Tamara Stellmach and John Stellmach v. State of Iowa D/B/A University of Iowa Hospitals and Clinics, 15-2105

Background

Tamara Stellmach underwent a transcranial magnetic stimulation (TMS) research procedure at UIHC on Feb 22, 2008; consent warned seizures are a rare risk but did not list facial paralysis.
She awoke Feb 23 with left-sided facial weakness and was diagnosed in the ER with post-infectious Bell’s palsy; treated with antiviral medication and discharged.
On March 5 Dr. Bruce Gantz (UIHC neuro-otologist) evaluated Tamara and recommended facial nerve decompression; medical records at one point attributed Bell’s palsy to TMS.
Plaintiffs sued UIHC alleging lack of informed consent, negligent performance of TMS, and negligent treatment; causation was a central disputed issue.
At trial, plaintiffs introduced prior statements and deposition testimony of Dr. Gantz (initially saying TMS could have caused the paralysis); Dr. Gantz later testified for the defense that, based on later information and literature, TMS could not have caused the paralysis.
The court excluded parts of Dr. Paul Towner’s deposition opinion that TMS caused swelling because Towner lacked relevant expertise; plaintiffs moved to sanction UIHC for failing to disclose Dr. Gantz’s changed opinion under Iowa Code § 622.10 and Iowa R. Civ. P. 1.508(3).

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether Dr. Towner’s deposition opinion that TMS caused nerve swelling was admissible as expert testimony	Towner’s status as treating physician supports admissibility to show causation	Towner admitted no familiarity with TMS and lacked technical expertise	Court excluded the testimony; no abuse of discretion because Towner lacked relevant specialized knowledge under Iowa R. Evid. 5.702
Whether defense violated Iowa Code § 622.10 notice provisions for meetings with plaintiff’s physicians, warranting striking Gantz’s changed opinion	UIHC met with Dr. Gantz without statutorily required notice; changed opinion should be stricken	Communications may have been privileged or protected; record lacks proof of substance of meeting	Court could not determine abuse of discretion because record did not show what was discussed and plaintiffs made no offer of proof; no sanction imposed
Whether UIHC failed to supplement expert disclosure under R. 1.508(3) by not disclosing Gantz’s new causation opinion	Gantz developed a new causation opinion after treatment and UIHC had a duty to supplement; sanction warranted	UIHC: Gantz was not a retained expert whose report triggered supplementation; plaintiffs were not unfairly surprised	Court found UIHC used Gantz like a retained expert and had a supplementation obligation, but declining to exclude testimony was not prejudicial because the jury never reached causation; no new trial
Whether failure to exclude or strike testimony required reversal/new trial	Exclusion required because nondisclosure prevented preparation and fairness	No prejudice because trial on fault proceeded and jury found no fault; causation evidence would have been irrelevant to verdict	Affirmed: no new trial because any error regarding causation testimony was harmless given jury’s verdict on fault

Key Cases Cited

Keefe v. Bernard, 774 N.W.2d 663 (Iowa 2009) (distinguishes attorney-client privilege for corporate employees depending on whether communication seeks legal advice or is as a witness)
Yates v. Iowa W. Racing Ass’n, 721 N.W.2d 762 (Iowa 2006) (Iowa courts favor liberal admission of expert opinion that will aid the jury)
Whitley v. C.R. Pharmacy Serv., Inc., 816 N.W.2d 378 (Iowa 2012) (duty to supplement expert disclosures aims to avoid surprise and clarify issues before trial)
Day v. McIlrath, 469 N.W.2d 676 (Iowa 1991) (treating physician who assumes a role analogous to retained expert can trigger discovery obligations)