The Iowa Supreme Court overturned a historic $97 million medical malpractice verdict on Nov. 8, dismissing the record-setting 2022 award tied to a botched birth case, citing legal errors during the trial that rendered the judgment invalid.

According to the statement of facts in the appeal, Kathleen Kromphardt gave birth to her son, referred to as S.K., on Aug. 11, 2018, at Mercy Hospital in Iowa City. What began as a routine labor escalated into a traumatic delivery as the baby showed signs of distress, requiring urgent intervention.

Jill Goodman, a doctor of Obstetric and Gynecologic Associates, used forceps and then a vacuum during delivery, allegedly causing S.K.’s skull fracture and brain hemorrhage. This led the family to sue Mercy Iowa City.

According to the lawsuit, S.K. was diagnosed with an ischemic brain injury, seizures, facial nerve palsy, and a skull fracture with subdural hemorrhage, all attributed to the head injury caused by the use of forceps and a vacuum.

In March 2022, a jury unanimously ruled in favor of the family in a medical malpractice lawsuit against Mercy Hospital, Obstetric and Gynecologic Associates of Iowa City and Coralville, P.C., and Jill Goodman. The jury awarded $97.4 million to the plaintiff, the largest in state history, after Goodman’s insurer refused to settle.

Following the verdict, Mercy Hospital settled with the family for $7 million.

The Iowa Supreme Court agreed with one of the clinic’s arguments for appeal and ruled the Mityvac vacuum package insert was hearsay under Iowa evidence rules as it was made outside the trial or hearing where it was introduced.

Ryan Koopmans, the attorney representing the clinic for the appeal, did not respond to The Daily Iowan’s request for comment.

Matt Patterson, partner of Beam Legal Team and an attorney for the Kromphardts, said he is deeply disappointed in the Iowa Supreme Court’s decision.

“It totally loses the forest for the trees,” Patterson said. “While I respect what the Iowa Supreme Court and their esteemed panel considered as far as evidence, I think they made a very big mistake in failing to consider the overall context of the trial.”

Jack Beam, founder and partner of Beam Legal Team, who also represented the Kromphardts in the first trial, said the evidence presented in the 2022 trial clearly showed Goodman was overwhelmed and did not respond to indicators of fetal distress in time, causing a lifelong brain injury to the newborn.

“[Goodman] knew there was problems. But then she gets distracted,” Beam said. “She goes off to these other two deliveries. By the time she comes back, the you-know-what has hit the fan, to put it bluntly. And she’s scared.”

Beam alleged that Goodman, realizing S.K. needed urgent delivery to survive, hastily used both forceps and a vacuum, defying Federal Drug Administration regulations, which require using only one instrument before proceeding to a C-section if unsuccessful.

“What’s really sad is [S.K] is going to need 24/7 care for the rest of his life,” Beam said. “The court could have easily done what other courts have done and said that it was harmless error for [the vacuum package] to be admitted because the evidence was so overwhelming.”

In the original trial, plaintiffs argued that S.K.’s brain injury stemmed from medical negligence, citing delayed responses to fetal distress and improper use of forceps and a vacuum. Expert testimony and imaging confirmed trauma caused by external factors during delivery, suggesting a timely C-section could have prevented the injury.

Conversely, the defense presented testimony from Leon Epstein, a pediatric neurologist, who asserted that S.K.’s brain injury was not significantly impactful and that S.K. would be capable of leading a normal life.

“They had an expert that testified that our little guy is fine. He’s going to be able to be a college professor. He’s going to be able to play golf,” Beam said, referring to Epstein’s testimony. “He’s going to be just fine, even though there was obviously organic brain damage on radiology MRI that showed he was going to be anything but fine.”

Beam and Patterson said S.K., now 6 years old, still requires constant care and suffers a significant impact on his quality of life due to the injuries sustained at birth. In the original trial, they presented an estimate of $42 million to provide necessary care for the rest of S.K.’s life, as well as $12 million in lost wages.

Citing Epstein’s testimony that S.K.’s injuries were insignificant, the defense estimated his future care costs at zero dollars. Epstein did not respond to the DI’s request for comment.

However, despite the evidence presented at trial — evidence Beam and Patterson called overwhelming — Patterson said he believes the opinion of the Iowa Supreme Court in this case had little to do with the evidence.

“I don’t think it mattered what the evidence was,” Patterson said. “Once it came back with a verdict of that number in that place, efforts were going to be taken but taken away.”

Beam expressed a similar sentiment.

“It is highly political,” Beam said.

Beam highlighted another key aspect of the case: Goodman’s insurer, MMIC, refused to settle and forced the case to trial, an uncommon occurrence as only seven percent of medical malpractice cases go to trial, according to data from the Department of Justice.

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Beam asserted this decision harmed both the Kromphardts and Goodman.

“There’s a lot of victims here,” Beam said. “The plaintiff’s a victim, obviously, for the rest of his life. But the doctor is a victim, too.”

Patterson echoed Beam’s statement, saying that MMIC’s refusal to settle the case ultimately drove the clinic into bankruptcy and Goodman out of practice.

“As a result of MMIC and their conduct, not just [S.K] hasn’t been paid on this case, but the doctor herself lost her practice, is no longer in business, and now my understanding is no longer even doing obstetrics,” Patterson said.

MMIC was later sued by the clinic for refusing to settle, leading to the $97 million award and the clinic’s bankruptcy.

That lawsuit, separate from the Kromphardt family’s medical malpractice suit, further alleged the insurance company used the $97 million ruling as “propaganda” to lobby the Iowa Legislature to impose caps on non-economic damages in medical malpractice cases.

During the legislative session earlier that year, Iowa Gov. Kim Reynolds signed a law capping these damages at $1 million for independent clinics and $2 million for hospitals.

“After the verdict, this company MMIC, they’re very clever,” Beam said.

While neither Beam nor Patterson speculated on the Iowa Supreme Court’s reasoning, Beam noted that some have suggested the insurer refused to settle to use the large jury award as leverage for legislative caps on non-economic damages.

“I can’t explain that motivation, but I know that’s one theory that has been propounded,” Beam said.

Curi, the company that has since merged with MMIC and now operates as its parent organization, did not respond to the DI‘s request for comment.

The Supreme Court’s judgment has led to a retrial; however, a date has not yet been set.

Patterson explained, however, that the cap placed on pain and suffering damages is unlikely to impact the verdict of the retrial that will occur as a result of the Iowa Supreme Court’s recent opinion.

Patterson said he is optimistic the new jury will rule in favor of the Kromphardts.

“I would be confident in every single trial because of just the facts and what happened to this kid,” Patterson said. “It’s tragic.”