ROGER WADDELL, Administrator of the Estate of CHRISTINA WADDELL, Plaintiff-Appellant,
UNIVERSITY OF IOWA COMMUNITY MEDICAL SERVICES, INC. d/b/a UNIVERSITY OF IOWA QUICK CARE NORTH LIBERTY, a/k/a UI FAMILY CARE CENTER NORTH LIBERTY, Defendant-Appellee.
from the Iowa District Court for Johnson County, Paul D.
appeals the summary judgment order dismissing a medical
malpractice action. AFFIRMED.
K. Weston II of Tom Riley Law Firm, PLC, Iowa City, for
Desirée A. Kilburg, Constance M. Alt, and Nancy J.
Penner of Shuttleworth & Ingersoll, PLC, Cedar Rapids,
by Vaitheswaran, P.J., and Doyle and Mullins, JJ.
plaintiff appeals from the district court's summary
judgment order dismissing the medical malpractice lawsuit
against the defendant. The court concluded the plaintiff
failed to establish essential elements of his claim.
Background Facts and Proceedings
10, 2011, Christina Waddell sued University of Iowa Community
Medical Services, Inc, (UICMS) d/b/a University of Iowa Quick
Care North Liberty (Quick Care) a/k/a UI Family Care Center
North Liberty (Family Care). She alleged negligence in the
medical care she received at Quick Care and Family Care for
failing to diagnose and treat cancer in her finger during
visits to two of its clinics.
Care and Family Care operate out of the same facility. Family
Care offers services during normal business hours, including
services dealing with long-term health care issues. Quick
Care is a walk-in medical clinic providing services during
evening hours and Saturday mornings, and it is geared toward
more common illnesses, such as the flu or strep throat. If
other or further medical care is required, Quick Care refers
the individual to a primary care physician or an emergency
2009, Christina presented at Quick Care with a sore on the
ring finger of her left hand and a rash on her face. A nurse
practitioner diagnosed Christina with a fungal infection,
prescribed a topical medication, and advised her to follow up
with a primary care physician. Christina returned to Quick
Care in July and presented to a physician's assistant
with complaints that, despite using the prescribed topical
medication, the sore on her ring finger had not improved, her
fingernail slid off, and the rash on her face was still
present. The physician's assistant removed the remaining
fingernail and instructed Christina to soak the finger in
Epsom salt and apply antibiotic ointment to her finger and
topical creams to the facial rash. In August, Christina
presented herself to Family Care for a non-healing nail bed.
A physician referred Christina to the University of Iowa
Hospitals and Clinics (UI) dermatology department for a
possible biopsy with the concern of nail-bed cancer. An
appointment was scheduled for August 11. Christina was not
seen on August 11 and an undated note on the referral form
indicates the appointment was canceled in the
December, Christina presented at the UI dermatology
department to Dr. Mary Stone with a lump on her ring finger
that she stated began three years prior as a pink line then
darkened. Christina also presented with the development of
brown spots on her fingertip, which enlarged over the prior
month. Dr. Stone conducted a biopsy, diagnosed Christina with
malignant melanoma, and referred Christina to the oncology
January 5, 2010, Dr. Mohammed Milhem, a UI oncologist, saw
Christina for her melanoma treatment. In her history to Dr.
Milhem, Christina indicated she had nail issues for the past
two years, which began as a white streak that widened over
time and darkened in color. She also reported that since
2008, her nail had softened in the middle. Christina told Dr.
Milhem she visited Quick Care on two occasions for treatment
of her fingernail. On each occasion she was prescribed a
fungal cream. After neither cream worked, she stated she was
then referred to the UI dermatology department. She did not
mention any visit to Family Care. After his examination and
discussion with the hospital tumor board, Dr. Milhem
determined the best course of treatment was a wide excision
of the tumor-i.e., amputation of the finger-and a biopsy of
lymph nodes, which would govern decisions on further
January 29, doctors amputated Christina's finger. At the
same time, Dr. Hisakazu Hoshi, a surgical oncologist,
performed a biopsy of Christina's lymph nodes and
determined her cancer was stage three as the cancer had
spread to a sentinel lymph node but not to an axillary node.
Despite treatment, the cancer continued to spread to her
lung, bone marrow, and brain. Christina died on March 30,
2012. After her death, her father, as administrator of her
estate, was substituted as plaintiff in Christina's
negligence suit. The plaintiff filed a designation of four
experts, naming Kim Quinn, R.N., and Drs. Hoshi, Milhem, and
Stone as experts who would testify on "issues of
informed consent, standard of care, causation and
2013, UICMS moved for summary judgment, alleging
plaintiff's designated expert, Quinn, was not qualified
to provide testimony on the applicable standards of care.
UICMS additionally moved to strike Quinn's testimony. In
the summary judgment motion, UICMS contended the plaintiff
could not establish a prima facie case for medical
malpractice due to a lack of causation evidence. The court
denied both of the motions. In its written ruling, the court
held there were genuine issues of material fact as
"[r]easonable minds could draw different inferences and
reach different conclusions from the facts as presented
through the testimony of Drs. ...