Rieder v. Segal

Decision Date14 May 2021
Docket NumberNo. 19-0767,19-0767
Citation959 N.W.2d 423
Parties Roxanne RIEDER and Tony Rieder, Appellants, v. David SEGAL, Theodore Donta, Eastern Iowa Brain & Spine Surgery, PLLC, Radiology Consultants of Iowa, PLC and Mercy Hospital, Cedar Rapids, Iowa d/b/a Mercy Medical Center, Cedar Rapids, Iowa, Appellees.
CourtIowa Supreme Court

Bruce L. Braley (argued), Brian N. Aleinikoff, Benjamin I. Sachs, and Timothy J. Luetkemeyer of Leventhal Puga Braley P.C., Denver, CO, for appellants.

Christine L. Conover (argued), Carrie L. Thompson, and Dawn M. Gibson of Simmons Perrine Moyer Bergman PLC, Cedar Rapids, for appellees.

McDonald, J., delivered the opinion of the court, in which all justices joined.

McDONALD, Justice.

Plaintiffs Roxanne and Tony Rieder filed suit against Mercy Medical Center for the negligent credentialing of Dr. David Segal after Ms. Rieder suffered complications following surgical procedures performed by Dr. Segal. A majority of jurisdictions recognize the tort of negligent credentialing, but Iowa is not one of them. This court has addressed the tort in a prior decision, but the court did not adopt the tort at that time. See Hall v. Jennie Edmundson Mem'l Hosp. , 812 N.W.2d 681, 685 (Iowa 2012) ("We assume without deciding that the tort is actionable in this state. As we find no reversible error in any of the district court's rulings ... we need not decide the question whether the tort is actionable."). In this case, the parties and the district court assumed the plaintiffs’ negligent credentialing claim against Mercy was cognizable in Iowa. The district court granted Mercy's motion for summary judgment. The court of appeals reversed the judgment of the district court, and we granted Mercy's application for further review. For the reasons set forth below, we vacate the court of appeals decision, reverse the judgment of the district court, and remand this matter for further proceedings.

I.

We review the grant of summary judgment for correction of errors at law. Susie v. Fam. Health Care of Siouxland, P.L.C. , 942 N.W.2d 333, 336 (Iowa 2020). The grant of summary judgment is appropriate "if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law." Id. (quoting Iowa R. Civ. P. 1.981(3) ). In reviewing the district court's decision, we look at the summary judgment record in the "light most favorable to the nonmoving party." Hedlund v. State , 930 N.W.2d 707, 715 (Iowa 2019).

II.

On May 8, 2015, Dr. Segal performed an anterior cervical discectomy

with fusion and a microscopic lumbar laminectomy on Roxanne Rieder. In other words, Dr. Segal performed upper neck and lower back surgery. In the days immediately after the surgery, Rieder experienced severe pain originating in her lower back and down the back of her leg. She was unable to lift her left leg out of the hospital bed. She reported increasing pain, weakness, numbness, and tingling in her left leg. Dr. Segal decided he had to perform additional procedures to "fix" Rieder. Four days after he performed the original procedures, Dr. Segal performed a lumbar decompressive laminectomy and decompression of the nerve roots. More generally, Dr. Segal performed a surgical reexamination of Rieder's lower back to relieve pressure and alleviate pain. Three days after the second surgical procedure, Rieder was discharged from the hospital. After being discharged, Rieder continued to experience symptoms including neck pain, left arm pain and numbness, intermittent shooting right arm pain, left foot drop, and pain and paresthesia extending into the buttocks, thighs, and calves in both legs. She treated with other physicians to address these symptoms.

On the same day Rieder was discharged from the hospital, the Iowa Board of Medicine (IBM) filed a statement of charges against Dr. Segal related to medical care he provided to patients other than Rieder. The charges stated Dr. Segal "demonstrated professional incompetency ... when he failed to provide appropriate neurosurgical care to numerous patients in Cedar Rapids, Iowa." IBM investigations are confidential. See Iowa Admin. Code r. 653—24.2(8) (2015). As a result, the charges were not public until May 15, 2015, when the IBM issued their formal statement of charges. However, Dr. Segal admitted he informed Mercy of the IBM's pending investigation at some point prior to Rieder's surgery on May 8, 2015.

The IBM charges were resolved against Dr. Segal in December 2016. Dr. Segal agreed to cease practicing surgery in Iowa. In a press release issued in December 2016, the IBM stated, "Dr. Segal discontinued his surgical practice due to his health condition of Parkinsonism

, which impacts the steadiness of his hands during surgery. ... Dr. Segal agreed that he will not engage in the practice of surgery under his Iowa medical license."

The Rieders filed this suit a few days prior to the IBM announcing the resolution of the charges against Dr. Segal. In their suit, the Rieders asserted claims for medical negligence against Dr. Segal and another physician as well as claims for negligent credentialing against the clinics and hospitals that employed or credentialed the doctors. The Rieders settled and dismissed their claims against all defendants except Mercy. As to Mercy, the Rieders alleged: (1) Mercy "was negligent in credentialing Dr. Segal as a member of its staff in that it failed to exercise reasonable care in investigating and selecting medical staff to permit only competent and qualified physicians the privilege of using its facilities"; (2) Mercy "knew, or should have known, that Dr. Segal did not possess the proper professional competency to practice"; and (3) Mercy's negligent credentialing of Dr. Segal caused Ms. Rieder's injuries.

There are two summary judgment rulings at issue in this appeal. Mercy first moved for partial summary judgment on the ground "there is no duty for the hospital to take immediate action with regard to a doctor's privileges upon finding out there is an open investigation by the Board of Medicine." The Rieders resisted the motion, relying on the opinion of their expert witness, Dr. Charles Pietrafesa. Dr. Pietrafesa opined,

based on the Iowa Medical Board's allegations[ and] the testimony of Dr. Segal that he alerted Mercy about these [IBM] allegations, the standard of care required Mercy to take swift and immediate action to limit, restrict, or suspend Dr. Segal's privileges with respect to care of any patients at Mercy at that time, including but not limited to Ms. Rieder, even on a conditional or temporary basis.

The district court granted Mercy's motion for partial summary judgment, holding "[d]efendant Mercy Hospital did not owe a duty to suspend or revoke Dr. Segal's credentials or privileges at the hospital in any way based solely upon the knowledge that an investigation had been opened by the Iowa Board of Medicine." (Emphasis added.) The district court continued, "Mercy Hospital, without knowing the basis of the investigation, could not have had a duty to ‘restrict or terminate Dr. David Segal's surgical privileges’ as of May 8, [2015] because it could not have known nor should it have known that he posed a serious risk to his patients, as the formal charges had not been filed yet and no final decision had been made."

After the district court entered its order, the parties continued on with motion practice and further discovery. In his deposition and supplemental disclosure, Dr. Pietrafesa opined Mercy breached the standard of care because it did not conduct an investigation into Dr. Segal's competency when it should have done so and, had it conducted an investigation, Mercy more likely than not would have suspended Dr. Segal's privileges prior to Dr. Segal performing procedures on Rieder. Dr. Pietrafesa clarified his opinion was not based solely on the IBM's investigation announced in May 2015. Instead, his opinion was based on numerous facts that should have put Mercy on alert: Dr. Segal was sued for medical malpractice on numerous occasions, including the years 2004, 2005, 2006, 2007, 2008, 2014, and 2015; due to concerns regarding his competency, Dr. Segal was sent to the Center for Personalized Education for Physicians (CPEP) in 2012; and the IBM issued subpoenas for records, credentialing information, and complication rates that should have alerted Mercy to a potential issue.

Mercy filed a motion to strike the supplemental opinion and a second motion for summary judgment. Mercy argued evidence of the prior malpractice suits was not admissible and could not be considered for the purposes of summary judgment. Without this evidence, Mercy argued, there was no evidence in support of the plaintiffs’ negligent credentialing claim. The district court agreed with Mercy on both points. First, after performing a balancing test under Iowa Rule of Evidence 5.403, the district court concluded "the probative value of evidence that Dr. Segal had been sued in the past, without any evidence as to the nature or results of those lawsuits, is substantially outweighed by the danger of unfair prejudice to Mercy as well as the danger of misleading the jury." The district court held evidence of the prior lawsuits was inadmissible as was Dr. Pietrafesa's opinion testimony to the extent it relied on the prior lawsuits. In the absence of the opinion evidence, the district court concluded there was no evidence in support of the Rieders’ claim and granted Mercy's motion for summary judgment.

The court of appeals reversed the judgment of the district court. The court of appeals concluded the district court's use of rule 5.403 to determine the admissibility of the evidence "amounted to an impermissible weighing of the evidence." Because weighing the evidence is for the fact finder, the court of appeals reasoned, the...

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4 cases
  • Iowa Ass'n of Bus. & Indus. v. City of Waterloo
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    • Iowa Supreme Court
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    ...this issue just last month. In Rieder v. Segal , the plaintiff brought a negligent credentialing claim against a hospital. See 959 N.W.2d 423, 425 (Iowa 2021). In that case, we stated it was an open question whether such a claim was cognizable in Iowa. See id. at ––––. In the district court......
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    ...was the kind of thing experts in Dr. Osterberg's field would reasonably rely on when developing their opinion. See Rieder v. Segal, 959 N.W.2d 423, 431 (Iowa 2021) ("The proponent [of the evidence] must demonstrate the information is customarily relied upon by experts in their field and tha......
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    ...any, show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law." Id. at 425-26 (citation III. Discussion The district court concluded summary judgment was appropriate for several reasons, including the public-duty doctri......

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