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Proving Causation in a Medical Malpractice Lawsuit

On Behalf of | Mar 5, 2021 | Personal Injury

The fact is that people make mistakes. And doctors, nurses, and other healthcare personnel are people, so they also make mistakes. But when those mistakes rise to the level of negligence and cause harm, patients’ lives can be upended. If a negligent healthcare provider caused harm to you or someone you love, the law allows you to seek compensation for your injuries. However, many medical mistakes do not amount to medical malpractice. So how can you know if you have a case?

Although there are four elements a plaintiff must prove to succeed in a medical malpractice lawsuit, one of them can be particularly tricky to understand. For a medical mistake to amount to malpractice, the mistake must cause actual harm. It is essential to recognize two elements in that statement: causation and actual harm. If the error caused no actual harm or was not the legal cause of harm, then there is no basis upon which to grant compensation. In this article, we look at this complex issue of causation as it relates to medical malpractice lawsuits.

Four Elements of Negligence in Medical Malpractice

There are four elements that a plaintiff must prove for any negligence claim to succeed, including medical malpractice. They must prove that:

  • The defendant (in medical malpractice this is the healthcare provider) owed them a duty of care;
  • The provider breached that duty;
  • This breach was the cause of harm; and
  • The plaintiff suffered actual harm or damages.

Many articles discuss what negligence is and how to prove it, but the least understood element among these four is causation. Additionally, out of these four elements, causation is typically the most difficult to prove, especially in medical malpractice cases.

Causation Explained

To prove causation in any negligence action you must prove two things: that the negligent act was the actual cause and that it was the proximate cause of harm.

Actual Cause

You can think of actual cause as the “cause in fact” of the injury. In other words, Did the negligent action actually cause the harm? This may seem obvious, and sometimes it is. But courts do not assume actual cause. Instead, they have two tests they use to make this determination. These are called the “but for” test and the “substantial factor” test. When using the “but for” test, judges ask, But for the defendant’s actions, would the injury have occurred? In other words, if the provider had not acted as they did, would the injury have happened? If the answer is NO, then the defendant’s action did actually cause the harm.

However, sometimes two or more causes intersect and both contribute to the harm. To illustrate this point, let’s use a simple, non-medical example. Suppose Car A is traveling south through an intersection and has the right-of-way. Then suppose Car B is traveling from the west, and Car C is traveling from the east—both heading towards that same intersection. Neither Car B nor Car C has the right of way, but they both barrel through their stop signs, causing a three-car crash. The driver of Car A (Jane) gets severely injured. Who caused the accident?

The “but for” test is insufficient here. But for Car B, would Jane have been injured? The answer is yes because Car C hit her too! Likewise, if we ask, But for Car C, would Jane have been injured? we get the same result. Yes, because Car B hit her also. Therefore, the “but for” test essentially exonerates each negligent actor when two or more are responsible for the plaintiff’s injuries. This unfair result prompted the birth of the substantial factor test, which asks whether Car B was a substantial factor that contributed to the injury. Here, both Car B and Car C substantially contributed to the accident. So under this second test, they are both the actual cause of Jane’s injuries.

Proximate Cause

Proximate cause deals with the foreseeability aspect of causation. Essentially, the law states that it is not fair or right to hold someone responsible for harm that is not foreseeable. For simplicity’s sake, let’s look at another non-medical example to illustrate this point.

Suppose Tina swerved her car off the road to avoid hitting Jack’s car when he ran a stop sign. Tina’s car swerves into a construction site where hazardous chemicals explode from the crash, severely injuring eight people. Jack could not have reasonably foreseen a chemical explosion would result from running a stop sign. Therefore, it’s likely that a judge or jury would not find him liable for the eight people injured in the blast. However, they may find him liable for Tina’s injuries.

This applies in similar fashion to medical malpractice cases. The harm must be a foreseeable result of a medical act to fulfill the proximate cause requirement.

Medical Malpractice and Causation

So why is proving causation in a medical malpractice lawsuit so difficult? As you can see, the issue of causation can get fairly complicated, which is why you need a lawyer for any negligence case. This is never more true than in a medical malpractice claim. In medical cases, several factors can contribute to a patient’s injuries. In fact, doctors often claim that injuries are more directly related to the patient’s underlying illness itself—as opposed to any negligent act on their part. Medical personnel can point to any number of alternative factors that may have contributed to or directly caused your injury, even when they know that their act was the major contributing factor.

That is why so many medical malpractice claims come down to the testimony of experts. These experts conduct careful examinations of the facts. After a thorough assessment, experts arrive at conclusions about the actual and proximate cause of the patient’s injury. Judges and juries unfamiliar with the medical intricacies at work often rely on these expert conclusions to decide a case.

Let Us Fight for You

The experienced, compassionate lawyers at Batson Nolan PLC know the upheaval caused by medical malpractice. Of course, doctors and nurses are human and make mistakes. But when their mistakes rise to the level of medical negligence, it can rock the foundation of your life. Due to the complex nature of proving causation in medical malpractice cases, you need the help of seasoned professionals by your side. So do not procrastinate. Call us today or contact us online to set up a free initial consultation.