Background
After ninety-two-year-old Betty Peer was discharged from a hospital, she moved into The Shores, an assisted-living facility. Peer alleged that the facility and registered nurse Myra Waltersdorf failed to follow her care plan, including by waiting twelve days to obtain prescribed compression socks, failing to help her put them on and remove them, and failing to tell her family or other providers that she was not wearing them. A wound later developed on Peer’s left foot, and surgeons amputated her left big toe.
Peer sued the facility and Waltersdorf for negligence. She served certificates of merit signed by Dr. Nathaniel Meyer, a physician board certified in family practice and hospice and palliative medicine who taught geriatrics and had served as a nursing-home director. The district court concluded that Meyer was not qualified to address the standard of care applicable to the nurse or facility and dismissed the claims with prejudice. After Peer died, Brianne Garrett, executor of Peer’s estate, was substituted as appellant.
The Court’s Holding
The Iowa Court of Appeals reversed. The majority held that Peer did not need expert testimony to establish the standard of care for the negligence allegations at issue. Lay jurors could determine whether ordinary care required staff to timely obtain doctor-ordered compression socks, assist Peer in using them as directed by her care plan, and communicate the failure to provide them. No professional judgment was necessary merely to comply with the prescription. Although expert testimony might be needed to prove causation, Iowa’s certificate-of-merit statute does not require a certificate addressing causation.
The court alternatively held that, even if a certificate of merit were required, Meyer qualified under Iowa Code sections 147.139 and 147.140. Medicine and registered nursing are “substantially similar” fields in this context because prescribing treatment is a core aspect of medicine and executing prescribed treatment is a core aspect of nursing. Meyer’s family-practice, hospice, geriatric, and nursing-home experience strengthened that similarity. Because he could address Waltersdorf’s standard of care, he could also address the standard applicable to the assisted-living facility that employed her. The case was remanded for further proceedings.
Key Takeaways
- Expert testimony was unnecessary to establish the standard of care for the alleged delay in obtaining prescribed compression socks and related failures to assist and communicate.
- A potential need for expert causation testimony did not trigger a certificate-of-merit requirement addressing causation.
- A physician may practice in a field substantially similar to nursing under Iowa’s expert-qualification statute when the fields share core characteristics, including prescribing and executing treatment.
Why It Matters
The decision limits dismissal under Iowa’s certificate-of-merit statute when alleged failures in patient care involve routine compliance with clear medical orders rather than specialized professional judgment. It also interprets “substantially similar field” broadly enough to permit some physicians to opine on nursing and facility standards of care, depending on the overlap between the licensed fields and the expert’s relevant practice.
The ruling does not resolve the estate’s negligence claims or establish that the defendants caused Peer’s injury. It restores those claims for further district-court proceedings.