Wendland v. Sparks

Supreme Court of Iowa · Torts

TortsMedical malpracticeLoss of chanceProximate causeDamagesloss of chancemedical malpracticeproximate cause

Facts

Callie Wendland, who suffered from several serious illnesses including fibrotic lung disease and multiple myeloma, was admitted to the hospital primarily to regain strength and, according to plaintiff's expert, was doing reasonably well in context. She suffered cardiorespiratory arrest in the hospital, a crash cart was obtained, and nurses were prepared to call a code and perform CPR. Dr. Sparks arrived as she was drawing her last breath, examined her, ordered that no code be made, and no CPR or other resuscitative effort was attempted, even though there was evidence in the summary-judgment record that resuscitation might have succeeded. Neither the patient nor her family had signed a no-code request, and Dr. Sparks knew the husband wanted her placed on a ventilator if needed; the patient had also previously been resuscitated after prior respiratory arrests.

Issue

Whether Iowa's loss-of-chance doctrine applies when a doctor allegedly negligently fails to attempt resuscitation, rather than negligently failing to diagnose, and whether a plaintiff may recover for loss of a survival chance that is less than fifty percent without proving that survival was more probable than not.

Rule

In Iowa, a plaintiff may pursue a loss-of-chance claim when negligent conduct deprives a patient of a chance of survival, and the doctrine is not limited to negligent-diagnosis cases. Recovery is based on the percentage value of the lost chance itself, so proof that the lost chance exceeded fifty percent or that survival was more probable than not is not required; the lost chance is evaluated independently and reflected proportionally in damages. Under notice pleading, a plaintiff need not specifically plead a loss-of-chance theory so long as the pleading gives notice of the incident and general nature of the claim and the theory is adequately raised in the proceedings.

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One of 10 multiple-choice questions for this case. Pick an answer to see why.

At a hospital in Des Moines, Priya Desai was recovering from severe pneumonia and chronic heart disease. When her breathing suddenly stopped, a respiratory therapist was preparing to begin bag-mask ventilation, but Dr. Nolan Pierce ordered the staff to stand down; expert testimony later estimated that immediate intervention would have given Priya a 20% chance of surviving to discharge.

If Priya's estate sues and the defendant argues that loss of chance applies only when a doctor negligently fails to diagnose a condition, how should the court rule under the majority opinion's doctrine?

Explanation. The majority held that Iowa's loss-of-chance doctrine is not confined to negligent-diagnosis cases. It applies when negligent medical conduct deprives a patient of a chance of survival, including failures to render treatment such as resuscitative care. The key issue is the lost chance itself, not the category of malpractice. (Derived from Wendland v. Sparks (n.d.).)