Summary
The Supreme Court of Iowa affirmed a conditional new trial in a medical malpractice action involving the delayed diagnosis of diverticulitis and the death of Lucille Humpal. The court held that traditional wrongful-death damages and lost-chance-of-survival damages may be pleaded in the alternative, but recovery for both theories in the same case would be duplicative. The court permitted the personal representative to avoid a new trial by remitting the $125,000 lost-chance award.
Topics
Practice areas
Questions Presented
- Whether traditional wrongful-death damages and lost-chance-of-survival damages may be submitted as alternative theories of recovery.
- Whether a plaintiff may recover predeath damages in addition to proportionally reduced lost-chance-of-survival damages.
- Whether submitting both traditional wrongful-death damages and lost-chance damages in a manner that permits duplicative recovery requires a new trial.
- Whether the conditional remittitur provision in the district court's new-trial order was appealable and what condition should govern the new trial on remand.
Holdings
- The claims may be asserted and submitted as alternative theories of recovery, but the jury must first consider the traditional negligence or wrongful-death claim and may consider the loss-of-chance claim only if traditional causation does not support recovery.
- A loss-of-chance claim is a separate negligence-based theory consisting of duty, breach, proximate causation, and damages; the compensable injury is the lost chance of avoiding the ultimate harm, not an additional item of damages alongside traditional negligence damages.
- Lost-chance damages must be proportionally reduced according to the percentage of chance lost because of the defendant's negligence, and the reduction applies to damages attributable to death as such; proximately caused predeath damages may be recovered in full.
- When the jury finds that traditional wrongful-death damages were proximately caused by the defendant's negligence, it is improper to award a separate lost-chance amount that is included within and duplicated by the traditional wrongful-death recovery.
- The Supreme Court of Iowa could sustain the conditional new trial on its own terms and permit the plaintiff to avoid a new trial by deleting the $125,000 lost-chance award, with interest on the remaining award calculated under the original judgment.
Key quotations
“As developed in our case law, the last-chance-of-survival doctrine is not an alteration of the traditional rules for determining proximate cause, but, rather, the creation of a newly recognized compensable event to which those traditional rules apply.” (178)
“However, if both a traditional wrongful-death claim and a lost-chance-of-survival claim are submitted, the proportionally reduced recovery for lost chance would be included within and duplicated by an award of traditional wrongful-death damages.” (180)
“Loss of chance is a separate theory of recovery from a traditional negligence claim that is normally brought as an alternative claim in a traditional negligence action.” (186)
“A loss of chance claim includes the basic elements of a traditional negligence claim—duty, breach of duty, causation, and damages.” (187)
Factual background
Lucille Humpal, age seventy-three, was hospitalized after weakness, abdominal distension, severe lower abdominal pain, and an elevated white blood cell count. Dr. Burton Adrian initially suspected a urinary-tract infection and ordered laxatives and enemas, but Humpal's condition did not improve over several days. Additional x-rays eventually revealed a ruptured colon caused by diverticulitis; she died during emergency surgery from toxicity caused by bacterial spread.
Procedural history
The jury awarded $253,500, including $125,000 for lost chance of survival. The district court granted a conditional new trial because the submitted damages theories were duplicative and because the jury was not properly instructed on calculating lost-chance damages. The personal representative declined the $125,000 remittitur and appealed; the Supreme Court of Iowa affirmed and remanded for further proceedings, allowing avoidance of a new trial if the representative accepted deletion of the $125,000 lost-chance award.
Remand instructions
The case was remanded for further proceedings consistent with the opinion. The personal representative could avoid a new trial by agreeing within thirty days after filing of the procedendo to delete the $125,000 lost-chance award; if accepted, interest on the remaining award was to be calculated as provided in the original judgment.