The Court of Appeals of Iowa (“Iowa Appellate Court”) stated in its opinion filed on October 6, 2021 in an Iowa medical malpractice case: “The medical professionals assert the action is time-barred by the statute of repose set forth in Iowa Code section 614.1(9) (2018). Linda’s estate acknowledges the action would be time-barred by the statute of repose, but they assert the fraudulent-concealment exception applies to defeat the statute-of-repose defense. The district court granted summary judgment in favor of the medical professionals, resulting in dismissal of Linda’s estate’s action. Finding a genuine issue of material fact over whether Linda’s estate’s claim of fraudulent concealment defeats the medical professionals’ statute-of-repose defense, we reverse the district court’s grant of summary judgment and remand for further proceedings.”
Statute Of Repose
Iowa’s statute of repose as it relates to Iowa medical malpractice claims is set forth in Iowa Code section 614.1(9) and states: “[I]n no event shall any action be brought more than six years after the date on which occurred the act or omission or occurrence alleged in the action to have been the cause of the injury or death unless a foreign object unintentionally left in the body caused the injury or death.”
In the case it was deciding, the Iowa Appellate Court stated, “there is no dispute Linda’s estate did not file suit within six years of the claimed act of malpractice that is alleged to have resulted in Linda’s injury (i.e., Dr. Grossman’s alleged failure to inform Linda of the kidney mass in 2009).”
The Iowa Appellate stated that fraudulent concealment is a common law doctrine that developed to prevent a party from benefiting from the protection of a limitations statute when by his own fraud he has prevented the other party from seeking redress within the period of limitations. The doctrine is a form of equitable estoppel that prevents a party from raising a statute-of-limitations or statute-of-repose defense in certain circumstances. The doctrine survived codification of the statute of repose set forth in section 614.1(9). If the doctrine applies, it allows a plaintiff to pursue a claim that would be otherwise time barred under the statute of repose. Equitable estoppel bars a defendant from pleading the running of statute of limitations or statute of repose if the plaintiff is induced to refrain from bringing a timely action by the defendant’s fraud, misrepresentation, or deception.
The Iowa Appellate Court stated that the act of concealment must be separate from and subsequent to the liability-producing act of malpractice. A doctor’s failure to disclose cannot be the ground of liability as well as the basis for the fraudulent concealment. If such were permitted, there would essentially be no statute of limitations for an action regarding a doctor’s negligent failure to inform a patient of something. In addition to separate acts, there must be temporal separation of the acts of negligence and the acts of concealment.
In the case it was deciding, the Iowa Appellate Court stated: “Viewing the evidence in the light most favorable to Linda’s estate, the negligence occurred no later than Linda’s initial visit to the Mercy Hospital emergency room in October 2009 when a Mercy Hospital radiologist reviewed Linda’s then-fresh CT scan, noted a kidney mass, and recommended further evaluation, but the medical professionals failed to disclose this information to Linda. By contrast, Linda’s estate alleges the fraudulent concealment occurred when Dr. Grossman and the resident supervised by Dr. Grossman gained actual knowledge of Linda’s kidney mass and concealed this information from her and her family in multiple direct interactions following Linda’s examination in the hospital on October 1, 2009. These interactions began when Linda and her daughter returned to the hospital after receiving the resident’s cryptic call that “not everything is okay” in Linda’s CT scan. Linda’s daughter testified this phone call occurred while they were on the interstate on the way home from the hospital, which provides the temporal break to constitute a separate act from the alleged negligence during the initial examination in the hospital immediately prior … These interactions ended in December 2009 when Dr. Grossman discharged Linda from her care after multiple follow-up appointments. The doctors’ failure to inform Linda of her kidney mass despite their actual knowledge of the kidney mass creates a fraudulent-concealment claim distinct from the medical professionals’ prior failure to inform Linda of the mass due to their negligence. In addition to these concealments, Dr. Grossman’s October 6 letter to Linda’s primary care physician, which omitted any reference to the kidney mass, is a further act of concealment distinct from the alleged malpractice.”
“Having alleged acts of fraudulent concealment separate from the earlier acts of negligence, Linda’s estate can defeat the statute-of–repose defense by pleading and proving by “a clear and convincing preponderance of the evidence” the following: (1) The defendant has made a false representation or has concealed material facts; (2) the plaintiff lacks knowledge of the true facts; (3) the defendant intended the plaintiff to act upon such representations; and (4) the plaintiff did in fact rely upon such representations to [the plaintiff’s] prejudice.”
“Usually, a plaintiff asserting fraudulent concealment must prove the defendant “engaged in affirmative conduct to conceal the plaintiff’s cause of action” … However, in instances where the plaintiff and defendant are in a confidential or fiduciary relationship—such as the doctor and patient relationship here—that requirement is relaxed.”
The Iowa Appellate Court held: “Viewing the evidence in the light most favorable to Linda’s estate, including accepting the deposition testimony from Linda and her daughters, the record shows a genuine issue of material fact on all four elements.”
Source Downing v. Grossman, M.D., No. 20-1124.
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