Darrin P. Miller, Individually, as of the Estate of Meredith R. Miller, and as Parent, Guardian, and Next of Friend of S.M.M., a Minor v. Catholic Health Initiatives-Iowa, Corp. d/b/a MercyOne Des Moines Medical Center, William Nowysz, Joseph Losh, Hijinio Carreon, Noah Pirozzi, Danielle Chamberlain, and Daron Darmening

Supreme Court of Iowa·Decided May 24, 2024·No. 22-1574·Published

Opinion

IN THE SUPREME COURT OF IOWA No. 22–1574

Submitted March 21, 2024—Filed May 24, 2024

DARRIN P. MILLER, individually, as executor of the ESTATE OF MEREDITH R. MILLER, and as parent, guardian, and next of friend of S.M.M., a minor,

Appellee, vs.

CATHOLIC HEALTH INITIATIVES-IOWA, CORP. d/b/a MERCYONE DES MOINES MEDICAL CENTER, WILLIAM NOWYSZ, JOSEPH LOSH, HIJINIO CARREON, NOAH PIROZZI, DANIELLE CHAMBERLAIN, and DARON DARMENING,

Appellants, and

IOWA DEPARTMENT OF TRANSPORTATION, STATE OF IOWA, SNYDER & ASSOCIATES, INC., COMPANY, INC. (an unidentified corporation),

Defendants.

Appeal from the Iowa District Court for Polk County, Joseph Seidlin, Judge.

Defendant medical providers bring interlocutory appeal from rulings denying their motion to dismiss and motion for summary judgment under Iowa Code section 147.140(6). REVERSED AND REMANDED.

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

Theodore T. Appel (argued) and Frederick T. Harris of Lamson Dugan &

Murray LLP, West Des Moines, for appellants Catholic Health Initiatives, Losh, Pirozzi, Chamberlain and Darmening.

Thomas F. Ochs (argued) and Richard A. Stefani of Gray, Stefani & Mitvalsky, PLC, Cedar Rapids, for appellants Nowysz and Carreon.

Jenna L. Cruise (argued) and Joshua L. Dewald of Hupy and Abraham, S.C. P.C., West Des Moines, and Marc S. Harding of Harding Law Office, Des Moines, for appellee.

Jessica A. Zupp of Zupp and Zupp Law Firm, P.C., Denison, for amicus curiae Iowa Association for Justice.

WATERMAN, Justice.

Does an unsworn signature on an expert’s certificate of merit substantially

comply with the statute requiring an affidavit signed under oath? In this appeal, we must decide whether the district court erred by denying dispositive motions filed by defendants in this medical malpractice action pursuant to Iowa Code section 147.140(6) (2021). This statute, entitled “Expert witness—certificate of merit affidavit,” requires the plaintiff to serve a certificate of merit affidavit signed under oath by an expert qualified under section 147.139 within sixty days of the defendants’ answer. The plaintiff, within that deadline, served a certificate of merit in the form of a report letter with the expert’s unsworn signature. The defendants sought dismissal on two grounds: (1) the unsworn, signed letter did not comply with section 147.140’s affidavit requirement, and (2) the expert, an anesthesiologist, was unqualified to testify against the defendant surgeons or respiratory therapist because the expert was not licensed to practice in the same or substantially similar field as required under section 140.139. More than ninety days after the statutory deadline, the plaintiff served the expert’s sworn declaration and argued substantial compliance. The district court ruled that the

expert’s original unsworn but signed letter substantially complied with the affidavit requirement and that the expert’s qualifications satisfied

section 147.139. We granted the defendants’ applications for interlocutory appeal and retained the case.

After the district court’s rulings, we held in Estate of Fahrmann v. ABCM Co., 999 N.W.2d 283, 288 (Iowa 2023), that a lawyer’s signature on initial disclosures did not substantially comply with section 147.140’s requirement for an expert’s sworn signature. We also held that the certificate of merit signed

under oath by the expert forty-two days after the statutory deadline did not cure the violation and that the defendant need not show prejudice. Id. at 288–89.

Applying that precedent, we now hold that the expert’s signed but unsworn report did not substantially comply with section 147.140’s affidavit requirement, and this violation was not cured by the expert’s sworn declaration served over three months after the statutory deadline. See id. A contrary holding would undermine section 147.140 as well as untold other statutes and rules requiring timely sworn statements. We reverse the district court rulings and remand for dismissal of the medical malpractice claims with prejudice. We do not reach the question of whether the expert anesthesiologist was qualified under section 147.139 to testify against these defendants.

I. Background Facts and Proceedings.

According to the plaintiff’s petition, on December 15, 2019, Meredith Miller was a passenger in a car driven by her daughter southbound on a snow-covered Interstate 35 in Polk County. Her daughter lost control of the car, which slid off the highway and collided with a tree. Meredith sustained head injuries. The Ankeny Fire Department responded within minutes. The paramedics at the scene determined that Meredith needed help breathing and placed a supraglottic device into her throat to maintain an open airway. The paramedics transported

Meredith by ambulance to MercyOne Des Moines Medical Center. Her blood oxygen level remained stable throughout the transport.

At MercyOne, Meredith was treated by emergency room physicians Dr. William Nowysz and Dr. Hijinio Carreon, trauma surgeon Dr. Joseph Losh, general surgeons Dr. Noah Pirozzi and Dr. Danielle Chamberlain, and respiratory therapist Daron Darmening. The physicians decided that the original airway device placed by the paramedics should be replaced with a different one: an oral endotracheal tube. But instead of placing the tube in the trachea, the

tube was placed in Meredith’s esophagus. Her oxygen levels plummeted, and she died within fifteen minutes. The Polk County Medical Examiner’s Autopsy report

identified the cause of death as a traumatic brain injury with esophageal intubation as a contributing cause.

On October 28, 2021, Meredith’s surviving husband Darrin Miller—individually, as executor of Meredith’s estate, and on behalf of their daughter as her parent and guardian—sued the Iowa Department of Transportation and the State of Iowa for negligent failure to remove the tree next to Interstate 35 and alleged medical malpractice claims against Catholic Health Initiatives (MercyOne Des Moines Medical Center) and the treating physicians and nurses.1 Miller alleged that the medical providers “were negligent by breaching the standard of care” by “negligently performing an esophageal intubation,” “negligently failing to identify that the esophageal intubation was performed instead of a tracheal intubation,” “negligently failing to correct the esophageal intubation,” “knowingly being aware of the esophageal intubation” and “not being forthcoming about the cause of [Meredith’s] death,” and “knowingly performing other attempts at tracheal intubation after [Meredith] was pronounced dead in an effort to cover up the esophageal intubation.”

Dr. Nowysz and Dr. Carreon filed their answer to Miller’s petition on

December 23, starting the sixty-day clock under Iowa Code section 147.140 for Miller to serve these defendants with certificate of merit affidavits by

February 21, 2022. Catholic Health Initiatives, Dr. Losh, Dr. Pirozzi, Dr. Chamberlain, and respiratory therapist Darmening filed their answer on January 3, triggering a March 4 statutory deadline for Miller’s certificate of merit for those defendants.

Miller retained two experts to testify about the standard of care and breach: Dr. Lynette Mark and Dr. Mustapha Saheed. Dr. Mark is a

1Miller subsequently dismissed the nurses and the State defendants.

board-certified anesthesiologist at Johns Hopkins Hospital, the Director of the Difficult Airway Response Team, and a Professor of Anesthesiology and Critical Care Medicine at Johns Hopkins University School of Medicine. Dr. Saheed is a board-certified emergency medicine physician at Johns Hopkins Medical Center.

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Darrin P. Miller, Individually, as of the Estate of Meredith R. Miller, and as Parent, Guardian, and Next of Friend of S.M.M., a Minor v. Catholic Health Initiatives-Iowa, Corp. d/b/a MercyOne Des Moines Medical Center, William Nowysz, Joseph Losh, Hijinio Carreon, Noah Pirozzi, Danielle Chamberlain, and Daron Darmening, (iowa 2024).

Darrin P. Miller, Individually, as of the Estate of Meredith R. Miller, and as Parent, Guardian, and Next of Friend of S.M.M., a Minor v. Catholic Health Initiatives-Iowa, Corp. d/b/a MercyOne Des Moines Medical Center, William Nowysz, Joseph Losh, Hijinio Carreon, Noah Pirozzi, Danielle Chamberlain, and Daron Darmening (Darrin P. Miller, Individually, as of the Estate of Meredith R. Miller, and as Parent, Guardian, and Next of Friend of S.M.M., a Minor v. Catholic Health Initiatives-Iowa, Corp. d/b/a MercyOne Des Moines Medical Center, William Nowysz, Joseph Losh, Hijinio Carreon, Noah Pirozzi, Danielle Chamberlain, and Daron Darmening) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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