Introduction

In this significant decision from the Supreme Court of Iowa dated March 7, 2025, the court addressed critical procedural and substantive issues in a medical malpractice context. In Marlene Banwart and Richard Banwart v. Neurosurgery of North Iowa, P.C., David Beck, and Thomas Getta, the central dispute revolved around the procedural form of the expert “certificate of merit” and questions regarding the statute of limitations as applied during the COVID-19 pandemic. The plaintiffs, the Banwarts, alleged medical negligence following a series of spinal surgeries and an ensuing complication, while the defendants contended that the case was time-barred and that the plaintiffs’ certificate of merit affidavits were deficient under Iowa Code §147.140.

The litigation involved two main issues: first, whether the expert certificates substantially complied with the statutory oath or affirmation requirements; and second, the proper interpretation and application of the tolling orders during the pandemic in determining the statute of limitations. With cross-appeals filed on both sides and deep scrutiny on statutory language, this ruling sets important precedents for medical malpractice cases in Iowa.

Summary of the Judgment

The Court reversed the district court’s summary judgment ruling with respect to the certificate of merit affidavits. The key findings include:

• The certificates of merit, which were merely “affirmed” by experts without being signed under oath or including a statement made “under penalty of perjury,” did not substantially comply with the requirements of Iowa Code §147.140.
• The court rejected the plaintiffs’ claims that the statute within §147.140 was unconstitutionally vague.
• The defendants’ argument that they waived their right to dismissal by delaying their challenge was rejected because their challenge was made well before the dispositive motion deadline.

Ultimately, the case was remanded for summary judgment in favor of the defendants under section 147.140(6)—reinforcing the imperative that expert certifications must satisfy the procedural requirements, which aim to deter false testimony in medical malpractice actions.

Analysis

Precedents Cited

The decision extensively relies on and distinguishes several precedents:

• Miller v. Catholic Health Initiatives-Iowa Corp.: This case was pivotal in determining that a certificate of merit must be personally signed under oath or “under penalty of perjury” to satisfy the statutory requirement. The ruling in Miller clearly stated that an unsworn letter—even if it uses the term “affirm”—falls short of the necessary standard.
• Shontz v. Mercy Medical Center-Clinton, Inc.: The court further reinforced its holding in Miller, reaffirming that expert affidavits that are not executed under oath or expressed as being under penalty of perjury do not “substantially comply” with the statutory mandate.
• Additional cases such as STATE v. CARTER and interpretations from out-of-state authorities were cited to illustrate how similar requirements are enforced, thereby supporting the need for rigorous adherence to sworn or perjury-attested statements.

Legal Reasoning

The court’s reasoning hinges on a strict construction of the statutory language contained in Iowa Code §147.140. It noted:

• Literal Interpretation: The statute explicitly uses the term “affidavit” multiple times, which by definition requires involvement of a notary or an official administering an oath. The absence of a jurat or a declaration indicating compliance “under penalty of perjury” renders the Banwarts’ certificates deficient.
• Purpose of the Oath Requirement: The court emphasized that the purpose behind invoking an oath or affirmation is to bind the expert’s conscience, thereby deterring false testimony. Allowing an unsworn affirmation would undermine statutory objectives designed to promote honesty and accountability.
• Rejection of Waiver by Delay Argument: The defendants’ delay in challenging the certificates did not amount to a waiver of their statutory rights because they acted well before the dispositive motion deadline. This bright-line approach upholds judicial economy and clarity regarding procedural deadlines.

Additionally, by reviewing the constitutional challenge regarding the tolling provision, the Court underscored that issues of separation of powers must be carefully balanced. However, it ultimately bypassed the limitations issue and focused on the certificate compliance, given the settled precedents in Miller and Shontz.

Impact on Future Cases and the Legal Landscape

This decision is expected to have broad implications in Iowa medical malpractice litigation:

• Stricter Compliance Standards: Plaintiffs must ensure that expert certificates strictly adhere to the oath or perjury requirement. Any deviation—no matter how minor in form—could result in dismissal.
• Guidance on Certification Language: Legal practitioners are now on notice that terms such as “affirm” without additional verification (jurat or explicit perjury language) are insufficient under §147.140.
• Procedural Certainty and Judicial Economy: The bright-line rule regarding the timing for raising certificate deficiencies reinforces the importance of timely objections, encouraging early scrutiny and reducing protracted litigation.

Complex Concepts Simplified

Several complex legal concepts featured prominently in this decision:

• Substantial Compliance: Rather than requiring exact replication of every mandated element, “substantial compliance” means meeting the essential criteria necessary for the statute’s objectives. In this case, the essential requirement was securing an oath or an explicit perjury statement. Without these, the certificate cannot achieve its protective purpose.
• Affidavit vs. Affirmation: An affidavit usually requires a sworn statement in front of an authorized official, complete with a jurat. An affirmation, while similar in function (subjecting the signer to penalties for perjury), must be clearly expressed to be effective. The omission of the “under penalty of perjury” language is treated as a fatal flaw.
• Waiver by Delay: The idea here is that if a party waits too long to challenge a defect, it might be deemed to have waived that objection. However, the Court’s bright-line rule ensures that as long as a challenge is made before the dispositive motion deadline, no waiver occurs. This simplifies the determination and avoids a fact-intensive inquiry.

Conclusion

The Supreme Court of Iowa’s decision in Banwart v. Neurosurgery of North Iowa marks a significant precedent by reaffirming the necessity of a strict adherence to the oath or affirmation requirement in expert certificates. By reversing the district court’s finding of “substantial compliance,” the Court has underscored that the statutory language in Iowa Code §147.140 leaves little room for deviation.

Key takeaways from this Judgment include:

• Expert certificates must be signed under oath or include a declaration made “under penalty of perjury” to meet the requirements of the statute.
• Claims that the statutory language is vague are unlikely to succeed when the language is examined in light of established case law.
• Timely objection to certificate deficiencies is critical; engaging in discovery does not equate to waiving defendants’ rights.

This ruling not only clarifies the procedural standards for medical malpractice claims in Iowa but also serves as a warning to litigants to rigorously comply with statutory requirements designed to safeguard the integrity of judicial proceedings.