Iowa Medical Malpractice Laws

Iowa sees an average of 150 medical malpractice lawsuits annually. Per the Iowa Insurance Division's 2021 medical malpractice report, misdiagnosis and surgical errors top the list of common claims. Now, while medical malpractice cases are infrequent compared to other civil suits, recent verdicts have been notably high. This has led to changes in Iowa's medical malpractice laws, particularly regarding non-economic damage caps.

One of the most prominent cases in the state occurred in 2022. Kathleen and Andrew Kromphardt sued Mercy Hospital of Iowa City and Obstetric and Gynecologic Associates of Iowa City and Coralville for the brain damage their son suffered during his birth in 2018. The Johnson County jury granted the family $75.6 million (reduced from the initial $97.4 million), the largest medical malpractice award in state history.

Essentially, when one is injured under a healthcare provider's care, it is imperative for them to learn and understand their rights. As such, this article delves into Iowa's relevant laws, providing examples of medical malpractice and discussing potential defendants, case filing requirements, and damage awards.

What Qualifies as Medical Malpractice in Iowa? 

Medical malpractice occurs when a healthcare provider's actions fall below the accepted standard of care, leading to patient harm or even death. This negligence can manifest in various ways, including:

• Birth defects and injuries caused by medical errors during pregnancy or childbirth.

• Misdiagnosis or delayed diagnosis, leading to untreated or worsening conditions.

• Administration of incorrect medications or dosages, causing adverse reactions.

• Surgical mistakes resulting in complications or injuries.

• Improper monitoring or treatment of a patient's condition, leading to deterioration or worsening symptoms.

• Post-operative complications arising from surgical procedures.

• Pregnancy-related problems caused by inadequate prenatal care or delivery management.

Note that in Iowa, the terms "medical malpractice" and "medical negligence" are interchangeable, both referring to healthcare provider actions that result in patient harm. Medical negligence is a broader term encompassing various types of substandard care, while medical malpractice is a specific form of negligence occurring within the medical field.

Who Can You Sue for Medical Malpractice in Iowa?

In Iowa, citizens have the right to sue healthcare providers for medical malpractice. These encompass various medical professionals, like:

• Nurses.

• Physicians and surgeons, including osteopathic and podiatric physicians.

• Pharmacists.

• Optometrists.

• Chiropractors.

• Physician assistants.

• Hospitals.

Exemptions

In certain situations, healthcare professionals are exempt from legal responsibility. Iowa has its own version of the Good Samaritan Law, which safeguards individuals who provide unpaid emergency care from potential civil lawsuits. However, they are liable if their actions toward the plaintiff are proven to be reckless.

The Iowa Tort Claims Act also grants sovereign immunity to state employees, meaning that suing them is typically prohibited. A lawsuit can only be filed if:

• The attorney general has made a final decision on the claim.

• The attorney general does not reach a final decision within six months of receiving the claim from the director of the Department of Management.

Furthermore, state employees cannot be held liable for punitive damages.

Medical Malpractice Liability Insurance Requirements

Medical malpractice liability insurance is not mandated for healthcare professionals in Iowa. Still, it is wise to safeguard oneself from potential financial repercussions, such as damages and legal fees, in the event of a lawsuit. In Iowa, the standard limit of liability for medical malpractice claims is $1 million per incident, with an overall maximum value of $3 million.

What Is the Statute of Limitations in Iowa for Medical Malpractice Cases?

In Iowa, individuals have two years to file a medical malpractice lawsuit from the date they reasonably discovered the harm or when they were informed of their injury through writing, whichever is later. This period is known as the statute of limitations.

To illustrate how this rule applies, look at the case of Pamela Rock. In October 2004, Rock filed a medical malpractice lawsuit against the doctors who had failed to diagnose her breast cancer. The defendants argued that Rock's lawsuit had been filed beyond the statute of limitations because she reasonably learned of the harm in June 2002 when she consulted another doctor about her condition. However, Rock maintained that she only discovered her condition in October 2002, when she received a formal diagnosis of cancer. After her case was dismissed, she appealed to the Iowa Supreme Court.

The Supreme Court sided with Rock, affirming that the statute of limitations begins when the plaintiff is diagnosed, not when they start investigating their condition. Also, the law allows the time limit to commence after the claimant receives written notification of their illness. Since Rock received written notification in October 2002, the court determined that she filed her complaint within the two-year time limit.

Other Factors

The two-year deadline to file a medical malpractice lawsuit in Iowa can be extended or paused, depending on specific circumstances. For instance, if the defendant does not reside in Iowa, the statute of limitations will be put on hold. Once the defendant returns to the state, the two-year window will start ticking again.

In cases where the plaintiff has a mental disability, the two-year period begins one year after the disability ends, providing them with three more years to file a medical malpractice claim.

Meanwhile, medical malpractice victims under the age of eight have two years or until their 10th birthday to file a lawsuit, whichever is later.

Statute of Repose

The statute of repose is the absolute time during which a claim can be filed. This means that if the statute of repose has passed, there is no option to extend the deadline. The statute of repose in Iowa is six years from the date of the alleged act of medical malpractice.

What Do You Need to Prove in an Iowa Medical Malpractice Case?

To succeed in a medical malpractice lawsuit in Iowa, the plaintiff must establish that the defendant's negligence caused injury or death. This involves proving three key elements:

• Standard of care: The defendant had a duty to exercise the level of skill and care that a reasonably competent healthcare provider would have exercised under similar circumstances. 

• Breach of duty: The defendant failed to meet that standard of care, falling below the expected level of competence. 

• Causation: The defendant's breach of duty directly caused the victim's injury or death. In other words, the victim's harm would not have occurred if the defendant had acted with reasonable care. 

Ultimately, the victim must demonstrate that the defendant's negligence was the proximate cause of their injuries. If they fail to establish these elements, their medical malpractice claim will likely be dismissed.

Petitions

Initiating a medical malpractice lawsuit in Iowa requires filing a petition with the appropriate court. This is crucial because the filing date determines whether one’s case falls within the statute of limitations. Moreover, a cover sheet is mandatory for administrative purposes. It must include essential information, such as the plaintiff’s contact details, the parties involved, the case title, and the court responsible for handling the claim.

Since the goal of a claim is often to receive compensation, the plaintiff must include a pleading statement outlining their entitlement to relief, as well as a demand for judgment specifying the type of remedy sought. Failure to include a notice pleading in the petition may result in case dismissal.

Medical Expert Witness Requirements

Establishing the defendant's negligence hinges on demonstrating their failure to uphold the standard of care during the victim’s treatment. This requires the expertise of a medical professional to testify on the latter’s behalf.

To be eligible to testify, a medical expert must meet the following criteria:

• Licensure: The expert must hold a valid medical license in the same or a similar field as the defendant and maintain a good reputation in each state where they are licensed.

• Disciplinary record: The expert's license must not have been revoked or suspended within the five years preceding the alleged negligent act or omission.

• Experience: The expert must have actively practiced in a similar field as the defendant or have held a teaching position in the same field at an accredited university within five years of the alleged negligent act.

• Board certification: If the defendant is board-certified, the expert must also be certified in the same or a substantially similar specialty by a board recognized by the American Board of Medical Specialties.

Certificate of Merit Affidavit

In Iowa, medical malpractice claims must be accompanied by a certificate of merit affidavit signed by an expert witness. This document must be submitted before discovery begins and within 60 days of the defendant's response. The expert witness must attest to their familiarity with the applicable standard of care and assert that the defendant violated this standard.

Res Ipsa Loquitur

Res ipsa loquitur, a legal doctrine meaning "the thing speaks for itself," can be invoked in cases where direct evidence of negligence is lacking. It typically applies when circumstantial evidence suggests that the injury would not have occurred under ordinary circumstances without negligence.

Consider the case of Jason Banks, who sued his doctor and The Iowa Clinic for medical malpractice after a catheter was mistakenly inserted into his vein during surgery, leading to its fracture. Banks argued that res ipsa loquitur could establish negligence, as he could not provide definitive proof that the surgical error caused the fracture. However, the Court of Appeals rejected his claim. He then appealed to the Iowa Supreme Court, which overturned the dismissal, considering it prejudicial to Banks.

I'm Sorry Law

In 42 states, including Iowa, an "I'm Sorry" law is in effect. This law states that any expression of sympathy, condolence, sadness, or general kindness toward the victim in connection with their injury or death caused by the alleged breach of the duty of care is inadmissible as evidence. In other words, if a doctor apologizes for their negligence toward the patient, this apology cannot be used as evidence against them in a medical malpractice case.

How Much Can You Sue For Medical Malpractice in Iowa?

The compensation awarded in an Iowa medical malpractice case depends on various factors, such as the severity of the injuries, legal limitations on damages, and the individuals or entities involved in the lawsuit. 

Types of Damages

Typically, plaintiffs in civil lawsuits can seek two types of compensatory damages: economic and non-economic. Economic damages are quantifiable financial losses resulting from an injury or accident. Examples include medical expenses and lost wages. However, if these expenses are covered by insurance or other sources, they cannot be claimed as economic damages.

Non-economic damages, on the other hand, are more subjective and intangible, encompassing physical pain, mental anguish, and emotional distress. Unlike economic damages, they do not include the loss of dependent care. For instance, if a victim is the primary caregiver of a child under 18 or an adult with a disability before suffering a serious injury or death, the associated damages are classified as economic.

In rare instances, punitive damages may also be awarded in court. These are intended to punish the defendant for egregious or malicious behavior that caused the injury. To be awarded punitive damages, two conditions must be met:

• The defendant's actions must demonstrate a willful and wanton disregard for the rights or safety of others.

• The defendant's actions must have been specifically directed at the victim.

While there are no limits on economic damages, non-economic damages are subject to caps. In 2023, House File 161 was passed, establishing limits on non-economic damages awarded against healthcare providers. The maximum payout for cases against hospitals is $2 million, while the cap for cases against independent clinics is $1 million. These will increase by 2.1% annually starting in 2028.

Note that the new statute eliminated the restrictions on punitive damages. Previously, if a case did not meet all the criteria, 75% of the punitive damages would be directed to a state fund. However, in medical malpractice cases, plaintiffs can now retain the full amount of punitive damages awarded.

Negligence System

Iowa’s modified comparative negligence system determines how much a plaintiff can recover in a lawsuit. This means that if they are partly to blame for their injuries, their compensation will be reduced by their percentage of fault.

For instance, if a plaintiff is found to be 20% at fault for their injuries, their damages will be reduced by 20%. Hence, if they were originally awarded $200,000, they would only receive $180,000. Additionally, if the plaintiff is found to be 51% or more at fault, they cannot recover any amount of damages at all.

Methods of Obtaining Compensation

If an individual has been injured due to medical malpractice, they can seek compensation for their damages. There are two main ways to pursue this type of claim: a lawsuit or an out-of-court settlement.

A lawsuit is a formal legal process in which one files a complaint against the healthcare provider they believe is responsible for their injuries. The lawsuit will then proceed through a series of hearings and motions, culminating in a trial if the parties cannot reach a settlement. Litigation can be a lengthy and expensive process, but it can also result in significant damages if one is successful.

Meanwhile, an out-of-court settlement is an agreement between the individual and the healthcare provider to resolve the claim without going to trial. This can be a faster and more cost-effective option than litigation, but it may result in a smaller damage award.

Regardless of whether one decides to pursue their claim through litigation or an out-of-court settlement, it is ideal to consult an attorney who specializes in medical malpractice law. They can help plaintiffs understand their legal options, assess the strength of their claims, and negotiate settlements on their behalf.

How Much Does It Cost to Pursue a Medical Malpractice Case in Iowa?

When filing a medical malpractice lawsuit in Iowa, be aware of the following potential costs:

• Attorney fees: Most attorneys in Iowa handle medical malpractice cases on a contingency fee basis, which means that they will only be paid if the client wins their case. In these cases, the attorney will receive a percentage of the client's damages as compensation.

• Expert witness fees: These can change based on the experience and qualifications of the witness, as well as the complexity of the case.

• Court filing fees: The fees for filing a medical malpractice lawsuit in Iowa depend on the type of case being filed. For example, filing a civil petition costs a minimum of $195.

Remember that there are no specific limits on how much an attorney can charge for their services in a medical malpractice case. However, the court will ultimately set a reasonable fee arrangement between the attorney and the client.

Legal Resources for Medical Malpractice Victims in Iowa

Overall, victims of medical malpractice in Iowa should remember that they have legal rights, which include filing a lawsuit to recover damages for their injuries. Several legal resources are also available to help them, such as:

Iowa State Bar Association

The Iowa State Bar Association is a nonprofit organization supporting attorneys and the general public. One of its key initiatives is Iowa Find-A-Lawyer, a program that facilitates connections between individuals and legal professionals. This program utilizes an online directory that enables locals to search for attorneys based on their location and legal expertise, encompassing personal injury, healthcare, product liability, and wrongful death. 

Additionally, the ISBA website provides a comprehensive library of resources and tools, including legal forms and videos, to empower individuals to navigate legal proceedings independently. 

Iowa Health & Human Services

As the state agency responsible for managing various health programs and services, the Iowa Health & Human Services offers comprehensive public health solutions, including immunization care, radiological health services, emergency medical care, and environmental health services. If a victim of medical malpractice is unsure whether they qualify for programs such as Medicaid, they can connect with the Iowa HHS by completing a contact form.

Iowa Insurance Division

The Iowa Insurance Division is the state agency overseeing insurance matters for consumers and insurance providers. It serves as the channel through which individuals, such as those involved in medical malpractice claims, can file complaints against their insurance carriers. Moreover, the division releases annual reports on medical malpractice cases based on data collected from licensed insurance companies, as mandated by law.