Charlene Jorgensen and Michael Jorgensen v. Adam B. Smith, M.D., Adam B. Smith, M.D., P.C., and Tri-State Specialists, LLP

Supreme Court of Iowa·Decided June 12, 2026·No. 25-0182·Published

Opinion

In the Iowa Supreme Court No. 25–0182

Submitted December 16, 2025—Filed June 12, 2026 Charlene Jorgensen and Michael Jorgensen, Appellees,

vs.

Adam B. Smith, Adam B. Smith, M.D., P.C., and Tri-State Specialists, LLP, Appellants,

Appeal from the Iowa District Court for Woodbury County, Robert D.

Tiefenthaler, judge.

In this second interlocutory appeal, defendant healthcare providers seek review of the denial of their second and third motions for summary judgment. Affirmed.

May, J., delivered the opinion of the court, in which all justices joined.

Jeff W. Wright (argued) and Zack A. Martin (until withdrawal) of Heidman Law Firm, P.L.L.C., Sioux City, for appellants.

Michael D. Bornitz (argued) of Cutler Law Firm, LLP, Sioux Falls, SD, and William D. Sims of Northern Plains Justice, LLP, Sioux Falls, SD, for appellees.

May, Justice.

The plaintiffs allege negligence by a surgeon and his employers. The defendants have sought and received two interlocutory appeals. Both appeals have centered on Iowa Code section 147.140 (2020), our certificate of merit affidavit statute. In the first appeal, “Jorgensen I,” we affirmed the district court’s denial of the defendants’ motion for partial summary judgment. Jorgensen v. Smith (Jorgensen I), 2 N.W.3d 868, 880 (Iowa 2024). Then, after remand, the defendants filed two new summary judgment motions, both of which were denied. Now, in this second appeal, the defendants again ask us to reverse and remand for entry of summary judgment. We decline this request based on the law-of-the- case doctrine, which prohibits us from reexamining decisions we made in a prior appeal in the same case. The prohibition extends both to “issues raised and passed on in a prior appeal” and also to “ ‘matters necessarily involved in the determination of a question’ settled in a prior appeal.” Lee v. State, 874 N.W.2d 631, 646 (Iowa 2016) (second quoting In re Lone Tree Cmty. Sch. Dist., 159 N.W.2d 522, 526 (Iowa 1968)). The defendants’ current arguments fall within these prohibited categories. Therefore, we do not reach the merits of those arguments. We affirm and remand for trial.

I. Factual and Procedural Background.

A. The Jorgensens’ Suit. Defendant Dr. Adam Smith performed two breast reduction surgeries on Charlene Jorgensen, one in 2016 and one in 2018. In May 2020, Charlene and her husband (the Jorgensens) brought this suit. The Jorgensens allege that the 2018 surgery was botched and that Charlene was left disfigured.

The Jorgensens’ petition names three defendants: Dr. Smith and his employers, Adam B. Smith, M.D., P.C. (Smith P.C.), and Tri-State Specialists, LLP

(Tri-State). The Jorgensens allege different claims against each defendant. As to Dr. Smith, the Jorgensens allege medical negligence and lack of informed consent. As to Smith P.C., the Jorgensens allege medical negligence and respondeat superior. As to Tri-State, the Jorgensens allege respondeat superior and negligent “hiring, supervising, employing, and/or retaining.” We refer to this last claim as a negligent retention claim. It is based on the idea that because Tri-State knew Dr. Smith was unfit to practice surgery, Tri-State was negligent in failing to discharge Dr. Smith before he could harm Charlene through his own negligence in the 2018 surgery.

B. Dr. Jewell’s Certificate. In June 2020, the defendants responded to the Jorgensens’ suit by filing answers. The filing of these answers started a sixty-day clock under Iowa Code section 147.140, Iowa’s certificate of merit affidavit statute. In some suits against healthcare providers, section 147.140 requires the plaintiff to serve a certificate of merit affidavit within “sixty days of the defendant’s answer.” Id. § 147.140(1)(a). The certificate of merit affidavit must contain an expert’s opinion that the applicable standard of care was breached. Id. § 147.140(1)(b)(2).

The Jorgensens timely served a document entitled “Certificate of Merit Affidavit,” which was signed by Dr. Mark Jewell, a plastic surgeon. We refer to this document as the “certificate” or “Dr. Jewell’s certificate.”

In the certificate, Dr. Jewell stated that he had reviewed medical records relating to the 2018 surgery and follow-up care. He also stated that “to a reasonable degree of [his] medical surgical experience and knowledge[, Dr. Smith] breached the standard of care with respect to” both the 2018 surgery and the follow-up care.

But Dr. Jewell’s certificate did not say whether Dr. Smith was unfit to practice surgery or whether Tri-State should have discharged Dr. Smith prior to

Charlene’s 2018 surgery. Nor did the Jorgensens serve a separate certificate of merit affidavit addressing those topics.

C. Trial Expert Designation. Three months later, in September 2021, the Jorgensens designated a different plastic surgeon, Dr. Edwards, to testify at trial. In his report, Dr. Edwards opined “that Dr. Smith fell below the accepted standard of care in the treatment of [Charlene] in the evaluation, planning[,] and conduct of her” surgical care.

Dr. Edwards also mentioned that he did “not feel that Dr. Smith had a good grasp of the fundamentals necessary” to successfully complete the 2018 reduction surgery for Charlene. But Dr. Edwards did not opine that Dr. Smith was unfit to practice plastic surgery. Nor did Dr. Edwards opine that Tri-State should have discharged Dr. Smith prior to the 2018 surgery. Nor did the Jorgensens designate a separate expert addressing those topics.

D. The First Motion for Summary Judgment. In December 2021, the defendants moved for partial summary judgment as to the Jorgensens’ negligent retention claim. Their motion was based primarily on the Jorgensens’ alleged failure to comply with section 147.140, although it also raised issues concerning section 668.11.

With regard to section 147.140, the defendants noted that the Jorgensens had submitted Dr. Jewell’s “certificate of merit affidavit,” which addressed Dr. Smith’s alleged surgical negligence. Conversely, the defendants emphasized, Dr. Jewell’s “certificate of merit affidavit” did not address any negligent retention by Tri-State. Therefore, the defendants argued, section 147.140 required dismissal of the Jorgensens’ negligent retention claim.1 1Here’s an excerpt from the defendants’ brief in support of their motion:

The certificate of merit affidavit filed by Plaintiffs is silent regarding any negligence of Tri-State. In it, Dr. Jewell’s sole allegation of negligence is that

In addition to their section 147.140 arguments, the defendants also argued that the Jorgensens’ negligent retention claim should be dismissed under Iowa Code section 668.11, which requires parties to “professional liability case[s] brought against a licensed professional” to designate trial experts within specified time frames. Here again, the defendants emphasized the differences between how the Jorgensens treated their claims against Dr. Smith, on the one hand, and their negligent retention claim, on the other hand. Although the Jorgensens had timely designated a trial expert to testify about Dr. Smith’s alleged surgical negligence, the Jorgensens had not designated a trial expert to testify about Tri-State’s alleged negligence in retaining Dr. Smith. Therefore, the defendants argued, section 668.11 also required dismissal of the negligent retention claim.

E. The Ruling and Subsequent Appeal. The district court denied the defendants’ partial summary judgment motion. The defendants then sought interlocutory review, which our court granted.

F. Our Opinion in the First Appeal. In February 2024, we issued an opinion affirming the district court’s denial of summary judgment. Jorgensen I, 2 N.W.3d at 880. We observed that Iowa Code section 147.140 (2018) does not apply to all claims against healthcare providers. Rather, section 147.140 only applies to a limited subset of those claims. And that subset is defined by four

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Charlene Jorgensen and Michael Jorgensen v. Adam B. Smith, M.D., Adam B. Smith, M.D., P.C., and Tri-State Specialists, LLP, (iowa 2026).

Charlene Jorgensen and Michael Jorgensen v. Adam B. Smith, M.D., Adam B. Smith, M.D., P.C., and Tri-State Specialists, LLP (Charlene Jorgensen and Michael Jorgensen v. Adam B. Smith, M.D., Adam B. Smith, M.D., P.C., and Tri-State Specialists, LLP) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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