September 23, 2026 by matray

A series of recent Iowa Supreme Court decisions reinforced the state’s strict certificate-of-merit requirements while recog-nizing limited exceptions for informed-consent claims and plaintiffs whose older cases were affected by changes in the law.

The rulings also restrict claims against healthcare institutions, clarify when malpractice cases may be refiled and require judges to consider lesser sanctions before excluding an expert witness. Many involve Iowa Code §147.140, which requires a medical malpractice plaintiff to serve a certificate-of-merit affidavit within 60 days after a defendant answers when expert testimony is needed.

The court interpreted the statute to require that the certificate be sworn before someone authorized to administer oaths or signed under penalty of perjury. Calling a document an affidavit or stating that the expert was “duly sworn” is insufficient without evidence that an oath was administered.

In Rarick v. Smidt, the plaintiffs timely served a certificate that contained neither a notarial jurat nor penalty-of-perjury language. They submitted a notarized version after the deadline.

The Supreme Court affirmed dismissal, holding that the original was not a valid affidavit and the corrected filing could not cure the defect. Iowa’s statute does not allow an amended certificate to relate back to the original filing.

The court applied similar reasoning in Bunce v. Hansen. The certificate stated that the expert was “duly sworn on oath” but was not notarized or signed under penalty of perjury.

The court rejected arguments for prospective application and directed dismissal even though the certificate had been submitted before the Supreme Court clarified the requirement in its 2024 Miller v. Catholic Health Initiatives-Iowa Corp. decision.

A divided court reached the same practical result in Willhoite v. Genesis Health System, a wrongful-death action involving an allegedly missed lung cancer diagnosis. The plaintiffs timely submitted certificates signed by their experts, but the documents were neither notarized nor signed under penalty of perjury. The justices divided 3-3 over dismissal. With one justice not participating, the lower court’s dismissal was affirmed by operation of law.

Two other decisions provided relief for plaintiffs whose lawsuits became vulnerable after the court clarified the affidavit requirement.

In Trask v. Ahmed, the plaintiff voluntarily dismissed his original action after the defendants challenged his certificates under Miller. He filed an identical lawsuit within six months under Iowa’s savings statute, which allows certain refiled actions to be treated as continuations of earlier lawsuits.

A district court dismissed the second suit, finding that the plaintiff had voluntarily abandoned the first case. The Supreme Court reversed, concluding that the certificate requirements were unsettled when the original action was filed. The plaintiff was not required to pursue futile arguments before dismissing and refiling.

The court reached the same conclusion in Williams v. Hartman, holding that a plaintiff who voluntarily dismissed her malpractice action after Miller could use the savings statute to preserve an otherwise untimely second lawsuit. Although later precedent indicated that the defendant’s original certificate challenge might have been untimely, that rule had not been established when the plaintiff dismissed her case. The court said lawyers were not required to predict future judicial decisions.

The rulings do not relax certificate requirements for new cases but provide limited relief for plaintiffs who filed defective certificates before the court clarified the statute and then refiled within six months.

The court identified another exception in Lofgren v. Simpson. A mother alleged that she consented to an ear, nose and throat specialist performing surgery on her 2-year-old son but was not told that a fourth-year medical resident would participate in the procedure. The child later died from postoperative bleeding.

The Supreme Court affirmed dismissal of conventional negligence claims because the certificate was defective but reinstated the informed-consent claim, finding that expert testimony was unnecessary to determine whether a reasonable parent would want to know that a resident might participate.

Because a certificate is required only when expert testimony is necessary to establish a prima facie case, the informed-consent claim could proceed without one.

In Baldwin v. Central Iowa Hospital Corp., the court limited claims that may be pursued directly against healthcare institutions.

The estate of a patient who died after a dialysis catheter became unsecured alleged that the hospital was vicariously liable for its nurse and independently liable for negligent hiring, supervision or retention.

The court held that when an employer admits vicarious liability for an employee’s negligence, a plaintiff generally may not pursue duplicative negligent hiring, retention or supervision claims.

The court also dismissed the patient’s wife’s bystander emotional-distress claim because she did not contemporaneously perceive the event that caused the injury.

Another ruling prevents defendants from repeatedly challenging a certificate after an earlier appeal. In Jorgensen v. Smith, the defendants sought summary judgment by reframing certificate-of-merit arguments following an interlocutory appeal. The Supreme Court held that the law-of-the-case doctrine barred reconsideration because the prior decision had necessarily treated the certificate as sufficient for the claims against the surgeon and determined the statute did not apply to the negligent-retention claim. The court returned the case for trial.

The court separately addressed expert-witness sanctions in Sondag v. Orthopaedic Specialists. It held that a trial court generally must consider the reason for a delayed expert designation, prejudice to the opposing party, disruption of the trial schedule and availability of lesser sanctions before excluding an expert.

Because striking a standard-of-care expert can effectively end a malpractice action, exclusion should not be an automatic consequence of a missed deadline.

Taken together, the Iowa Supreme Court’s 2026 decisions preserve strict enforcement of the state’s certificate-of-merit statute while identifying limited circumstances in which claims may survive without a compliant certificate. They also restrict separate institutional-negligence claims when a healthcare employer accepts vicarious liability.