Patrick Willhoite, individually and as the of The Estates of Margaret Ruth Willhoite and Michael Willhoite, and Jessie Gafeller, individually v. Genesis Health System, Dean A. Bunting, M.D., Joseph M. Phelan, M.D., Radiology Group, P.C., S.C., Steven D. Lamer, D.O., Tenille M. Miller, A.R.N.P.

── Patrick Willhoite, individually and as the of The Estates of Margaret Ruth Willhoite and Michael Willhoite, and Jessie Gafeller, individually v. Genesis Health System, Dean A. Bunting, M.D., Joseph M. Phelan, M.D., Radiology Group, P.C., S.C., Steven D. Lamer, D.O., Tenille M. Miller, A.R.N.P. ── Court: Supreme Court of Iowa Date: May 22, 2026 Category: General In the Iowa Supreme Court No. 24–1380 Submitted November 12, 2025—Filed May 22, 2026 Patrick Willhoite, individually and as the administrator of the Estate of Margaret Ruth Willhoite and as the executor of the Estate of Michael Willhoite, and Jessie Gafeller, Appellants, vs. Genesis Health System, Dean A. Bunting, Joseph M. Phelan, Radiology Group, P.C., S.C., Steven D. Lamer, Tenille M. Miller, Appellees, Appeal from the Iowa District Court for Scott County, Jeffrey C. McDaniel, judge. Two estates and two individuals appeal the dismissal of their medical malpractice suit for failure to comply with Iowa Code section 147.140. The defendants seek dismissal of the estates’ appeal because of defects in the filing of the notice of appeal. Motion to Dismiss Appeal Denied; District Court Judgment Affirmed. May, J., delivered the opinion of the court as to parts I, II, and IV, in which all participating justices joined, and announced the judgment of the court as to part III. As to part III, Christensen, C.J., and McDonald and May, JJ., would affirm; Mansfield, Oxley, and McDermott, JJ., would reverse. Waterman, J., took no part in the consideration or decision of the case. Matthew G. Sease of Sease & Wadding, Des Moines, for appellants.  2 Connie L. Diekema, Jeffrey R. Kappelman, and Peter R. Lapointe of Finley Law Firm, Des Moines, for appellee Lamer. Christine L. Conover, Carrie L. Thompson, and Dawn M. Gibson of Simmons Perrine Moyer Bergman PLC, Cedar Rapids, for appellees Phelan and Radiology Group, P.C., S.C. Jennifer E. Rinden and Graham R. Carl of Shuttleworth & Ingersoll, PLC, Cedar Rapids, for appellee Bunting. Frederick T. Harris, Ryan P. Tunink, and Andrew C. Johnson of Lamson Dugan & Murray, LLP, West Des Moines, and John E. Hall, Jr., of Hall Booth Smith, P.C., Atlanta, GA, for appellees Miller and Genesis Health System.  3 May, Justice. Two estates and two individuals appeal the dismissal of their wrongful-death medical malpractice suit. Our court must resolve two questions: 1. Should we dismiss the estates’ appeal because a non-attorney—who is the executor for one estate and the administrator for the other—signed and filed the estates’ notice of appeal? 2. Was the district court correct to dismiss the suit based on the plaintiffs’ failure to comply with Iowa Code section 147.140 (2020), our certificate of merit affidavit statute? We answer those questions as follows: 1. We unanimously agree that the estates’ appeal should not be dismissed. 2. We are divided 3–3 as to whether the district court should have dismissed the suit. Therefore, the dismissal is affirmed by operation of law. Iowa Code § 602.4107 (2026); Juckette v. Iowa Utils. Bd., 992 N.W.2d 218, 222 (Iowa 2023). I. Factual and Procedural Background. We start with facts alleged in the petition. In July 2016, Margaret Willhoite was injured in a motor vehicle accident. She sought treatment at Genesis Medical Center. She received an X-ray to determine whether there were any broken ribs. Although the X-ray was negative for fractures, it indicated a nodule in her left lung. And her medical records noted that she should receive a computerized tomography (CT) scan of her chest to investigate the nodule. But no CT scan was ordered or conducted. Margaret was released. In March 2018, Margaret suffered a fracture to her left femur. She received care at a different hospital. This time, a CT scan was performed. The scan