Proximate Cause in Medical Malpractice

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The ‘If Not For’ Argument in a Medical Negligence Trial Can Be More Complex Than It Sounds When Legal Standards Are Contended

Winning medical malpractice claims is not always about successfully arguing a case before the jury. In fact, most cases are won because the defense attorney successfully briefed and argued one or more legal concepts to the judge in advance of the trial. One of those concepts is proximate cause.

An essential element of the plaintiff’s cause of action for negligence, or any other tort for that matter, is some reasonable connection between the act or omission by the defendant and the damage upon which the plaintiff suffered.

More Than Just a Cause-and-Effect Way of Rationalizing

Proximate cause is a technical term that is often misunderstood by almost everyone, including some attorneys. In general, proximate cause refers to causation in fact. Most people believe proximate cause only refers to “but for proximate cause” — as in, “But for the fact you turned off the oxygen, the patient would not have died.” This is a cause-and-effect way of saying,  “Your action of turning off the oxygen caused the death.”

However, there is a second, more troubling proximate cause concept referred to as the “legal proximate cause.” This type of proximate cause is merely the limitation the courts or state legislatures have placed upon an actor’s responsibility for the consequences of his/her conduct.

Legal proximate cause is established when the statutory or legal underlying principles are proven. Under this concept, the law establishes when someone may potentially be liable.

For example, in failure-to-diagnose cases, many state statutes require a probability threshold before legal proximate cause is established. If the plaintiff brings a claim for failing to diagnose breast cancer, the following facts must be established by a preponderance of the evidence (more-likely-than-not standard):

    1. The defendant owed a duty to the plaintiff;
    2. The defendant breached that duty; 
    3. The breach caused the injury (but for cause); and
    4. The plaintiff’s probability to achieve a better result was reduced by more than 50% percent.

‘Legal Proximate Cause’ Plus ‘But For Proximate Cause’

In our example, assume that when the breast cancer was diagnosed, it was Stage 4 and the plaintiff had a 20% probability of a five-year survival. Further, assume that if the cancer had been diagnosed 11 months earlier, the probability of five-year survival would have been eighty 80%. Subtracting the 20% percent from the 80% percent leaves a 60% probability of survival reduction.

Therefore, the plaintiff established the “legal proximate cause” as well as the “but for proximate cause,” and he/she is able to bring a lawsuit against the healthcare provider. In this example, the plaintiff would argue that the medical malpractice caused the probability of survival to be reduced by 60%.

In law, damages cannot be speculative. Therefore, the theory of proximate cause is necessary to link the alleged damages to the actual breach of a legal duty and eliminate any speculation of whether or not the damages were proximately caused by the act or omission.

Trust the National Medical Malpractice and Professional Liability Defense Attorneys to Handle Your Case

At Chapman Law Group, our 35 years’ experience in professional healthcare liability and medical malpractice defense has made us a reputable, nationally known health care defense firm. We represent medical professionals such as general and specialty physicians, dentistsmental health professionals,pain management specialists, and other licensed medical providers. In addition, our clients include uninsured healthcare providers in Florida and other states, as well as correctional healthcare, urgent care, and other regulated facilities.

We have four national health care defense offices: Detroit, MichiganSarasota, Florida and Miami; and Los Angeles/Southern California. Reach out to us to learn more about what we can do for you.

Need an Attorney? Contact us now!

Need an Attorney? Contact us now!

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