Statutes of Limitations

In Iowa, any medical malpractice action for either personal injury or wrongful death must be brought within two years after the date upon which the claimant knew or reasonably should have known of the injury or death. Iowa Code Ann. § 614.1(9) (West Supp. 1997). No such action, however, may be brought more than six years after the date upon which the alleged wrongful act occurred, unless the action involves a retained foreign object. Id. With respect to minors and mentally ill persons, Iowa extends the statutory period to one year from the date that the disability is removed. Iowa Code Ann. § 614.8 (West Supp. 1997).

Contributory or Comparative Negligence

Iowa has adopted the doctrine of modified comparative negligence. Iowa Code Ann. § 668.3(1) (West 1987). Under this doctrine, a claimant's action is barred if his negligence exceeds the combined negligence of all other parties. Id. Otherwise, the claimant's recovery is diminished in proportion to his degree of negligence. Id. Parties include defendants, third-party defendants, and defendants who have settled.

Joint and Several Liability

Only those joint tortfeasors whose fault accounts for 50 percent or more of the total fault assigned to all parties may be held jointly and severally liable. Iowa Code Ann. § 668.4 (West 1987). Any joint tortfeasor whose fault accounts for less than 50 percent of the fault assigned to all parties will only be liable for a proportion of the judgment equal to the joint tortfeasor's share of the total fault.

Contribution

Joint tortfeasors are generally afforded a right of contribution in tort actions. Iowa Code Ann. §§ 668.5(1) and 668.6 (West 1987). A contribution action may be brought within either the original medical malpractice action or a separate action brought within a year if the parties' percentages of fault have not been established by the court. Id. Generally, a settling tortfeasor must have extinguished the liability of the tortfeasor against whom contribution is sought in order to bring a separate action, which must be brought within one year. Iowa Code Ann. § 668.6(3) (West 1987).

Vicarious Liability

Iowa courts have not applied the doctrine of ostensible or apparent agency as a means of imposing liability on hospitals for the negligence of their independently-contracted physicians. The standard for vicarious liability is actual agency, and physicians are generally held to be independent contractors. See Biddle v. Sartori Memorial Hospital, 518 N.W.2d 795 (Iowa 1994).

Expert Testimony

Medical malpractice claimants must prove their claim of negligence via expert testimony, unless the lack of care is so obvious as to be within the average juror's comprehension. Forsmark v. State, 349 N.W.2d 763 (Iowa 1984).

Further, Iowa Code Ann. § 147.139 (West 1997) provides that when the standard of care is at issue in a medical malpractice action:

the court shall only allow a person to qualify as an expert witness and to testify on the issue of the appropriate standard of care if the person's medical or dental qualifications relate directly to the medical problem or problems at issue and the type of treatment administered in the case.

Damage Caps

Iowa does not place a cap on the amount of damages recoverable in a medical malpractice action.

Statutory Cap on Attorneys' Fees

Iowa does not place a limit on the fees an attorney may recover in a medical malpractice action. However, Iowa courts are charged with the responsibility of determining the reasonableness of fee arrangements between medical malpractice claimants and their counsel. Iowa Code Ann. § 147.138 (West 1997).

Periodic Payments

If petitioned by a party in a medical malpractice action, the court may order that the payment of the judgment, in whole or in part, be pursuant to a structured, periodic or any other non-lump sum payment plan. Iowa Code Ann. § 668.3(7) (West 1987). Nonetheless, the court may not make such an order if the payment method would be inequitable, there are insufficient guarantees of future collectibility, or such payments would be subject to other claims against the defendant or the defendant's insurer. Id.

Collateral Source Rule

Economic damages in a medical malpractice case may not include amounts that have been or will be replaced or indemnified by insurance, or by governmental, employment, or service benefit programs, or from any other source except the assets of the claimant or of the members of the claimant's immediate family. Iowa Code Ann. § 147.136 (West 1997).

Pre-Judgment Interest

Iowa generally allows a successful claimant to recover pre-judgment interest from the date the action was commenced. Iowa Code Ann. § 668.13 (West 1987). However, pre-judgment interest may not be awarded with respect to future damages; instead, interest awarded on future damages does not begin to accrue until the date upon which judgment is entered. Id.

Patient Compensation Funds and Physician Insurance

Iowa does not have a patient compensation fund or a program of state-sponsored liability insurance for physicians.

Immunities

The State of Iowa is subject to suit for the negligence of its employees if a written claim is made to the state appeal board within two years from the time the action accrued. Iowa Code Ann. § 669.13 (West Supp. 1997). The state owes its employees a duty of defense and indemnification so long as the employee's conduct was not willful or malicious. Iowa Code Ann. § 669:21 (West Supp. 1997).

Political subdivisions, including municipalities, cities, and counties, are generally liable in tort for the negligent conduct of employees acting within the scope of their employment. Iowa Code Ann. § 670.2 (West Supp. 1997). Political subdivisions owe a duty of defense and indemnification to their officers and employees. Iowa Code Ann. § 670.8 (West Supp. 1997). Such duty, however, does not apply to actions for punitive damages. Id.

Arbitration

Iowa law does not require the reference of medical malpractice actions to an arbitrator.