Phillips v. Covenant Clinic

Decision Date25 April 2001
Docket NumberNo. 99-0865.,99-0865.
Citation625 N.W.2d 714
PartiesJanet PHILLIPS, Executor of the Estate of Paul Harvey Phillips, Appellant, v. COVENANT CLINIC, Ronald Roth, Thomas Pattee, and Ronald Flory, Appellees.
CourtIowa Supreme Court

Roman Vald and David L. Phillips of Phillips, McCollom, Kozlowski & Vald, P.L.C., West Des Moines, for appellant.

George L. Weilein of Gallagher, Langlas & Gallagher, P.C., Waterloo, for appellees.

Considered en banc.

CADY, Justice.

Janet Phillips, as executor of her father's estate, brought this wrongful death action against the Covenant Clinic and three physicians after her father died of heart failure shortly after being treated at the clinic. The district court granted summary judgment for the clinic and the physicians, concluding that Janet had presented insufficient facts to support the proximate cause element of her claim. Janet appeals, claiming she was entitled to an inference derived from the failure of the clinic to produce medical records to support a genuine issue of material fact with respect to causation. We affirm.

I. Background Facts and Proceedings.

Paul Harvey Phillips went to the Covenant Clinic in Waterloo on January 3, 1996, complaining of flu-like symptoms. He was eighty years old. Debra Cortes, a physician's assistant, examined Paul and learned he was experiencing chest pains. Paul had recently suffered congestive heart failure. Dr. Ronald Roth, who was supervising Cortes, ordered an EKG and a chest x-ray.

After the EKG was performed, Paul was permitted to walk on his own to the neighboring hospital for the chest x-ray. He collapsed, however, on his way to the hospital in cardiac arrest. Around the same time, Dr. Thomas Pattee reviewed Paul's EKG strip. When Dr. Pattee learned Paul had collapsed on his way to the hospital, he grabbed Paul's entire medical file from the clinic, which included the EKG results, and hand-delivered the file to the intensive care unit of the hospital, where Paul was being treated. Doctors at the hospital were unable to save Paul's life. He died at the hospital.

In June 1996, Janet sought her father's medical records from the clinic. The clinic subsequently informed Janet that her father's medical file was missing. No one at the hospital or clinic had seen Paul's medical file since it had been hand-delivered to the intensive care unit by Dr. Pattee on January 3, 1996. The only document the clinic was able to produce was Cortes' notes from the January 3 office visit. The clinic asked Janet to check Paul's personal belongings from the January 3 hospitalization to ensure the clinical records had not been inadvertently included with those belongings. The medical records were not found.

Janet filed this wrongful death action on January 2, 1998. She alleged medical malpractice against the Covenant Clinic, Dr. Roth, Dr. Pattee, and Dr. Ronald Flory.1 Pursuant to Iowa Code section 668.11 (1997), Janet named Dr. R. William Overton, III, as her medical expert. Dr. Overton concluded the clinic doctors breached their duty of care in treating Paul on January 3, 1996, by permitting him to leave the clinic before reviewing the EKG results. However, because Paul's medical file was unavailable for review, Dr. Overton was unable to conclude the breach caused Paul's death. The only document available for Dr. Overton to review was the office notes prepared by Cortes regarding the January 3 office visit. This document consisted of both dictated and handwritten notes. Dr. Overton concluded Cortes added the handwritten notes after her dictation had been transcribed, and found this conduct was potentially indicative of an attempt to conceal the medical records.

The defendants moved for summary judgment. They claimed Janet's failure to establish a causal relationship between the doctors' purported breach of the standard of care and Paul's death was fatal to her claim. Janet resisted the motion. She claimed the defendants' failure to produce relevant records within their control entitled her to an inference that the missing medical records contained evidence unfavorable to the defendants, and that this inference gave rise to a genuine issue of material fact on the causation element.

The district court granted the motion for summary judgment. Janet appeals. She claims the district court erred in holding the spoliation inference could not support a proximate cause finding under the circumstances.

II. Scope of Review.

We review a ruling on a summary judgment motion for errors at law. Crippen v. City of Cedar Rapids, 618 N.W.2d 562, 565 (Iowa 2000); Swartzendruber v. Schimmel, 613 N.W.2d 646, 649 (Iowa 2000); Iowa Comprehensive Petroleum Underground Storage Tank Fund Bd. v. Mobil Oil Corp., 606 N.W.2d 359, 362 (Iowa 2000); Bennett v. MC # 619, Inc., 586 N.W.2d 512, 516 (Iowa 1998). A district court properly grants summary judgment when there is no genuine issue of material fact and the moving party is entitled to judgment as a matter of law. Iowa R. Civ. P. 237(c); Crippen, 618 N.W.2d at 565; Swartzendruber, 613 N.W.2d at 649; Shivvers v. Hertz Farm Mgmt., Inc., 595 N.W.2d 476, 478 (Iowa 1999); Bennett, 586 N.W.2d at 516. A factual issue is "material" only if "the dispute is over facts that might affect the outcome of the suit." Fouts ex rel. Jensen v. Mason, 592 N.W.2d 33, 35 (Iowa 1999) (citation omitted). The burden is on the party moving for summary judgment to prove the facts are undisputed. Interstate Power Co. v. Ins. Co. of N. Am., 603 N.W.2d 751, 756 (Iowa 1999); Bennett, 586 N.W.2d at 516; Sandbulte v. Farm Bureau Mut. Ins. Co., 343 N.W.2d 457, 464 (Iowa 1984).

In ruling on a summary judgment motion, the court must look at the facts in a light most favorable to the party resisting the motion. Crippen, 618 N.W.2d at 565; Iowa Comprehensive Petroleum Underground Storage Tank Fund Bd.,606 N.W.2d at 362; Shivvers, 595 N.W.2d at 478-79; Fouts, 592 N.W.2d at 35; Sandbulte, 343 N.W.2d at 464. The court must also consider on behalf of the nonmoving party every legitimate inference that can be reasonably deduced from the record. Crippen, 618 N.W.2d at 565; Shivvers, 595 N.W.2d at 479; Schlader v. Interstate Power Co., 591 N.W.2d 10, 14 (Iowa 1999). An inference is legitimate if it is "rational, reasonable, and otherwise permissible under the governing substantive law." Butler v. Hoover Nature Trail, Inc., 530 N.W.2d 85, 88 (Iowa Ct.App. 1994). On the other hand, an inference is not legitimate if it is "based upon speculation or conjecture." Id. If reasonable minds may differ on the resolution of an issue, a genuine issue of material fact exists. Swartzendruber, 613 N.W.2d at 649; Shivvers, 595 N.W.2d at 479; Fouts, 592 N.W.2d at 35; Schlader, 591 N.W.2d at 14.

III. Spoliation of Evidence.

To establish a prima facie case of medical malpractice, the plaintiff must demonstrate the applicable standard of care, the violation of this standard of care, and a causal relationship between the violation and the harm allegedly suffered by the plaintiff. Kennis v. Mercy Hosp. Med. Ctr., 491 N.W.2d 161, 165 (Iowa 1992). Expert testimony is nearly always required to establish each of these elements. Id.; see Edwards v. City of Des Moines, 349 N.W.2d 786, 789-90 (Iowa Ct.App. 1984). Moreover, proximate cause, like the other elements, cannot be based upon mere speculation. See Walls v. Jacob N. Printing Co., 618 N.W.2d 282, 286 (Iowa 2000) ("[t]he record cannot be stretched that far without rank speculation"). No consequential fact in a case can be resolved by pure guesswork. Id.

Although the expert in this case, Dr. Overton, concluded the defendants breached the duty of care they owed to Paul, he was unable to establish the existence of a causal relationship between this breach and Paul's death. Additionally, Dr. Overton could not even state that there was a possibility that Paul would have survived absent the defendants' breach. See Edwards, 349 N.W.2d at 790.

Notwithstanding, Janet argues that the clinic's failure to produce the medical records gives rise to an inference that the physicians' conduct in treating her father was negligent and the cause of his death. She claims this inference is sufficient to overcome the motion for summary judgment.

It is a well established legal principle that the intentional destruction of or the failure to produce documents or physical evidence relevant to the proof of an issue in a legal proceeding supports an inference that the evidence would have been unfavorable to the party responsible for its destruction or nonproduction. Hendricks v. Great Plains Supply Co., 609 N.W.2d 486, 491 (Iowa 2000); State v. Langlet, 283 N.W.2d 330, 333 (Iowa 1979); 2 Clifford S. Fishman, Jones on Evidence § 13:12, at 489 (7th ed.1994) [hereinafter Fishman]. The nonproduction, alteration, or destruction of evidence is commonly referred to as spoliation. Langlet, 283 N.W.2d at 333. When established, the inference is regarded as an admission by conduct of the weakness of the party's case. Edward W. Cleary et al., McCormick on Evidence § 273, at 808 (3d ed.1984); 2 Fishman § 13:12, at 489-90. The inference is imposed both for evidentiary and punitive reasons. Langlet, 283 N.W.2d at 333; 2 Fishman § 13:12, at 490. The evidentiary value of the inference is derived from the common sense observation that a party who destroys a document with knowledge that it is relevant to litigation is likely to have been threatened by the document. Beil v. Lakewood Eng'g & Mfg. Co., 15 F.3d 546, 552 (6th Cir.1994) (when a party to an action has notice that an item is relevant to the lawsuit and proceeds to destroy the item, "common sense" dictates an inference that the party destroying the item is likely to have been threatened by the evidence); 2 Fishman § 13:12, at 490. Additionally, an inference serves to deter parties from destroying relevant evidence. Beil, 15 F.3d at 552; 2 Fishman § 13:12, at 490.

The inference can arise in a variety of circumstances,...

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