Hummel v. Smith
| Docket Number | 22-1572 |
| Decision Date | 22 December 2023 |
| Parties | Renee Hummel, Appellee, v. Adam B. Smith, Adam Smith, M.D., P.C., and Tri-State Specialists, L.L.P., Appellants. |
| Court | Iowa Supreme Court |
1
Renee Hummel, Appellee,
v.
Adam B. Smith, Adam Smith, M.D., P.C., and Tri-State Specialists, L.L.P., Appellants.
No. 22-1572
Supreme Court of Iowa
December 22, 2023
Submitted November 15, 2023
Appeal from the Iowa District Court for Woodbury County, Roger L. Sailer, Judge.
The defendants in a medical malpractice case seek interlocutory review of an order denying their motion to strike and for summary judgment because the expert who signed the plaintiff's certificate of merit did not have an active license to practice medicine. Reversed and Remanded.
Jeff W. Wright and Zack A. Martin of Heidman Law Firm, P.L.L.C., Sioux City, for appellants.
Jon Specht of Trial Lawyers for Justice, Decorah, for appellee.
Mansfield, J., delivered the opinion of the court, in which Christensen, C.J., and Waterman, McDonald, and Oxley, JJ., joined, and in which McDermott and May, JJ., joined in part. McDermott, J., filed a special concurrence, in which May, J., joined.
MANSFIELD, JUSTICE.
I. Introduction.
To establish a prima facie case of medical malpractice, the plaintiff must ordinarily provide expert testimony that the defendant breached the relevant standard of care. See Oswald v. LeGrand, 453 N.W.2d 634, 635 (Iowa 1990). In such a case, the plaintiff must submit a certificate of merit affidavit signed by an expert witness within sixty days of the defendant's answer. Iowa Code § 147.140(1)(a) (2020). Failure to substantially comply with this requirement will lead, upon motion, to dismissal of the case with prejudice. Id. § 147.140(6). Iowa law also requires that an expert witness on standard of care or its breach be "licensed to practice in the same or a substantially similar field as the defendant." Id. § 147.139(1).
In this medical malpractice case, the plaintiff submitted a certificate of merit signed by a physician who had practiced in the same field-plastic surgery-as the defendant. But due to his retirement, the physician's active practice licenses had expired and become inactive, meaning that he was no longer able to practice medicine. The defendants moved to strike the expert and for summary judgment on this ground. After the district court denied the defendants' motion, we granted their application for an interlocutory appeal.
We now conclude that the "licensed to practice" language in the statute requires the expert to have an active license that allows the actual practice of medicine; an inactive license does not meet this requirement. Therefore, we reverse the district court's ruling and remand for entry of judgment in favor of the defendants.
II. Background Facts and Proceedings.
On March 23, 2020, Renee Hummel sued Dr. Adam Smith and entities that employed him for injuries she sustained as a result of a 2018 breast
reduction surgery.[1] Hummel's petition alleged negligence, breach of warranty, and failure to obtain informed consent. On June 15, pursuant to Iowa Code section 147.140, Hummel submitted a certificate of merit affidavit signed by Richard Marfuggi, M.D. Dr. Marfuggi's affidavit stated that Smith had breached the standard of care with respect to Hummel's surgery and follow-up care. The affidavit also stated that Dr. Marfuggi had actively performed plastic surgery and postsurgical care in the five years leading up to April 26, 2018, the date of Hummel's surgical procedure.
However, Dr. Marfuggi acknowledged in the affidavit that he had retired from clinical practice on July 1, 2019. As it turned out, by the time Dr. Marfuggi signed the affidavit, both his New York and New Jersey licenses had become "inactive" or "retired," meaning that he was no longer authorized to practice medicine in either state.
Later, Hummel designated Dr. Marfuggi as an expert witness for purposes of Iowa Code section 668.11. In an expert report, Dr. Marfuggi explained in greater detail the ways in which he believed Dr. Smith had breached the applicable standard of care.
On April 25, 2022, Dr. Smith moved to strike Dr. Marfuggi as an expert witness and moved for summary judgment. Dr. Smith contended that the case should be dismissed because Dr. Marfuggi had not met the expert witness requirements of Iowa Code section 147.139(1). See Iowa Code § 147.140(1)(a) (stating that the expert witness for a certificate of merit affidavit "must meet the qualifying standards of section 147.139"). Section 147.139(1) requires-among other things-that a person serving as an expert witness in a medical malpractice
case be "licensed to practice in the same or a substantially similar field as the defendant." Id. § 147.139(1).
Hummel resisted Dr. Smith's motion. She later supplemented her resistance with a sworn declaration from Dr. Marfuggi stating that he was eligible to restore his New Jersey license to "active" status and was in the process of doing so.
Following a hearing, the district court denied Dr. Smith's motions. The court reasoned that Dr. Marfuggi's status as "licensed" in New Jersey and New York was sufficient for purposes of Iowa Code section 147.139(1). It noted that Iowa Code section 147.139(1) only requires the expert to be "licensed to practice," while in the very next subsection, the statute requires that the expert have "actively practiced" within the five years preceding the alleged negligence. See id. § 147.139(2). In the district court's view, this contrast in wording meant that a "license to practice" need not be "active," and it held that Dr. Marfuggi's inactive and retired licenses satisfied the statutory requirements for in section 147.139(1) for an expert witness.
Dr. Smith filed a timely application for an interlocutory appeal. We granted the application and stayed district court proceedings. We retained the appeal.
III. Standard of Review.
The issue is one of statutory interpretation. "Our review is . . . for correction of errors at law." State v. Ness, 907 N.W.2d 484, 487 (Iowa 2018) (quoting State v. Albrecht, 657 N.W.2d 474, 479 (Iowa 2003)).
IV. Analysis.
In 2017, the Iowa legislature amended Iowa Code section 147.139 relating to expert witness standards. See 2017 Iowa Acts ch. 107, § 3 (codified at Iowa Code § 147.139 (2018)). Previously, Iowa law simply required that the standard-of-care expert's "medical or dental qualifications relate directly to the
medical problem or problems at issue and the type of treatment administered in the case." Iowa Code § 147.139 (2016). The 2017 legislation established more elaborate standards, as follows:
If the standard of care given by a health care provider, as defined in section 147.136A, is at issue, the court shall only allow a person the plaintiff designates as an expert witness to qualify as an expert witness and to testify on the issue of the appropriate standard of care or breach of the standard of care if all of the following are established by the evidence:
1. The person is licensed to practice in the same or a substantially similar field as the defendant, is in good standing in each state of licensure, and in the five years preceding the act or omission alleged to be negligent, has not had a license in any state revoked or suspended.
2. In the five years preceding the act or omission alleged to be negligent, the person actively practiced in the same or a substantially similar field as the defendant or was a qualified instructor at an accredited university in the same field as the defendant.
3. If the defendant is board-certified in a specialty, the person is certified in the same or a substantially similar specialty by a board recognized by the American board of medical specialties or the American osteopathic association.
4. If the defendant is a licensed physician or osteopathic physician under chapter 148, the person is a physician or osteopathic physician licensed in this state or another state.
Id. § 147.139 (2018). With some additions that are not material to this case, those 2017 changes remain in place for standard-of-care experts today. See id. § 147.139 (2023). No one disputes that Dr. Marfuggi was "licensed" in New York and
New Jersey when he signed the certificate of merit affidavit and his expert report for this case in 2020. Under New York law, a physician's license "shall be valid during the life of the holder unless revoked, annulled or suspended." N.Y. Educ. Law § 6502(1) (McKinney 2020). However, Dr. Marfuggi had transitioned to an
"inactive license" in New York when he retired as of July 1, 2019. As the New York State Education Department website explains, a medical professional- including a physician-must have their license "registered" if they wish to practice. General Information &Policies, N.Y. State Educ. Dep't [hereinafter N.Y. General Information &Policies], https://www.op.nysed.gov/about/general- information-policies [https://perma.cc/4AVX-DEVF]. Registration requires, among other things, the payment of a fee and completion of continuing education. License Requirements for Physicians, N.Y. State Educ. Dep't, https://www.op.nysed.gov/professions/physicians/license-requirements [https://perma.cc/5QAU-C4QJ]. A physician's registration is good for two years and must be renewed. N.Y. General Information &Policies. If the physician is not practicing, they may place their registration on inactive status free of charge. Online Registration Renewal, N.Y. State Educ. Dep't, https://www.op.nysed.gov/ registration-renewal/online-registration-renewal [https://perma.cc/RG8S-YJR5] (select the underlined text titled "How to Request Inactive Status Online").
Likewise, Dr. Marfuggi had become a "retired" licensee upon his 2019 retirement in New Jersey. New Jersey recognizes the status of a "retired" licensee who is licensed but not authorized to practice medicine. See N.J. Stat. Ann. § 45:9-6.1 (West 2020) ("The certificate of registration which shall be issued to a retired physician shall...
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