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Bowman v. Gronstedt11/14/2002
On review from the Iowa Court of Appeals.
Plaintiffs appeal from order for directed verdict in medical-malpractice case. DECISION OF COURT OF APPEALS AFFIRMED; JUDGMENT OF DISTRICT COURT REVERSED; CASE REMANDED.
The plaintiffs in this medical-malpractice action appeal from a district court order granting the defendants' motion for directed verdict. The court of appeals reversed, and we granted the defendants' application for further review. We affirm the decision of the court of appeals, reverse the judgment of the district court, and remand. Other parties originally named as defendants have been dismissed, and this appeal involves only the defendants Gronstedt and Lee.
Wendy Bowman was found in an Altoona park on September 4, 1996, disoriented and delusional. Defendant, Gary J. Gronstedt, a psychiatrist, examined her on September 16, 1996. He diagnosed her as suffering from a bipolar disorder and prescribed a mood-stabilizing medication. Dr. Gronstedt set up an appointment for Wendy in a month. On September 28, 1996, Wendy disappeared again and was found again in a confused state. She was hospitalized until October 2, 1996, when Dr. Gronstedt discharged her. After her discharge, Wendy went home, packed her belongings, and disappeared again. She was found on October 4, 1996, in Dyersville, in northeast Iowa, again confused, and this time incontinent as well. Local police took her to a Dubuque hospital, where she was examined by defendant, Yasyn Lee, another psychiatrist. Dr. Lee diagnosed her as bipolar but did not treat her. Instead, Dr. Lee instructed Wendy to return home and contact Dr. Gronstedt.
Wendy went to her parents' home, and her father contacted Dr. Gronstedt on October 7, 1996. Dr. Gronstedt told him Wendy already had an appointment for October 14, 1996, and that would be soon enough. On October 11 she disappeared, and the next day her car was found along Interstate 80 in Pottawattamie County. Wendy's body was found five days later in a ditch along the interstate.
Dr. Thomas Bennett, the state medical examiner, performed an autopsy, furnishing this report:
After full toxicology screens had been performed, plus the addition of a search into the past drinking behavior, drug use has not been identified as a cause for the untimely death of Wendy Bowman. Likewise, no history of alcohol abuse has been found. The most significant finding at the autopsy was the finding of the fatty liver, which has been associated with sudden death. Fatty liver has numerous causes besides alcohol. For the death of Wendy Bowman, certainly starvation or other undisclosed causes must be considered more likely than alcohol use in her death.
Thus, the cause of death will still be ruled as "sudden death with fatty liver, cause undetermined," and the manner of death would be ruled as "undetermined," also.
(Emphasis added.)
The lack of a specific conclusion by the medical examiner as to the cause of death prompted the district court to direct a verdict in favor of the defendants on the ground the plaintiffs had not provided a submissible issue on proximate cause. This appeal does not involve the sufficiency of the evidence on the issues of negligence or damages.
The plaintiffs alleged negligence of Dr. Gronstedt in (1) discharging Wendy from Iowa Lutheran Hospital on October 2, 1996, when Dr. Gronstedt knew or should have known she was dangerous to herself or others; (2) failing to involuntarily commit Wendy; and (3) failing to promptly see her on her return from Dubuque. The plaintiffs claim Dr. Lee was negligent in discharging Wendy on October 5, 1996, when she was aware that Wendy was bipolar and
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