BETTENDORF, Iowa — Iowa lawmakers are considering a bill that would cap how much money is won in medical lawsuits. The proposal would put a $1 million limit on medical cases against health care providers that involve serious injury or death.
Advocates hope it will attract more doctors to the state, but a Quad Cities mom who lost her 3-year-old son to surgery complications says it puts a price on someone's life.
What's in the bill?
It's part of House File 2279, a bill proposed by Iowa Gov. Kim Reynolds. While the majority of the document deals with unemployment, a section nearly halfway down the 13-page proposal calls for changes to the state's tort liability for civil lawsuits.
If passed, the most money someone could receive in a civil action case involving personal injury or death caused by a healthcare provider, would be $250,000 or less. However, if a jury were to decide the loss, impairment, disfigurement or death in the case were even more serious, the most a person could win would be $1 million.
A list of sponsors for the Republican-backed bill (which covers a broad range of unemployment issues) includes Sanford Health, Genesis Health System, American Property Casualty Insurance Association, the Iowa Insurance Institute, UnityPoint Health, MercyOne and more.
On the other side, groups against the bill include the IA Mental Health Planning Council, the Iowa Association for Justice, Common Good Iowa and more.
What are supporters saying?
Advocates for the bill say the inclusion of a malpractice cap would lower insurance costs, which would help attract more health care professionals to the state.
State Rep. Mike Bousselot, R-Ankeny, is the floor manager for the proposed legislation. He argues that several surrounding states, including Nebraska, South Dakota and Missouri, all have similar caps.
"We look at this bill as an opportunity to make sure that we're protecting health care professionals who are providing critical services in rural Iowa, while also not doing something that is beyond what other states in the country have already done," Bousselot said.
He said he's confident the bill will pass, citing Republican support in a GOP-controlled state legislature.
Smaller hospitals, he argued, face increasing financial challenges. By relieving some of the economic burdens of malpractice suits, Bousselot said it can help sustain health care facilities in the state's most rural areas. While it's not a "silver bullet" guaranteed to fix Iowa's health care provider needs, he believes it can be a step forward.
"What we want to do is make sure that there are protections in place for our providers and so that out-of-state trial attorneys aren't coming here trying to get rich off of Iowa juries and Iowa injuries," Bousselot said. "There is no price that we can ever put on any level, of any age. What the legislature is trying to tackle is to make sure, though, that we're not losing access to health care."
What are opponents saying?
On the other side, challengers to the bill argue each case should have its own evaluation of what should be awarded since each suit is different.
And the numbers show malpractice suits are actually decreasing in the state, not rising.
The Medical Liability Monitor is an independent publisher focused on gathering and compiling malpractice data across the country. Every October, the group publishes a rate survey diving into the changing rates physicians pay for malpractice.
According to the Monitor's data, for the past 20 years, the number of malpractice filings in Iowa has steadily dropped. A total of 335 cases were filed in 2002, compared to 154 in 2019, 170 in 2020 and 145 in 2021.
Iowa's malpractice insurance rates are also some of the nation's lowest. Monitor's most recent rate survey compared the state's earliest available data, in 2009, to 2021's figures and examined how insurance rates have changed for Iowa's top three carriers. It found:
- ProAssurance's rates dropped by 7.6%.
- MMIC/Constellation's rates had no change.
- COPIC's rates went down by 42%.
The battle over this bill is deeply personal for one Quad Cities mom. News 8 sat down with Jenelle Shamrell in her Bettendorf home. She told us all about her son Caleb.
Even as a toddler, Caleb was known by his love for music. He could often be found playing piano with his father or clapping along to the beat of the radio during car drives, his mother remembers. The sixth of seven children, he would go with his parents to his older sisters' dance classes.
"Outside the dance room the doors were closed and he'd lay and look under the crack of the door to watch feet inside and he'd laugh," Shamrell said. "He'd shake his little booty in time with the music while he's laying on his stomach!"
His mom remembered nights cuddled up with him in her lap, head nestled into her chin as she would work. Not even his typically sweaty slumber could take him away from her.
Caleb's favorite color was yellow, a fitting shade for someone whose family referred to as their sunshine.
"He was just full of life and energy. He loved to play outside and get dirty and play in the mud," Shamrell laughed. "He always wanted his nails painted when his sisters were getting their nails painted, but he always wanted like blue or green or sometimes dark purple."
But Shamrell was only able to spend two years and 364 days with her son.
In December 2014, shortly before his third birthday, Caleb was discharged from the hospital after a tonsillectomy and adenoidectomy surgery. Within a few hours of returning home, the little boy began to cough up blood on his father's shirt. As his parents frantically drove him back to the emergency room, he began to vomit blood.
His parents got him to an operating room and began the grueling wait outside the doors of their youngest son.
"We just prayed and prayed and prayed for over an hour, watching people run in and out," Shamrell said. "We're eventually told that his heart had stopped right after he got into the operating room."
Caleb was transferred to a hospital in Iowa City where he hung on, unconscious, for a few days before being declared brain dead.
He died the day before his third birthday.
"He loved people," Shamrell said. "One of the greatest lessons that Caleb taught us in his nearly three years of life was how to live. And we didn't realize that's what he was doing while he was alive until after he had died."
After Caleb's death, his parents attempted to obtain his medical records from the original hospital but were told they were sealed. To Shamrell, something didn't seem right.
"Our main objective was just to find out if anything had gone wrong or if anything could have been done differently, so that we could ask for some changes to be made to prevent it in the future," she said. "Because at the end of the day, nothing's going to fix anything for us. Nothing gets better. Our son was dead, and nothing was going to fix that."
The next few years would be a long, painful process involving attorneys and the Iowa legal system. Eventually, the Shamrells settled for an undisclosed amount.
Now, Jenelle uses Caleb's memory to advocate against malpractice caps and organ donations. She said a cap like the one Iowa is considering would "put a price on someone's life."
"For the legislature to come in and think that they can just put a blanket cap on these situations is really insulting. Because they're saying it doesn't matter what you've dealt with. It doesn't matter the hurt and pain. They're putting a price on my son's life," Shamrell said. "They're saying this is the cap that a person is worth. That a person's mobility is worth, a person's life is worth. And I find that really insulting."
To her, each malpractice suit is different, and should be judged on an individual basis. She lamented that all of the paperwork in Caleb's case stacked up to six inches.
"And 13 pages of a bill is going to predetermine the worth of my son," she said. "It's not right to limit anyone's life or pain or suffering."
Instead, she said settlements and malpractice cases often bring a new form of pain for the grieving families involved, from the scrutiny during trials to personal attacks from community members and the media over the "worth" of a specific trial.
"It's a really terrible process to have to go through, really mentally, physically and emotionally exhausting in every way," Shamrell said.
She's been a long-time opponent of medical caps and has frequently traveled to Des Moines to speak with legislators on the issue.
"Health and safety are not about money, and I'd ask (legislators) to stop making it about money," she said.
And when families do win money, Shamrell argued, it often goes toward a cause close to their hearts.
"I don't know a single family who has not done good with it moving forward in the form on community donations, donations to health systems, starting foundations in memory of their loved one and really using it to affect positive change in their communities," she said.
Caleb even has his own foundation, Alive In Me, which sponsors scholarships, supports organ donor awareness and donates money to children's arts, academics and athletics. His parents also continue to advocate on his behalf as public speakers and are passionate about supporting families navigating similar medical situations.
The Shamrells know nothing they do will bring Caleb back. But his mom said she's able to keep his memory alive through sharing his story and fighting against the legislation, such as House File 2279.
Still, even seven years on, the pain remains.
At the end of our interview with Jenelle, she pointed out a painting above her living room mantle. It features her and her husband surrounded by all seven of their children.
"That's him in the middle right there," she said, pointing out the tiny, smiling face of a blue-eyed, blonde-haired boy frozen just before age three. "It sticks that that's the only way that I can have a family picture with all of my kids … is to have someone paint one."