Articles Posted in Hospital Negligence

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.

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In order to hold a defendant liable in a medical malpractice claim, the plaintiff must establish that the defendant owed them a duty of care. In the absence of a doctor-patient relationship, there are rare circumstances under which the law may impose a duty of care to a third party who never received treatment. The Court of Special Appeals of Maryland addressed this issue in Puppolo v. Holy Cross Hosp. of Silver Spring, Inc. (Md. Ct. Spec. App. Nov. 14, 2016), a recent case arising out of the medical treatment of the plaintiff’s mother.

In Puppolo, the plaintiff’s mother received treatment at the defendant’s hospital for an intracranial hemorrhage, involving a bedsore on her lower back. The bedsore became a serious health issue that required extensive treatment, and the plaintiff’s mother eventually passed away. The plaintiff sued the hospital, alleging claims of medical malpractice, battery, fraudulent concealment, intentional infliction of emotional distress, and wrongful death. The trial court dismissed the plaintiff’s personal claim for fraudulent concealment, and the plaintiff appealed.

In her complaint, the plaintiff alleged that the defendant intentionally concealed the existence of the bedsores and its failure to treat those bedsores, thus placing undue and unnecessary mental strain on the plaintiff. The necessary elements for fraudulent concealment are:  (1) the defendant owed a duty to the plaintiff to disclose a material fact; (2) the defendant failed to disclose that fact; (3) the defendant intended to defraud or deceive the plaintiff; (4) the plaintiff took action in justifiable reliance on the concealment; and (5) the plaintiff suffered damages as a result of the defendant’s concealment.

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