Senate
Study
Bill
1087
-
Introduced
SENATE
FILE
_____
BY
(PROPOSED
COMMITTEE
ON
JUDICIARY
BILL
BY
CHAIRPERSON
ZAUN)
A
BILL
FOR
An
Act
relating
to
medical
malpractice
claims,
including
1
noneconomic
damage
awards,
contingency
fees,
expert
2
witnesses,
and
defenses.
3
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
4
TLSB
1987XC
(5)
87
jh/nh
S.F.
_____
Section
1.
Section
135P.1,
subsection
2,
Code
2017,
is
1
amended
to
read
as
follows:
2
2.
“Health
care
provider”
means
a
physician
or
osteopathic
3
physician
licensed
under
chapter
148
,
a
physician
assistant
4
licensed
under
and
practicing
under
a
supervising
physician
5
pursuant
to
chapter
148C
,
a
podiatrist
licensed
under
chapter
6
149
,
or
a
chiropractor
licensed
under
chapter
151,
a
licensed
7
practical
nurse,
a
registered
nurse,
or
an
advanced
registered
8
nurse
practitioner
licensed
pursuant
to
under
chapter
152
or
9
152E
,
a
dentist
licensed
under
chapter
153,
an
optometrist
10
licensed
under
chapter
154,
a
pharmacist
licensed
under
chapter
11
155A,
or
any
other
person
who
is
licensed,
certified,
or
12
otherwise
authorized
or
permitted
by
the
law
of
this
state
to
13
administer
health
care
in
the
ordinary
course
of
business
or
in
14
the
practice
of
a
profession
.
15
Sec.
2.
NEW
SECTION
.
147.136A
Noneconomic
damage
awards
16
against
health
care
providers.
17
1.
For
purposes
of
this
section:
18
a.
“Health
care
provider”
means
a
physician
or
an
19
osteopathic
physician
licensed
under
chapter
148,
a
20
chiropractor
licensed
under
chapter
151,
a
podiatrist
21
licensed
under
chapter
149,
a
physician
assistant
licensed
and
22
practicing
under
a
supervising
physician
under
chapter
148C,
a
23
licensed
practical
nurse,
a
registered
nurse,
or
an
advanced
24
registered
nurse
practitioner
licensed
under
chapter
152
or
25
152E,
a
dentist
licensed
under
chapter
153,
an
optometrist
26
licensed
under
chapter
154,
a
pharmacist
licensed
under
chapter
27
155A,
a
hospital
as
defined
in
section
135B.1,
or
a
health
care
28
facility
as
defined
in
section
135C.1.
29
b.
“Health
care
services”
means
medical
diagnosis,
30
treatment,
evaluation,
advice,
or
acts
that
are
permitted
under
31
chapter
148,
148C,
149,
152,
152E,
153,
154,
or
155A,
or
any
32
other
health
care
licensing
statutes
of
this
state.
33
c.
“Noneconomic
damages”
means
damages
arising
from
34
pain,
suffering,
inconvenience,
physical
impairment,
mental
35
-1-
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1987XC
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11
S.F.
_____
anguish,
emotional
pain
and
suffering,
loss
of
chance,
loss
of
1
consortium,
or
any
other
nonpecuniary
damages.
2
2.
The
total
amount
of
noneconomic
damages
recoverable
from
3
all
defendants
in
all
civil
actions,
whether
in
tort,
contract,
4
or
otherwise
and
including
derivate
actions,
that
arise
out
of
5
an
act
or
omission
in
connection
with
the
provision
of
health
6
care
services
shall
not
exceed
two
hundred
fifty
thousand
7
dollars.
8
3.
The
limitation
on
damages
contained
in
this
section
9
shall
not
apply
as
to
a
defendant
if
that
defendant’s
actions
10
constituted
actual
malice.
11
Sec.
3.
Section
147.138,
Code
2017,
is
amended
to
read
as
12
follows:
13
147.138
Contingent
fee
of
attorney
reviewed
by
court.
14
1.
In
any
action
for
personal
injury
or
wrongful
death
15
against
any
physician
and
surgeon,
osteopathic
physician
16
and
surgeon,
dentist,
podiatric
physician,
optometrist,
17
pharmacist,
chiropractor
or
nurse
licensed
under
this
chapter
18
or
against
any
hospital
licensed
under
chapter
135B
a
health
19
care
provider,
as
defined
in
section
147.136A
,
based
upon
the
20
alleged
negligence
of
the
licensee
health
care
provider
in
the
21
practice
of
that
profession
or
occupation
or
in
patient
care
,
22
or
upon
the
alleged
negligence
of
the
hospital
in
patient
care,
23
the
court
shall
determine
the
reasonableness
of
any
contingent
24
fee
arrangement
between
the
plaintiff
and
the
plaintiff’s
25
attorney
,
which,
subject
to
subsection
2,
shall
not
exceed
26
thirty-five
percent
of
the
total
settlement
or
award
.
27
2.
Upon
petition
by
the
plaintiff
or
the
plaintiff’s
28
attorney,
the
court
may
permit
an
attorney
fee
in
an
amount
29
greater
than
the
amount
allowed
under
subsection
1
if
the
court
30
determines
that
the
additional
amount
is
fair
and
reasonable.
31
Sec.
4.
Section
147.139,
Code
2017,
is
amended
to
read
as
32
follows:
33
147.139
Expert
witness
standards.
34
1.
If
the
standard
of
care
given
by
a
physician
and
surgeon
35
-2-
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1987XC
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11
S.F.
_____
or
an
osteopathic
physician
and
surgeon
licensed
pursuant
1
to
chapter
148
,
or
a
dentist
licensed
pursuant
to
chapter
2
153
health
care
provider,
as
defined
in
section
147.136A
,
3
is
at
issue,
the
court
shall
only
allow
a
person
to
qualify
4
as
an
expert
witness
and
to
testify
on
the
issue
of
the
5
appropriate
standard
of
care
if
the
person’s
medical
or
dental
6
qualifications
relate
directly
to
the
medical
problem
or
7
problems
at
issue
and
the
type
of
treatment
administered
in
the
8
case.
,
breach
of
the
standard
of
care,
or
proximate
cause
if
9
all
of
the
following
are
true:
10
a.
The
person
is
licensed
to
practice
in
the
same
field
as
11
the
defendant,
is
in
good
standing
in
each
state
of
licensure,
12
and
in
the
five
years
preceding
the
act
or
omission
alleged
to
13
be
negligent,
has
not
had
a
license
in
any
state
revoked
or
14
suspended.
15
b.
In
the
five
years
preceding
the
act
or
omission
alleged
16
to
be
negligent,
the
person
actively
practiced
in
the
same
17
field
as
the
defendant
or
was
a
qualified
instructor
at
an
18
accredited
university
in
the
same
field
as
the
defendant.
19
c.
The
person
practiced
or
provided
university
instruction
20
in
the
same
or
substantially
similar
specialty
as
the
21
defendant.
22
d.
The
person
is
trained
and
experienced
in
the
same
23
discipline
or
school
of
practice
as
the
defendant
or
has
24
specialty
expertise
in
the
disease
process
or
procedure
25
performed
in
the
case.
26
e.
If
the
defendant
is
board-certified
in
a
specialty,
the
27
person
is
certified
in
the
same
specialty
by
a
board
recognized
28
by
the
American
board
of
medical
specialties
or
the
American
29
osteopathic
association.
30
2.
A
person
not
licensed
in
this
state
but
licensed
in
31
another
state
who
testifies
on
the
issue
of
the
appropriate
32
standard
of
care,
breach
of
the
standard
of
care,
or
proximate
33
cause
as
an
expert
witness
shall
be
deemed
to
hold
a
temporary
34
license
to
practice
in
this
state
solely
for
the
purpose
of
35
-3-
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1987XC
(5)
87
jh/nh
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11
S.F.
_____
and
while
providing
such
testimony
and
shall
be
subject
to
1
the
authority
of
the
applicable
licensing
board
in
this
state
2
including
but
not
limited
to
the
provisions
of
section
147.55.
3
Sec.
5.
NEW
SECTION
.
147.140
Expert
witness
——
certificate
4
of
merit
affidavit.
5
1.
a.
In
any
action
for
personal
injury
or
wrongful
6
death
against
a
health
care
provider
based
upon
the
alleged
7
negligence
in
the
practice
of
that
profession
or
occupation
or
8
in
patient
care,
including
a
cause
of
action
for
which
expert
9
testimony
is
necessary
to
establish
a
prima
facie
case,
the
10
plaintiff
shall,
within
ninety
days
of
the
defendant’s
answer,
11
serve
upon
the
defendant
a
certificate
of
merit
affidavit
for
12
each
expert
witness
listed
pursuant
to
section
668.11
who
will
13
testify
with
respect
to
the
issues
of
standard
of
care,
breach
14
of
standard
of
care,
or
causation.
All
expert
witnesses
must
15
meet
the
qualifying
standards
of
section
147.139.
16
b.
A
certificate
of
merit
affidavit
must
be
signed
by
the
17
expert
witness
and
certify
the
purpose
for
calling
the
expert
18
witness
by
providing
under
the
oath
of
the
expert
witness
all
19
of
the
following:
20
(1)
The
expert
witness’s
statement
of
familiarity
with
the
21
applicable
standard
of
care.
22
(2)
The
expert
witness’s
statement
that
the
standard
of
care
23
was
breached
by
the
health
care
provider
named
in
the
petition.
24
(3)
The
expert
witness’s
statement
of
the
actions
that
the
25
health
care
provider
failed
to
take
or
should
have
taken
to
26
comply
with
the
standard
of
care.
27
(4)
The
expert
witness’s
statement
of
the
manner
by
which
28
the
breach
of
the
standard
of
care
was
the
cause
of
the
injury
29
alleged
in
the
petition.
30
c.
A
plaintiff
shall
serve
a
separate
certificate
of
merit
31
affidavit
on
each
defendant
named
in
the
petition.
32
d.
Answers
to
interrogatories
may
serve
as
an
expert
33
witness’s
certificate
of
merit
affidavit
in
lieu
of
a
34
separately
executed
affidavit
if
the
interrogatories
satisfy
35
-4-
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1987XC
(5)
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11
S.F.
_____
the
requirements
of
this
subsection
and
are
signed
by
the
1
plaintiff’s
attorney
and
by
each
expert
witness
listed
in
the
2
answers
to
interrogatories
and
served
upon
the
defendant
within
3
ninety
days
of
the
defendant’s
answer.
4
2.
An
expert
witness’s
certificate
of
merit
affidavit
does
5
not
preclude
additional
discovery
and
supplementation
of
the
6
expert
witness’s
opinions
in
accordance
with
the
rules
of
civil
7
procedure.
8
3.
The
parties
by
agreement
or
the
court
for
good
cause
9
shown
and
in
response
to
a
motion
filed
prior
to
the
expiration
10
of
the
time
limits
specified
in
subsection
1
may
provide
for
11
extensions
of
the
time
limits.
Good
cause
shall
include
12
but
not
be
limited
to
the
inability
to
timely
obtain
the
13
plaintiff’s
medical
records
from
health
care
providers
when
14
requested
prior
to
filing
the
petition.
15
4.
If
the
plaintiff
is
acting
pro
se,
the
plaintiff
16
shall
sign
the
certificate
of
merit
affidavit
or
answers
to
17
interrogatories
referred
to
in
this
section
and
shall
be
bound
18
by
those
provisions
as
if
represented
by
an
attorney.
19
5.
a.
Failure
to
substantially
comply
with
subsection
20
1
shall
result,
upon
motion,
in
dismissal
with
prejudice
of
21
each
cause
of
action
as
to
which
expert
witness
testimony
is
22
necessary
to
establish
a
prima
facie
case.
23
b.
A
written
notice
of
deficiency
may
be
served
upon
the
24
plaintiff
for
failure
to
comply
with
subsection
1
because
of
25
deficiencies
in
the
certificate
of
merit
affidavit
or
answers
26
to
interrogatories.
The
notice
shall
state
with
particularity
27
each
deficiency
of
the
affidavit
or
answers
to
interrogatories.
28
The
plaintiff
shall
have
twenty
days
to
cure
the
deficiency.
29
Failure
to
comply
within
the
twenty
days
shall
result,
upon
30
motion,
in
mandatory
dismissal
with
prejudice
of
each
action
31
as
to
which
expert
witness
testimony
is
necessary
to
establish
32
a
prima
facie
case.
A
party
resisting
a
motion
for
mandatory
33
dismissal
pursuant
to
this
section
shall
have
the
right
to
34
request
a
hearing
on
the
motion.
35
-5-
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S.F.
_____
6.
For
purposes
of
this
section,
“health
care
provider”
1
means
the
same
as
defined
in
section
147.136A.
2
Sec.
6.
NEW
SECTION
.
622.31A
Evidence-based
medical
3
practice
guidelines
——
affirmative
defense.
4
1.
For
purposes
of
this
section:
5
a.
“Evidence-based
medical
practice
guidelines”
means
6
voluntary
medical
practice
parameters
or
protocols
established
7
and
released
through
a
recognized
physician
consensus-building
8
organization
approved
by
the
United
States
department
of
9
health
and
human
services,
the
American
medical
association’s
10
physician
consortium
for
performance
improvement
or
similar
11
activity,
or
a
recognized
national
medical
specialty
society.
12
b.
“Health
care
provider”
means
the
same
as
defined
in
13
section
147.136A.
14
2.
In
an
action
for
personal
injury
or
wrongful
death
15
against
a
health
care
provider
based
upon
the
alleged
16
negligence
in
the
practice
of
that
profession
or
occupation
or
17
in
patient
care,
the
health
care
provider
may
establish
as
an
18
affirmative
defense
that
the
health
care
provider
complied
with
19
evidence-based
medical
practice
guidelines
in
the
diagnosis
and
20
treatment
of
the
patient.
21
3.
The
court
shall
admit
evidence-based
medical
practice
22
guidelines
into
evidence
if
introduced
by
a
health
care
23
provider
or
the
health
care
provider’s
employer
and
if
the
24
health
care
provider
or
the
health
care
provider’s
employer
25
submits
evidence
that
the
evidence-based
medical
practice
26
guidelines
were
appropriate
for
the
patient
and
that
the
27
health
care
provider
complied
with
such
evidence-based
28
medical
practice
guidelines.
Evidence
of
departure
from
an
29
evidence-based
medical
practice
guideline
is
admissible
only
on
30
the
issue
of
whether
the
health
care
provider
is
entitled
to
31
establish
an
affirmative
defense
under
this
section.
32
4.
This
section
shall
not
apply
to
any
of
the
following:
33
a.
The
health
care
provider’s
mistaken
determination
that
34
an
evidence-based
medical
practice
guideline
applied
to
a
35
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11
S.F.
_____
particular
patient
where
such
mistake
was
caused
by
the
health
1
care
provider’s
negligence
or
intentional
misconduct.
2
b.
The
health
care
provider’s
failure
to
properly
follow
3
an
evidence-based
medical
practice
guideline
where
such
4
failure
was
caused
by
the
health
care
provider’s
negligence
or
5
intentional
misconduct.
6
5.
There
shall
be
no
presumption
of
negligence
if
a
health
7
care
provider
did
not
adhere
to
an
evidence-based
medical
8
practice
guideline.
9
EXPLANATION
10
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
11
the
explanation’s
substance
by
the
members
of
the
general
assembly.
12
This
bill
relates
to
medical
malpractice
claims,
including
13
noneconomic
damage
awards,
contingency
fees,
expert
witnesses,
14
and
defenses.
15
ADVERSE
HEALTH
CARE
INCIDENTS.
Under
Code
chapter
135P,
if
16
an
adverse
health
care
incident
occurs,
a
health
care
provider
17
may
offer
to
engage
in
an
open
discussion
with
the
patient.
If
18
the
patient
agrees,
the
health
care
provider
may
investigate
19
the
incident,
disclose
the
results
to
the
patient,
and
discuss
20
steps
the
health
care
provider
will
take
to
prevent
similar
21
incidents.
The
health
care
provider
may
also
communicate
to
22
the
patient
whether
the
health
care
provider
believes
that
23
an
offer
of
compensation
is
warranted.
All
communications
24
made
related
to
the
open
discussion
are
privileged
and
25
confidential,
are
not
subject
to
discovery
or
subpoena,
and
26
are
not
admissible
in
evidence
in
a
judicial,
administrative,
27
or
arbitration
proceeding.
Under
current
Code
chapter
135P,
28
“health
care
provider”
is
defined
as
a
physician
licensed
under
29
Code
chapter
148,
a
physician
assistant
licensed
under
Code
30
chapter
148C,
a
podiatrist
licensed
under
Code
chapter
149,
or
31
an
advanced
registered
nurse
practitioner
licensed
pursuant
32
to
Code
chapter
152
or
152E.
The
bill
redefines
“health
33
care
provider”
to
mean
a
physician
or
osteopathic
physician
34
licensed
under
chapter
148,
a
physician
assistant
licensed
and
35
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_____
practicing
under
a
supervising
physician
pursuant
to
chapter
1
148C,
a
podiatrist
licensed
under
chapter
149,
a
chiropractor
2
licensed
under
chapter
151,
a
licensed
practical
nurse,
a
3
registered
nurse,
or
an
advanced
registered
nurse
practitioner
4
licensed
under
chapter
152
or
152E,
a
dentist
licensed
under
5
chapter
153,
an
optometrist
licensed
under
chapter
154,
a
6
pharmacist
licensed
under
chapter
155A,
or
any
other
person
who
7
is
licensed,
certified,
or
otherwise
authorized
or
permitted
by
8
the
law
of
this
state
to
administer
health
care
in
the
ordinary
9
course
of
business
or
in
the
practice
of
a
profession.
10
NONECONOMIC
DAMAGES
IN
MEDICAL
MALPRACTICE
CASES.
The
11
bill
defines
“noneconomic
damages”
as
damages
arising
from
12
pain,
suffering,
inconvenience,
physical
impairment,
mental
13
anguish,
emotional
pain
and
suffering,
loss
of
chance,
14
loss
of
consortium,
or
any
other
nonpecuniary
damages.
The
15
bill
provides
that
the
total
amount
of
noneconomic
damages
16
recoverable
from
all
defendants
in
all
civil
actions,
whether
17
in
tort,
contract,
or
otherwise
and
including
derivate
actions,
18
that
arise
out
of
an
act
or
omission
in
connection
with
the
19
provision
of
health
care
services
shall
not
exceed
two
hundred
20
fifty
thousand
dollars.
However,
the
limitation
does
not
apply
21
as
to
a
defendant
if
that
defendant’s
actions
constituted
22
actual
malice.
23
CONTINGENCY
FEES.
Under
current
law,
in
any
action
for
24
personal
injury
or
wrongful
death
against
any
physician
and
25
surgeon,
osteopathic
physician
and
surgeon,
dentist,
podiatric
26
physician,
optometrist,
pharmacist,
chiropractor,
nurse,
or
27
hospital,
based
upon
the
alleged
negligence
of
the
licensee
28
in
the
practice
of
that
profession
or
occupation,
or
upon
the
29
alleged
negligence
of
the
hospital
in
patient
care,
the
court
30
determines
the
reasonableness
of
any
contingent
fee
arrangement
31
between
the
plaintiff
and
the
plaintiff’s
attorney.
The
bill
32
provides
that
a
court
shall
also
review
the
reasonableness
of
33
a
contingent
fee
in
a
negligence
case
involving
an
advanced
34
registered
nurse
practitioner,
physician
assistant,
or
a
35
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_____
residential
care
facility,
a
nursing
facility,
an
intermediate
1
care
facility
for
persons
with
mental
illness,
or
an
2
intermediate
care
facility
for
persons
with
an
intellectual
3
disability.
The
bill
also
provides
that
the
contingent
fee
4
shall
not
exceed
35
percent
of
the
total
settlement
or
award
5
unless
the
plaintiff
or
the
plaintiff’s
attorney
petitions
the
6
court
for
a
greater
amount
and
the
court
determines
that
the
7
additional
amount
is
fair
and
reasonable.
8
EXPERT
WITNESSES
IN
MEDICAL
MALPRACTICE
CASES.
The
9
bill
provides
standards
for
an
expert
witness
in
a
medical
10
malpractice
case.
The
bill
provides
that
a
person
is
11
only
qualified
to
serve
as
an
expert
witness
in
a
medical
12
malpractice
case
if
the
person
is
a
licensed
health
care
13
provider,
is
in
good
standing
in
each
state
of
licensure,
and
14
in
the
five
years
preceding
the
act
or
omission
alleged
to
15
be
negligent,
has
not
had
a
license
in
any
state
revoked
or
16
suspended;
in
the
five
years
preceding
the
act
or
omission
17
alleged
to
be
negligent,
actively
practiced
in
the
same
field
18
as
the
defendant
or
was
a
qualified
instructor
at
an
accredited
19
university
in
the
same
field
as
the
defendant;
practiced
or
20
provided
instruction
in
the
same
or
substantially
similar
21
specialty
as
the
defendant;
is
trained
and
experienced
in
the
22
same
discipline
or
school
of
practice
as
the
defendant
or
23
has
specialty
expertise
in
the
disease
process
or
procedure
24
performed
in
the
case;
and,
if
the
defendant
is
board-certified
25
in
a
specialty,
the
person
is
certified
in
the
same
specialty.
26
The
bill
provides
that
a
person
who
is
not
licensed
in
Iowa
27
but
is
licensed
in
another
state
and
who
testifies
as
an
expert
28
witness
in
a
medical
malpractice
case
shall
be
deemed
to
hold
29
a
temporary
license
to
practice
in
Iowa
and
shall
be
subject
30
to
the
authority
of
the
applicable
licensing
board
in
Iowa
31
including
but
not
limited
to
Code
section
147.55.
32
The
bill
establishes
a
requirement
for
a
certificate
of
33
merit
affidavit
for
expert
witnesses
in
medical
malpractice
34
cases.
In
an
action
for
personal
injury
or
wrongful
death
35
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_____
against
a
health
care
provider
based
upon
alleged
negligence
1
in
the
practice
of
that
profession
or
in
patient
care,
the
2
bill
requires
the
plaintiff,
within
90
days
of
the
defendant’s
3
answer,
to
serve
upon
the
defendant
a
certificate
of
merit
4
affidavit
for
each
expert
witness
who
will
testify
with
respect
5
to
the
issues
of
standard
of
care,
breach
of
standard
of
care,
6
or
causation.
A
certificate
of
merit
affidavit
must
be
signed
7
by
the
expert
witness
and
certify
the
purpose
for
calling
8
the
expert
witness
by
providing
under
the
oath
of
the
expert
9
witness
the
expert
witness’s
statement
of
familiarity
with
the
10
applicable
standard
of
care;
statement
that
the
standard
of
11
care
was
breached
by
the
health
care
provider;
statement
of
the
12
actions
that
the
health
care
provider
failed
to
take
or
should
13
have
taken;
and
statement
of
the
manner
by
which
the
breach
of
14
the
standard
of
care
was
the
cause
of
the
injury.
15
The
bill
provides
that
answers
to
interrogatories
may
16
serve
as
an
expert
witness’s
certificate
of
merit
affidavit
17
if
the
interrogatories
satisfy
the
requirements
of
the
bill.
18
The
bill
provides
that
the
expert
witness’s
certificate
of
19
merit
affidavit
does
not
preclude
additional
discovery
and
20
supplementation
of
the
expert
witness’s
opinions.
21
The
bill
provides
that
failure
to
substantially
comply
with
22
the
new
requirements
shall
result,
upon
motion,
in
dismissal
23
with
prejudice
of
each
cause
of
action
as
to
which
expert
24
witness
testimony
is
necessary
to
establish
a
prima
facie
25
case.
A
written
notice
of
deficiency
may
be
served
upon
the
26
plaintiff
for
failure
to
comply
with
the
bill
requirements
27
because
of
deficiencies
in
the
certificate
of
merit
affidavit
28
or
answers
to
interrogatories,
and
the
plaintiff
shall
have
20
29
days
to
cure
the
deficiency.
Failure
to
comply
within
the
20
30
days
shall
result,
upon
motion,
in
mandatory
dismissal
with
31
prejudice
of
each
action
as
to
which
expert
witness
testimony
32
is
necessary
to
establish
a
prima
facie
case.
33
EVIDENCE-BASED
MEDICAL
PRACTICE
GUIDELINES.
The
bill
34
defines
“evidence-based
medical
practice
guidelines”
as
35
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_____
voluntary
medical
practice
parameters
or
protocols
established
1
and
released
through
a
recognized
physician
consensus-building
2
organization.
3
The
bill
provides
that
in
any
action
for
personal
injury
4
or
wrongful
death
against
a
health
care
provider
based
5
upon
the
alleged
negligence
of
the
health
care
provider
in
6
patient
care,
the
health
care
provider
may
establish
as
an
7
affirmative
defense
that
the
health
care
provider
complied
with
8
evidence-based
medical
practice
guidelines
in
the
diagnosis
and
9
treatment
of
the
patient.
10
The
bill
provides
that
the
court
shall
admit
evidence-based
11
medical
practice
guidelines
into
evidence
if
introduced
by
a
12
health
care
provider
or
the
health
care
provider’s
employer
13
and
if
the
health
care
provider
or
the
health
care
provider’s
14
employer
submits
evidence
that
the
evidence-based
medical
15
practice
guideline
was
appropriate
for
the
patient
and
that
16
the
health
care
provider
complied
with
such
evidence-based
17
medical
practice
guidelines.
Evidence
of
departure
from
a
18
guideline
is
admissible
only
on
the
issue
of
whether
the
health
19
care
provider
is
entitled
to
establish
an
affirmative
defense
20
under
the
bill.
There
shall
be
no
presumption
of
negligence
21
if
a
health
care
provider
did
not
adhere
to
an
evidence-based
22
medical
practice
guideline.
23
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