The Supreme Court of Iowa (“Iowa Supreme Court”) ruled in its opinion dated January 21, 2022 that a patient who suffered a stroke following allegedly unnecessary surgery was entitled to a new trial due to the trial court’s errors that led to a defense verdict.
The Underlying Facts
A patient suffered a disabling stroke after undergoing surgery to relieve stenosis, or narrowing, of the carotid artery. The patient remains wheelchair-bound, unable to move his left side, and in need of nursing home care due to the stroke. The patient’s family promptly sought a second opinion from a neurologist. He read the CT angiogram as showing a lesser degree of stenosis and opined that the surgery had been unnecessary. He also referred the CT angiogram to a neuroradiologist who likewise interpreted the angiogram as showing a lesser degree of stenosis. Later, the patient brought an Iowa medical malpractice lawsuit against the surgeon. At trial, the patient was allowed to introduce evidence that both the neurologist and the neuroradiologist had read the angiogram as showing a lesser degree of stenosis. However, based on an alleged failure to provide proper pretrial disclosures, other evidence was excluded. Specifically, the neurologist was not permitted to testify that the surgeon fell below the standard of care; the neuroradiologist was not permitted to testify as to how he calculated the lesser degree of stenosis; and certain contemporaneous medical records were either admitted in redacted form or not admitted at all. The jury returned a no-negligence verdict in favor of the surgeon. The plaintiff appealed.
Iowa Supreme Court Opinion
The Iowa Supreme Court stated: “we disagree with the district court’s application of the pretrial disclosure requirements of Iowa Code section 668.11 (2016) and Iowa Rule of Civil Procedure 1.500(2). Neither the neurologist nor the neuroradiologist was retained for litigation purposes; to the contrary, they developed their opinions from being involved in patient care. This means no expert report under rule 1.500(2)(b) was required. Both physicians could offer expert opinions subject only to two disclosure requirements. First, if the opinions were not formed as a part of treatment, the witnesses had to be designated under section 668.11. Second, regardless of when the opinions were formed, they needed to be adequately disclosed under rule 1.500(2)(c). Both conditions were met here, so the physicians’ testimony and contemporaneous medical records should have been admitted.”
“We also decline the surgeon’s invitation to find that the error was harmless. At trial, the parties essentially agreed on the standard of care for when surgery would have been medically indicated. The trial centered instead on the degree of stenosis and other symptoms in the patient, a subject where the parties presented conflicting evidence. Ultimately, we conclude that the district court’s erroneous ruling on permissible expert opinions unfairly hampered the patient in presenting his side of his case. Therefore, we reverse and remand for a new trial.”
Source McGrew v. Otoadese, No. 19–2137.
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