Oral arguments were heard in front of the Iowa Supreme Court Wednesday for a two-year-old trial regarding medical malpractice in which an infant suffered brain damage.
Kathleen and Andrew Kromphardt, parents of a newborn who suffered severe brain damage during delivery due to improper use of forceps and a vacuum, received $97 million in damages from Mercy Hospital and Obstetric and Gynecologic Associates of Iowa City and Coralville in a 2021 ruling.
The decision was the largest medical malpractice settlement in the state of Iowa.
The parents also sued Jill Goodman, the primary doctor of the delivery and one of the directors of the Coralville clinic.
The handling of the trial has now been put to question in front of the Iowa Supreme Court. Appellate Attorney Troy L. Booher argued that the reported negligence had no supporting evidence, and the language used in the complaint was biased in favor of the Kromphardts.
Booher discussed the issue of low blood pressure during the delivery, stating responsibilities were wrongly placed upon Goodman when the nurses and the anesthesiologist played a role in the error.
The anesthesiologist’s order was to the nurses, not Goodman, to administer ephedrine if blood pressure dropped below a certain threshold. Booher said there was no evidence presented in the case that illustrated Goodman was aware of the low blood pressure.
Booher also drew attention to what he called “emotionally charged” grammar in the trial. Goodman was brought up repeatedly in the trial due to her “abandoning” of Kathleen Kromphardt while complications in the delivery unfolded.
While Booher recognized that such language wasn’t being used as a cause of action to sue, he questioned why such language was used as opposed to “just not being in the room.”
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Booher would go on to question the use of the vacuum’s package insert, which is a set of instructions that described when the vacuum device was permitted, as evidence in the trial.
He argued that it was not relevant to the standard of care and was prejudicial due to its “misrepresentation” as an FDA document, going as far as to call it hearsay. He also questioned the language used by the plaintiff’s council when bringing this evidence forward.
“You don’t have to be a doctor to know what the package says,” Booher said.
The appellee’s attorney, Ryan G. Koopmans, said Goodman could still be seen as negligent. He argued Goodman’s epidural order for Kromphardt’s “non-reassuring heart pattern” was harmful due to the baby’s already low blood pressure. An epidural increases the risk of lowering the blood pressure of the mother, reducing the blood flow of the baby.
He went on to say Goodman claimed she would have called a partner if she “couldn’t handle an emergency,” indicating she was responsible for backup support.
Koopmans also said the package insert was not hearsay, but a set of instructions advising operators to not attempt to perform delivery if complications with forceps preceded it.
Koopmans stated the case was ultimately about whether Goodman cracked Kromphardt’s skull with forceps and whether the vacuum caused additional injury. He said the jury’s verdict was influenced by overwhelming evidence in the medical records provided by the University of Iowa, and the package insert itself did not impact the outcome.
Booher closed the arguments by saying the plaintiffs will not seek any more money from Mercy. This would make Mercy a release party, immune from contribution claims from the plaintiffs. He strongly urged the court to grant a new trial as the arguments closed.
The Iowa Supreme Court will release their decision in the summer of 2025.