The Court of Appeals of Maryland recently explained its position regarding evidence of superseding causes of injury by non-parties in a medical malpractice case decided on May 24, 2017. The family of a deceased patient sued several doctors and hospitals that had treated the patient before his stroke. Before trial, the plaintiffs had settled with or dismissed their claims against all of the defendants except one radiologist and his employer. The plaintiffs alleged that the doctor was negligent when interpreting the patient’s radiological images, leading to the patient’s fatal stroke six days later. After the trial, the jury found in favor of the defendants, and the plaintiffs appealed.
The key question for the Court of Appeals was whether the defendant could present evidence of negligence on the part of non-party doctors who had subsequently treated the patient as intervening and superseding causes of harm to the patient. The plaintiffs argued that evidence of the non-parties’ negligence was irrelevant and immaterial to the issue of whether the defendant violated the standard of care in his treatment of the patient, and the evidence tended to mislead the jurors into believing the non-parties who had settled were the responsible parties, rather than the defendant. The plaintiffs also contended that the trial court improperly applied the doctrine of intervening and superseding causes in the context of a medical negligence action involving acts of multiple concurrent tortfeasors.
The four elements required for a negligence action are duty, breach, causation, and damages. Causation-in-fact may be found if it is more likely than not that the defendant’s conduct was a substantial factor in producing the plaintiff’s injuries. However, the issue of superseding causation is not even relevant unless the antecedent negligence of a third person is a substantial factor in bringing about the injury and could not have been anticipated by the defendant.