On December 20, 2017, the Court of Appeals of Iowa (“Iowa Appellate Court”) affirmed summary judgment in favor of the defendant hospital in an Iowa medical malpractice case in which the plaintiff claimed that a nurse’s insertion of an indwelling catheter led to the subsequent erosion of his penile implant. The trial court had granted the defendant hospital’s motion on that claim after concluding that the plaintiff lacked a causation expert.
The Iowa medical malpractice plaintiff responded to the defendant’s motion for summary judgment by alleging that an inference can be drawn that if a discussion had occurred between the nurse and the ordering physician regarding condom versus indwelling catheter, the ordering physician would have used a condom catheter. The plaintiff based his argument on his nurse expert’s opinion that there was a breach in the standard of care when the patient condition and the potential for likelihood of penile implant complication were not addressed by the nursing and physician staff of the defendant hospital, and her opinion that the standard of care required the nurse, who inserted the indwelling catheter, to have a conversation with the physician about the use of a condom catheter instead of an indwelling catheter. The plaintiff further argued the deposition testimony of his physician expert who opined that if the plaintiff had not had an indwelling catheter, he probably would not have had an erosion of his prosthesis, so in that sense, it was probably a contributing cause.
The trial court held that the Iowa medical malpractice plaintiff’s expert testimony failed to establish causation (there was expert testimony that the nurse breached the standard of care in not questioning the order but there was no opinion that the failure to question the order caused the penile erosion).
The trial court stated: “Plaintiff’s claim fails because a jury would have to infer that when [the nurse] asked the ordering physician if a condom catheter was required, that the physician would have said yes and changed her order. If the ordering physician does not change the order, then [the nurse’s] failure to question the order would not have caused Plaintiff’s injury, because an indwelling catheter would have been placed in spite of [the nurse] questioning the order. In other words, [the physician’s] testimony on causation relates to the placement of an indwelling catheter and not to the factual circumstance of [the nurse’s] failure to ask the ordering physician if a condom catheter should be used.”
The Iowa Appellate Court stated that the trial court did not err in reaching this conclusion – without expert testimony that the claimed breach of the standard of care was the cause of his harm, the Iowa medical malpractice plaintiff could not establish a prima facie case of medical negligence, and therefore the Iowa Appellate Court affirmed the trial court’s summary judgment ruling in favor of the defendant.
Source Carter v. Genesis Health System, No. 17-0045.
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