For attorneys and litigants not dealing with medical malpractice cases, the recently concluded Iowa Supreme Court term may have been a quiet one.
Iowa’s highest court heard and decided 107 cases in its 2025-26 term, which concluded June 30. While the court heard cases touching on gun rights, police violence and other controversial topics, such cases were fewer than in recent years, with a docket tilted more toward workers’ compensation, child welfare and esoteric disputes over legal procedures.
And medical malpractice cases. The court heard eight malpractice appeals this term, most of them stemming from two rulings it made in 2024 that have caused turmoil across dozens of pending cases. The court, now in its fourth year with the same seven members, all Republican-appointed, had to address what Justice Edward Mansfield described as “chaos and disruption” from the 2024 rulings, which resulted in many cases being dismissed without trial.
In the wake of those rulings, which involved the validity of so-called “certificates of merit” submitted by plaintiffs’ medical experts, the courts have seen dozens of motions and appeals over whether already pending cases could continue. The Supreme Court’s rulings this term clarified that, in many cases, the answer was no.
The decisions provide finality ― in many cases disappointingly so ― for numerous plaintiffs and their families, some of whom had been waiting years for their day in court. Attorneys for a number of the plaintiffs declined to comment on the decisions.
Attorney Rick Stefani, who has represented malpractice insurers and medical providers in cases before the court, said the rulings confirm the certificate of merit law should be “followed as written.”
“The statute provides a clear framework for medical malpractice claims, helping ensure that meritorious claims move forward while those that do not satisfy the statutory requirements do not,” he said. “We believe the Iowa Supreme Court’s recent decisions provide additional clarity regarding how the statute should be applied.”
A multiyear medical malpractice mess
Enacted in 2017, Iowa’s certificate of merit law requires plaintiffs with medical malpractice claims to provide a sworn statement by a medical expert early in the case attesting that the claim has merit.
In 2024, the Iowa Supreme Court held in two cases that the certificate of merit must be in affidavit form, meaning they either must be signed before a notary or state that they have been made “under penalty of perjury.” Other common language, such as “hereby affirms and states” or “being first duly sworn on oath, deposes and states,” doesn’t cut it.
Those rulings led to a wave of motions to dismiss pending cases, some of which had been working through litigation for years. The Supreme Court last year held that such motions, even years later, should be granted, so long as they are made before a case’s pretrial motion deadline.
How the court ruled in malpractice disputes
In the wake of the 2024 rulings, plaintiff-side attorneys adopted two strategies to preserve at-risk cases. Some plaintiffs sought to belatedly amend their certificates with “penalty of perjury” language despite being well after the deadline set by law. Others dismissed and refiled their cases entirely, even for claims that now fell outside the statute of limitations, relying on Iowa’s “savings statute” that in some cases allows a new case to be treated as a continuation of a previous one.
Over several cases this term, the court rejected the former course of action while unanimously endorsing the latter. In a case involving an allegedly botched knee surgery, Justice David May wrote that filing a new certificate after years of litigation is insufficient to save a pending lawsuit.
Mansfield and Justices Matthew McDermott and Dana Oxley dissented in this and several other cases, arguing the challenged certificates in fact were valid under the law.
In a different case, where physicians allegedly missed a patient’s growing cancer for nearly four years, the plaintiff had better luck dismissing and refiling his entire lawsuit. McDermott wrote for the unanimous court that because the new case was a continuation of the first suit, it survived the statute of limitations.
“A plaintiff is not required to exhaust futile procedural maneuvers to fall within the protection of the savings statute,” McDermott wrote.
A second case that followed a similar procedural path also was sent back to the lower court to move toward trial.
In addition to medical malpractice, the court touched on a number of other significant issues this term.
Gun laws remain in flux after 2022 amendment
Gun rights were a hot topic in the 2024-25 term as the court addressed the first cases touching on a 2022 amendment adding a right to keep and bear arms to the Iowa constitution that goes beyond the U.S. Constitution’s Second Amendment. While the issue wasn’t as prominent in the most recent term, the court still issued two notable decisions applying the new standard to existing gun restrictions.
In one case, the court upheld Iowa’s felon-in-possession ban, finding a restriction on gun rights for those convicted of felonies to be historically grounded and justified, protecting public safety.
In the second ruling, a week later, the court found a different law banning convicted domestic abusers from possessing guns is unconstitutional, at least in some cases. The defendant, who was charged 14 years after a misdemeanor conviction, no longer posed a clear threat to public safety, McDermott wrote for the court. Mansfield, in a concurrence, suggested possible legislative tweaks that might save the law, including creating a process for convicted abusers to formally request reinstatement of their rights.
Court considers several police lawsuits
The court heard several cases alleging police misconduct. In one, the justices affirmed a $4.25 million verdict against an officer over a high-speed chase that resulted in fatal injuries to the fleeing motorcyclist.
In another, unanimous ruling, the court reinstated a lawsuit against Waterloo police for the 2021 shooting of Brent Boggess. It’s one of several cases where the court refused to apply Iowa’s qualified immunity statute to tort claims such as negligence or assault and battery.
In a third case, the court deadlocked, leaving in place a lower court’s order dismissing a lawsuit against a Scott County sheriff’s deputy who in 2018 shot and killed a man who was trying to escape arrest. Justice Thomas Waterman recused himself from that case.
Other 2025-26 cases of note
Other noteworthy rulings included decisions affirming the admissibility and reliability of firearm ballistics testing evidence, upholding Iowa’s ban on pornography in state prisons and denying the state auditor access to the attorney-client communications of those subject to an audit .
As in past years, the justices frequently spoke with one voice. A Des Moines Register analysis found that 72 cases ― 67% of the total ― were decided unanimously, comparable to past terms.
Of the seven justices, May and Christopher McDonald were the most often on the winning side, joining or concurring with the majority in 98 cases each. On the flip side, Mansfield, Oxley and McDermott were most often in dissent, largely due to their stance in the medical malpractice cases.
Mansfield was the most prolific writer of opinions in the term, filing 28, while Chief Justice Susan Christensen wrote the fewest, at 17. Mansfield also authored the most dissenting opinions, at nine, and led the court with six solo dissents or concurrences.
The 2026-27 term begins in September.
William Morris covers courts for the Des Moines Register. He can be contacted at wrmorris2@registermedia.com or 715-573-8166.
This article originally appeared on Des Moines Register: Medical malpractice woes headline Iowa Supreme Court term I Exclusive
Reporting by William Morris, Des Moines Register / Des Moines Register
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By William Morris, Des Moines Register | USA TODAY Network
