Andersen v. Khanna, No. 14-1682

CourtUnited States State Supreme Court of Iowa
Writing for the CourtWIGGINS, Justice.
Citation913 N.W.2d 526
Parties Alan ANDERSEN, Individually and as Injured Parent of Chelsea Andersen and Brody Andersen, and Diane Andersen, Wife of Alan Andersen, Appellants, v. Sohit KHANNA, Iowa Heart Center, P.C., and Catholic Health Initiatives Iowa Corp. d/b/a Mercy Hospital Medical Center, Appellees.
Docket NumberNo. 14-1682
Decision Date15 June 2018

913 N.W.2d 526

Alan ANDERSEN, Individually and as Injured Parent of Chelsea Andersen and Brody Andersen, and Diane Andersen, Wife of Alan Andersen, Appellants,
v.
Sohit KHANNA, Iowa Heart Center, P.C., and Catholic Health Initiatives Iowa Corp. d/b/a Mercy Hospital Medical Center, Appellees.

No. 14-1682

Supreme Court of Iowa.

Filed June 15, 2018


Marc S. Harding of Harding Law Office, Des Moines, for appellants.

Nancy J. Penner, Jennifer E. Rinden, and Robert D. Houghton of Shuttleworth & Ingersoll, P.L.C., Cedar Rapids, for appellees.

WIGGINS, Justice.

A patient and his family brought a medical negligence action against a physician and the physician’s employer. They alleged specific negligence and the failure of the physician to obtain informed consent. The district court granted summary judgment in favor of the defendants on the claim of informed consent based on the physician’s failure to disclose his lack of training and experience in performing the particular procedure. During trial, the court refused to allow the plaintiffs to proceed with their informed-consent claim based on the physician’s failure to disclose the risk of the surgery considering the patient’s bad heart.

The case proceeded to trial on the specific negligence claim. However, the court would not submit a specification of negligence regarding the physician’s lack of training or experience. The jury returned a verdict for the defendants, and the court entered judgment for the defendants. The patient and his family appealed. We transferred the case to the court of appeals, and it affirmed the judgment of the district court. The patient and his family sought further review, which we granted.

On further review, we affirm the district court’s judgment on the specific negligence claim. However, we find the district court erred when it removed the two informed-consent claims from the case. Accordingly, we remand the case back to the district court to allow the patient and his family to proceed on their two informed-consent claims consistent with this opinion.

I. Factual and Procedural Background.

On January 2, 2004, Alan Andersen underwent a Bentall heart procedure performed by Dr. Sohit Khanna, an employee of the Iowa Heart Center, P.C. Khanna performed the procedure at the Mercy Hospital Medical Center in Des Moines. At the time, Khanna did not have any experience or training in performing the particular Bentall procedure used on Andersen. There were several complications with the procedure that resulted in Andersen being in a coma, undergoing a second heart surgery, and having a heart transplant.

In September 2005, Andersen, his wife, and children1 filed a petition against Khanna, Iowa Heart, and Mercy. In addition to alleging negligence against Khanna,

913 N.W.2d 531

Iowa Heart, and Mercy, Andersen alleged Khanna and Mercy failed to obtain informed consent from Andersen prior to surgery. The basis of the informed-consent allegation was that Khanna, Iowa Heart, and Mercy failed to properly advise Andersen of the risks and dangers of the procedure.

Andersen filed an amended petition in August 2008. In the amended petition, he alleged Khanna and Iowa Heart did not obtain informed consent because they failed to advise Andersen that Khanna had limited experience in performing a Bentall procedure.

In May 2010, Khanna and Iowa Heart filed a motion for partial summary judgment on the informed-consent allegations in the amended petition, claiming a physician does not have a duty to disclose physician-specific characteristics or experience in obtaining a patient’s informed consent. Notably, the motion for partial summary judgment did not explicitly challenge Andersen’s informed-consent claim to the extent it was based on Khanna’s and Iowa Heart’s alleged failure to disclose the risks and dangers of the procedure.

On June 15, 2010, the district court agreed with Khanna and Iowa Heart that under Iowa law a physician does not have a duty to disclose physician-specific characteristics or experience in obtaining informed consent. Therefore, the court granted Khanna and Iowa Heart’s motion for partial summary judgment. The relevant part of the ruling stated,

The first motion the Court considers is Dr. Sohit Khanna and the Iowa Heart Center’s Motion for Partial Summary Judgment in regard to the issue of informed consent. The Court having read and reviewed the motion, the memorandum of authorities in support of the motion for partial summary judgment, the resistance filed by the Plaintiffs, the affidavits and the entire court file and otherwise being duly advised in the premises finds that the Motion for Partial Summary Judgment should be, and is, hereby sustained. The Court agrees with the Defendant Khanna and the Iowa Heart Center that the informed consent for patients as defined under Iowa law requires a disclosure to the patient of all known material information concerning the procedure to be performed which includes disclosing the material risks concerning a particular procedure. The Court finds that Iowa law does not include a duty to disclose personal characteristics or the experience of a physician or doctor in obtaining informed consent from a patient. Therefore, pursuant to Iowa law, the Court finds that the motion for summary judgment filed by Dr. Khanna and the Iowa Heart Center regarding informed consent is hereby sustained.

This ruling removed from the case the informed-consent claim based on failure to disclose lack of experience. This ruling did not remove the informed-consent claim based on failure to advise Andersen of the risks and dangers of the procedure due to his bad heart.

In May 2011, Dr. Henri Cuenoud, one of the defendants' experts, was deposed. In that deposition, Dr. Cuenoud opined Andersen’s heart valve "was severely stenotic and leaking a lot as well[, which] is the worst valve condition you can get" and described Andersen’s heart’s presurgery condition as exhausted, "like somebody at the end of a marathon." Dr. Cuenoud also concluded Khanna was aware of the poor condition of Andersen’s heart. When asked, "[G]iven Mr. Andersen’s dire condition prior to surgery, were there any special or out-of-the-ordinary steps that Dr. Khanna should have taken to deal with it," Dr. Cuenoud replied, "I would say that I

913 N.W.2d 532

would have quoted a higher risk of surgery of not being able to come off the pump ... something like 25 percent chance of not making it" and that, retrospectively, Khanna should have been more forthcoming about the risk of surgery.

Based on that information from Dr. Cuenoud’s deposition, on June 1, 2011, Andersen filed a motion to reconsider the June 15, 2010 partial summary judgment ruling on informed consent. Andersen asserted Khanna should have informed him of the increased risk of surgery due to Andersen’s heart’s poor presurgical condition. Andersen requested the court reverse its partial summary judgment grant and "allow[ ] the parties to adduce evidence regarding the informed consent issue as it has now developed in light of the anticipated testimony of Dr. Henri Cuenoud."

On September 9, 2011, the plaintiffs voluntarily dismissed Mercy from the lawsuit. Therefore, any reference to Khanna will hereinafter also refer to Iowa Heart.

On September 20, 2011, a second judge ruled on the motion to reconsider. The ruling provided in its entirety,

The Court reconsiders its June 15, 2010, ruling and enters the following ruling modifying the same only as follows: The Plaintiffs shall be allowed to present evidence relating to Dr. Cuenoud’s awareness of the Plaintiff’s increased mortality risk and apprising the Plaintiff of the same.[2 ]

This ruling allowed Andersen to pursue an informed-consent claim based on Khanna’s failure to disclose the increased risk from the heart’s presurgery condition.

This ruling also addressed Khanna’s second motion in limine, filed June 10, 2011, which requested the court disallow "[a]ny reference to, or evidence concerning, allegations of lack of informed consent, negligent credentialing, and that Dr. Khanna was not qualified." The court ruled that limine request was

SUSTAINED as to negligent credentialing. Dr. Khanna’s qualifications may be pursued by the Plaintiffs in the context of general negligence claim, along with the issue of informed consent consistent with the Court’s ruling on this issue on the Plaintiff’s Motion to Reconsider.

Trial began in October 2011 but resulted in a mistrial on October 31, 2011. The court reset the case for trial to begin in April 2013. In anticipation of the second trial, Andersen submitted proposed jury instructions, including an informed-consent instruction based on Khanna’s failure to disclose a material risk due to the presurgery condition of Andersen’s heart. The second trial also resulted in a mistrial on April 15, 2013. Following the second mistrial, both Andersen and Khanna retained new counsel.

The court reset the case for a third trial to begin in July 2014. On June 30, 2014, Andersen submitted proposed jury instructions, which again included informed consent based on Khanna’s failure to disclose a material risk due to the presurgery condition of Andersen’s heart.

At the pretrial conference on July 2, 2014, the parties argued...

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11 practice notes
  • Wood v. Rutherford, AC 40142
    • United States
    • Appellate Court of Connecticut
    • January 8, 2019
    ...aware of it in the exercise 187 Conn.App. 92of ordinary care."25 (Footnote added; internal quotation marks omitted.) Andersen v. Khanna , 913 N.W.2d 526, 537 n.4 (Iowa 2018) ; see also Holt v. Nelson , 11 Wash. App. 230, 240–41, 523 P.2d 211 (1974) (enumerating various exceptions). The emer......
  • State v. Hauge, 20-1568
    • United States
    • United States State Supreme Court of Iowa
    • April 22, 2022
    ...at 413–15, 117 S.Ct. 882.25 Mimms , 434 U.S. at 111, 98 S.Ct. 330.26 Becker , 458 N.W.2d at 607–08.27 See, e.g. , Andersen v. Khanna , 913 N.W.2d 526, 537 (Iowa 2018).28 Id.29 Christo Lassiter, Consent to Search by Ignorant People , 39 Tex. Tech. L. Rev. 1171, 1192 (2007) [hereinafter Lassi......
  • Willet v. Johnson & Johnson, No. 1:12-cv-00034-JAJ-RAW
    • United States
    • United States District Courts. 8th Circuit. United States State District Court of Southern District of Iowa
    • June 3, 2020
    ...material to making a truly informed and intelligent decision concerning the proposed medical procedure. See Andersen v. Khanna , 913 N.W.2d 526, 536 (Iowa 2018) (citing Pauscher v. Iowa Methodist Medical Center , 408 N.W.2d 355, 359, 360–61 (Iowa 1987) ). Even if this opinion might be admis......
  • Bindner v. Traub, Civ. 21-492 GBW/SCY
    • United States
    • United States District Courts. 10th Circuit. District of New Mexico
    • July 27, 2022
    ...circumstances bearing on the risk of receiving the consented-to treatment from that provider. See, e.g., Andersen v. Khanna, 913 N.W.2d 526, 542 (Iowa 2018) (a lack of experience and training in the procedure); Goldberg v. Boon, 912 A.2d 698, 717 (Md.Ct.App. 2006) (a lack of experience and ......
  • Request a trial to view additional results
11 cases
  • Wood v. Rutherford, AC 40142
    • United States
    • Appellate Court of Connecticut
    • January 8, 2019
    ...aware of it in the exercise 187 Conn.App. 92of ordinary care."25 (Footnote added; internal quotation marks omitted.) Andersen v. Khanna , 913 N.W.2d 526, 537 n.4 (Iowa 2018) ; see also Holt v. Nelson , 11 Wash. App. 230, 240–41, 523 P.2d 211 (1974) (enumerating various exceptions). The emer......
  • State v. Hauge, 20-1568
    • United States
    • United States State Supreme Court of Iowa
    • April 22, 2022
    ...at 413–15, 117 S.Ct. 882.25 Mimms , 434 U.S. at 111, 98 S.Ct. 330.26 Becker , 458 N.W.2d at 607–08.27 See, e.g. , Andersen v. Khanna , 913 N.W.2d 526, 537 (Iowa 2018).28 Id.29 Christo Lassiter, Consent to Search by Ignorant People , 39 Tex. Tech. L. Rev. 1171, 1192 (2007) [hereinafter Lassi......
  • Willet v. Johnson & Johnson, No. 1:12-cv-00034-JAJ-RAW
    • United States
    • United States District Courts. 8th Circuit. United States State District Court of Southern District of Iowa
    • June 3, 2020
    ...material to making a truly informed and intelligent decision concerning the proposed medical procedure. See Andersen v. Khanna , 913 N.W.2d 526, 536 (Iowa 2018) (citing Pauscher v. Iowa Methodist Medical Center , 408 N.W.2d 355, 359, 360–61 (Iowa 1987) ). Even if this opinion might be admis......
  • Bindner v. Traub, Civ. 21-492 GBW/SCY
    • United States
    • United States District Courts. 10th Circuit. District of New Mexico
    • July 27, 2022
    ...circumstances bearing on the risk of receiving the consented-to treatment from that provider. See, e.g., Andersen v. Khanna, 913 N.W.2d 526, 542 (Iowa 2018) (a lack of experience and training in the procedure); Goldberg v. Boon, 912 A.2d 698, 717 (Md.Ct.App. 2006) (a lack of experience and ......
  • Request a trial to view additional results

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