Patrick Willhoite, individually and as the of The Estates of Margaret Ruth Willhoite and Michael Willhoite, and Jessie Gafeller, individually v. Genesis Health System, Dean A. Bunting, M.D., Joseph M. Phelan, M.D., Radiology Group, P.C., S.C., Steven D. Lamer, D.O., Tenille M. Miller, A.R.N.P.

Supreme Court of Iowa·Decided May 22, 2026·No. 24-1380·Published

Opinion

In the Iowa Supreme Court No. 24–1380

Submitted November 12, 2025—Filed May 22, 2026

Patrick Willhoite, individually and as the administrator of the Estate of Margaret Ruth Willhoite and as the executor of the Estate of Michael Willhoite, and Jessie Gafeller,

Appellants,

vs.

Genesis Health System, Dean A. Bunting, Joseph M. Phelan, Radiology Group, P.C., S.C., Steven D. Lamer, Tenille M. Miller,

Appellees,

Appeal from the Iowa District Court for Scott County, Jeffrey C. McDaniel, judge.

Two estates and two individuals appeal the dismissal of their medical malpractice suit for failure to comply with Iowa Code section 147.140. The defendants seek dismissal of the estates’ appeal because of defects in the filing of the notice of appeal. Motion to Dismiss Appeal Denied; District Court Judgment Affirmed.

May, J., delivered the opinion of the court as to parts I, II, and IV, in which all participating justices joined, and announced the judgment of the court as to part III. As to part III, Christensen, C.J., and McDonald and May, JJ., would affirm; Mansfield, Oxley, and McDermott, JJ., would reverse. Waterman, J., took no part in the consideration or decision of the case.

Matthew G. Sease of Sease & Wadding, Des Moines, for appellants.

Connie L. Diekema, Jeffrey R. Kappelman, and Peter R. Lapointe of Finley Law Firm, Des Moines, for appellee Lamer.

Christine L. Conover, Carrie L. Thompson, and Dawn M. Gibson of Simmons Perrine Moyer Bergman PLC, Cedar Rapids, for appellees Phelan and Radiology Group, P.C., S.C.

Jennifer E. Rinden and Graham R. Carl of Shuttleworth & Ingersoll, PLC, Cedar Rapids, for appellee Bunting.

Frederick T. Harris, Ryan P. Tunink, and Andrew C. Johnson of Lamson Dugan & Murray, LLP, West Des Moines, and John E. Hall, Jr., of Hall Booth Smith, P.C., Atlanta, GA, for appellees Miller and Genesis Health System.

May, Justice.

Two estates and two individuals appeal the dismissal of their wrongful-death medical malpractice suit. Our court must resolve two questions:

1. Should we dismiss the estates’ appeal because a non-attorney—who is the executor for one estate and the administrator for the other—signed and filed the estates’ notice of appeal?

2. Was the district court correct to dismiss the suit based on the plaintiffs’

failure to comply with Iowa Code section 147.140 (2020), our certificate of merit affidavit statute?

We answer those questions as follows:

1. We unanimously agree that the estates’ appeal should not be dismissed.

2. We are divided 3–3 as to whether the district court should have dismissed the suit. Therefore, the dismissal is affirmed by operation of law. Iowa Code § 602.4107 (2026); Juckette v. Iowa Utils. Bd., 992 N.W.2d 218, 222 (Iowa 2023).

I. Factual and Procedural Background.

We start with facts alleged in the petition. In July 2016, Margaret Willhoite was injured in a motor vehicle accident. She sought treatment at Genesis Medical Center. She received an X-ray to determine whether there were any broken ribs. Although the X-ray was negative for fractures, it indicated a nodule in her left lung. And her medical records noted that she should receive a computerized tomography (CT) scan of her chest to investigate the nodule. But no CT scan was ordered or conducted. Margaret was released.

In March 2018, Margaret suffered a fracture to her left femur. She received care at a different hospital. This time, a CT scan was performed. The scan

revealed tumors in her left lung, left femur, left adrenal gland, and right scapula. She was diagnosed with cancer. In May, she passed away as a result of the cancer.

A. This Suit. In January 2020, a team of lawyers filed this wrongful-death medical malpractice suit against Genesis Medical Center and several providers who cared for Margaret following her July 2016 accident. We refer to the defendants collectively as “Genesis.”

The original plaintiffs in the suit were Margaret’s husband, Michael Willhoite, in his individual capacity; Michael, as the executor for Margaret’s estate; Patrick Willhoite, Margaret’s son; and Jessie Gafeller, Margaret’s daughter.

The legal team that filed the suit was made up of lawyers from two law firms: Trial Lawyers for Justice, PC, and Hinshaw & Humke, PC. Attorneys with these firms appeared on the plaintiffs’ behalf throughout the entirety of the suit. While some of their lawyers sought and received leave to withdraw, other lawyers never did. For instance, in May 2024—about two months before the case was dismissed—one of the lawyers (Jon Specht) sought and was granted leave to withdraw because he was ending his employment with Trial Lawyers for Justice. But the lawyer’s motion assured the court that several other lawyers—“Nicholas Rowley, Dominic Pechota, Karen Zahka, [and] Barrie Duchesneau” from Trial Lawyers for Justice, and Mark Hinshaw, a named partner at Hinshaw & Humke—“will remain as counsel for the plaintiffs.” And, indeed, it appears that those lawyers did represent the plaintiffs to the end. The very last filing before dismissal was a joint motion to amend a deadline. That motion was filed on July 12—just two weeks before the case was dismissed. In the motion’s signature block, the plaintiffs’ attorneys were identified as follows:

B. Certificates. We return now to the start of the case. The petition was filed in January 2020, and the defendants answered in February and March. These answers started sixty-day clocks for the plaintiffs to serve certificate of merit affidavits under Iowa Code section 147.140 (2020). The plaintiffs timely served certificates in March, April, and May.

Each certificate was entitled, “Certificate of Merit Affidavit of [a particular expert].” Each certificate opened by stating, “In compliance with Iowa Code § 147.140, [the expert], does hereby affirm and state as follows: . . . .” Each certificate was dated and signed by a certifying expert. But none of the certificates included a notary stamp or jurat. And none of the certificates included a statement that it was signed under penalty of perjury.

C. Substitution. Michael passed away in June 2021. Patrick was then appointed as the executor of Michael’s estate as well as the administrator of Margaret’s estate. The court granted an unresisted motion to make appropriate substitutions among the plaintiffs. Going forward, the plaintiffs in the suit were

Patrick, individually; Patrick, as the administrator of Margaret’s estate; Patrick, as the executor of Michael’s estate; and Jessie Gafeller, individually.

D. Motion to Dismiss. Discovery continued into 2024. After multiple continuances, trial was scheduled for September 9, 2024. Under the trial scheduling plan, the dispositive motion deadline was sixty days before trial. That was July 11.

In May, this court issued our opinion in Miller v. Catholic Health Initiatives-Iowa, Corp., 7 N.W.3d 367 (Iowa 2024). Miller held that an expert’s unsworn letter did not fulfill section 147.140’s “affidavit” requirement. Id. at 374.

In response to Miller, Genesis filed a motion to dismiss in June. Genesis noted that the plaintiffs’ 2020 certificates did not “contain a jurat demonstrating that an oath or affirmation was properly conducted on each of the expert witnesses.” “Nor [were the] certificates of merit signed under penalty of perjury pursuant to Iowa Code section 622.1,” Genesis observed. Therefore, Genesis argued, the plaintiffs’ certificates did not comply with section 147.140’s “affidavit” requirement as interpreted in Miller.

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Patrick Willhoite, individually and as the of The Estates of Margaret Ruth Willhoite and Michael Willhoite, and Jessie Gafeller, individually v. Genesis Health System, Dean A. Bunting, M.D., Joseph M. Phelan, M.D., Radiology Group, P.C., S.C., Steven D. Lamer, D.O., Tenille M. Miller, A.R.N.P., (iowa 2026).

Patrick Willhoite, individually and as the of The Estates of Margaret Ruth Willhoite and Michael Willhoite, and Jessie Gafeller, individually v. Genesis Health System, Dean A. Bunting, M.D., Joseph M. Phelan, M.D., Radiology Group, P.C., S.C., Steven D. Lamer, D.O., Tenille M. Miller, A.R.N.P. (Patrick Willhoite, individually and as the of The Estates of Margaret Ruth Willhoite and Michael Willhoite, and Jessie Gafeller, individually v. Genesis Health System, Dean A. Bunting, M.D., Joseph M. Phelan, M.D., Radiology Group, P.C., S.C., Steven D. Lamer, D.O., Tenille M. Miller, A.R.N.P.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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