Roberta Ann Butterfield was a resident of Chautauqua Guest Home, Inc., a skilled nursing facility, from October 2017 through May 2019. On or about May 19, 2018, Chautauqua staff heard a “pop” while transferring Butterfield from the bathroom into her wheelchair. Butterfield promptly complained of left leg pain. Chautauqua transferred Butterfield to a hospital six days later. She was diagnosed with a subtrochanteric intertrochanteric left hip fracture and underwent surgical intervention on May 27, 2018. Butterfield was readmitted to Chautauqua on June 1, 2018.
Butterfield spent significant time in bed after her return to Chautauqua. By January 10, 2019, she developed an ischial pressure injury in the form of a fluid-filled blister on her left buttocks area. This pressure injury grew over time and became infected. By April 3, 2019, the pressure injury advanced to stage four with bone visualization and required surgical intervention. Butterfield died on May 18, 2019.
In April 2020, the Estate of Roberta Ann Butterfield filed an action against Chautauqua for personal injury, wrongful death, and loss of consortium. The petition alleged Chautuaqua was negligent in the care and treatment provided to Butterfield, which resulted in her injuries and death. On July 16, 2021, Chautauqua moved to dismiss based on the Estate’s failure to timely file a certificate of merit affidavit pursuant to Iowa Code section 147.140. The district court granted Chautauqua’s motion and dismissed the case with prejudice. The Estate filed a timely appeal.
Iowa Appellate Court Opinion
The Iowa Appellate Court stated, “we agree with the district court’s finding that the Estate failed to establish a prima facie case because causation required expert testimony. While section 147.140 does not require the certificate of merit affidavit to attest specifically to causation, the requirement for an affidavit is triggered by “a cause of action for which expert testimony is necessary to establish a prima facie case.” Iowa Code § 147.140.”
“We do not believe that understanding the causation behind a subtrochanteric intertrochanteric hip fracture, an ischial pressure injury, or the death of a woman with a myriad of underlying health conditions is within the common knowledge of a non-medically trained person. Therefore, expert witness testimony was needed with respect to the element of causation, which triggers the statutory requirement for a certificate of merit affidavit.”
Source Estate of Roberta Ann Butterfield v. Chautauqua Guest Home, Inc., No. 22-0101.
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