Linda Jones filed an Iowa medical malpractice action against Broadlawns Medical Center and Dr. Larry Lindell. Jones alleged that she underwent a total hysterectomy and bilateral salpingo-oophorectomy at Broadlawns. The procedure involved the removal of her uterus, cervix, ovaries, and fallopian tubes. Dr. Lindell performed the surgery. Dr. Lindell holds a license to practice medicine in the State of Iowa, and he holds a board certification in Obstetrics and Gynecology from the American Board of Obstetrics and Gynecology.
Immediately following the surgery, Jones experienced pain, fever, dysuria, and other symptoms. Despite these symptoms, she was discharged from the hospital. Her symptoms persisted after being discharged, and she called 911 later that same day. Emergency personnel transported Jones to a different medical center, where surgeons identified and repaired injuries to her right ureter. In her petition, Jones alleged the defendants were negligent in their surgical and postoperative care.
Jones designated Dr. Robert Wayment as her expert witness to testify regarding the standard of care and breach of the standard of care. Dr. Wayment holds licenses to practice medicine in Utah, North Dakota, and Wyoming, and he holds a board certification in Urology from the American Board of Urology. In his expert report, Dr. Wayment identified the standard of care and opined that Dr. Lindell breached the standard of care during and after Jones’s surgery by damaging the right ureter with a cautery device, failing to perform a cystoscopy to detect a ureteral injury, discharging Jones instead of ordering appropriate diagnostic assessments when she reported experiencing certain symptoms after the procedure, and failing to consult a urologist postoperatively when complications involving the ureter became apparent.
After deposing Dr. Wayment, the defendants filed a combined motion to strike and exclude Dr. Wayment as unqualified and a motion for summary judgment. They argued that Dr. Wayment could not be qualified as an expert witness in this case pursuant to Iowa Code section 147.139 because he was not licensed to and did not maintain a practice in the same or a substantially similar field as Dr. Lindell and because he was not certified in the same or substantially similar specialty as Dr. Lindell. Because Dr. Wayment could not be qualified as an expert witness in this case, Jones had no expert witness to opine on the standard of care and breach of the standard of care necessary to establish a prima facie case of negligence. Accordingly, the defendants argued, they were entitled to judgment as a matter of law.
The district court granted the motion. The district court relied on dictionary definitions of “substantially” and “similar” and concluded that “an appropriate definition of the phrase ‘substantially similar’ would be that the field of the designated expert and the physician who is the subject of the negligence claim must have considerable characteristics in common with and be, to a large degree, very much alike in substance and essentials. Applying that definition, the district court found that the plaintiff could not meet her burden to establish that urology is the same or substantially similar specialty as obstetrics and gynecology. Because Jones failed to establish that the specialties themselves are substantially similar, the court struck Dr. Wayment’s report and dismissed the case. The plaintiff appealed.
The Iowa Supreme Court stated in its March 6, 2026 opinion: “A designated expert and a health care provider defendant are thus licensed in and practice in the same field if they hold the same license and practice under the same license … The statute first requires that the qualifying expert be “licensed to practice in the same or a substantially similar field” as the defendant health care provider. Iowa Code § 147.139(1) (emphasis added). The defendants concede that Dr. Lindell does not hold a license in obstetrics and gynecology, however, because there is no separate license for obstetrics and gynecology. We thus cannot interpret field to mean the defendant health care provider’s limited area of practice within a license without reading the word license out of the statute, and this we decline to do … it is clear that subsections (1) and (2) of the statute are satisfied here. Dr. Lindell and Dr. Wayment are both licensed physicians, and they both practice medicine. They are thus licensed to practice and do in fact practice in the same field within the meaning of the statute. Because Drs. Lindell and Wayment are both licensed to practice and do in fact practice in the same field, we need not consider the issue of what constitutes a substantially similar field within the meaning of the statute.”
“The statute now requires courts to make a categorical determination of whether the proposed expert and the defendant health care provider are board-certified in the same or substantially similar specialty without any consideration of the actual problems or treatments at issue in the case. Generally speaking, “substantially similar” means that one thing has a high degree of likeness to another but may be less than identical … As used here, then, substantially similar board-certified medical specialties are those specialties that have a high degree of likeness but are not identical.”
The Iowa Supreme Court stated: “We conclude that two board-certified medical specialties are substantially similar when they share a high degree of likeness in their core characteristics such that a practitioner certified in one specialty would, by virtue of that certification alone, possess the foundational knowledge and competence to evaluate and opine on the standard of care applicable to the other specialty. The inquiry is categorical, not case specific. Courts must assess whether the specialties themselves are substantially similar without regard to whether the particular expert has individual training or experience relevant to the specific medical problems or treatments at issue in the case. It requires more than incidental overlap or occasional clinical collaboration. Relevant factors might include, but are not limited to, the following: the formal definitions of the specialties, the certifying board structures, similarities in education and training, similarities in the scope of practice, overlap in core and procedural competencies, professional association overlap, and hospital credentialing patterns.”
The Iowa Supreme Court held in the case it was deciding: “We cannot conclude the district court erred in concluding that Jones failed to meet her burden in this case. The formal definitions of urology, obstetrics, and gynecology do not support the conclusion that these specialties are substantially similar … Urology is the scientific study of the urine and is that branch of medical science embracing the study and treatment of the diseases and the abnormalities of the urogenital tract in the human male and the urinary tract in the female … We can infer from the fact that urology is a specialization in the study of the male reproductive system that it does not include, generally, specialization in the female reproductive system, which appears to be a primary area of focus of obstetrics and gynecology.”
“The certifying board structure also supports the conclusion that these are not substantially similar specialties. The record establishes that urology and obstetrics and gynecology are certified by separate member boards of the
American Board of Medical Specialties … The fact that a designated expert witness and defendant health care provider hold certifications from the same boards may evidence substantial similarity between the specialties. As noted, however, the specialties in this case are certified by different boards … The record shows that Dr. Wayment has never been trained to perform surgeries on the female reproductive organs. Dr. Wayment explicitly testified that he would not be familiar with the standard of care imposed on an ob-gyn.”
“We find no error in the district court’s conclusion that the plaintiff failed to prove Dr. Wayment was qualified under the statute to provide expert testimony in this case. Here, the plaintiff failed to produce sufficient evidence to establish that board certification in urology is substantially similar to board certification in obstetrics and gynecology. Because Jones failed to establish the requisite similarity between the specialties, the district court did not err in striking Dr. Wayment as an expert. Without a qualified expert remaining to testify on her behalf, Jones’s medical malpractice claim cannot proceed. Accordingly, the district court properly granted the defendants’ motion for summary judgment. Affirmed.”
Source Jones v. Lindell, No. 25–0287.
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