Maryland Court Reviews Evidence of Causation in Medical Malpractice Appeal

In order to succeed in a negligence lawsuit, a plaintiff must not only prove that the defendant breached a duty of care but also prove that the defendant’s breach was the cause of the plaintiff’s injury. The Court of Special Appeals of Maryland addressed the issue of causation in a recent medical malpractice action, Hardy v. Advanced Radiology, P.A. (Md. Ct. Spec. App. Aug. 17, 2016). Although the court accepted that the doctor breached the standard of care, it ultimately held that the plaintiff failed to establish the necessary causal link between the doctor’s breach and the plaintiff’s injury.

In Hardy, the plaintiff underwent a CT scan of his abdomen in February 2006. The defendant, a radiologist, interpreted the scan as showing nothing abnormal. The plaintiff sought a second opinion from another hospital 19 days later. Two different radiologists detected a mass, and a surgical consult was ordered. The surgeon reviewed the scan and reported that it looked benign, recommending follow-up CT scans. For the next several years, follow-up CT scans were performed annually. In December 2011, the plaintiff underwent a sixth CT scan, showing that the mass had doubled in size, and a biopsy of the mass led to a diagnosis as a cancerous tumor. The plaintiff filed a medical malpractice lawsuit in January 2013 against his doctors, including the defendant who interpreted his first CT scan.

At trial, the plaintiff’s experts testified that the defendant had breached the medical standard of care by failing to identify the mass in the plaintiff’s abdomen. At the close of evidence, the defendant moved for judgment, arguing that the plaintiff failed to prove that the defendant’s breach caused the plaintiff’s injury. The trial court denied the defendant’s motions. The jury found the defendant negligent and awarded $20,635 in damages. On appeal, the defendant again argued that the plaintiff failed to establish the element of causation.

A cause of action for negligence requires proof of a duty or standard of care, a breach of the standard, causation, and damages. To prove causation when only one negligent act is at issue, the plaintiff must show that the injury would not have occurred “but for” the defendant’s negligent act. However, if two or more independent negligent acts result in an injury, the substantial factor test is applied. In such cases, causation may be established if it is more likely than not that the defendant’s conduct was a substantial factor in producing the plaintiff’s injuries. Expert testimony is generally required to establish causation in medical malpractice cases.

On appeal, the court found that no reasonable jury could find evidence of causation. The court explained that, even after the second radiologist identified the mass properly, the surgeon decided not to remove it. Therefore, the plaintiff was unable to establish that the three-week delay after the defendant’s incorrect interpretation was the cause of the plaintiff’s terminal prognosis several years later. As a result, the court reversed the judgment against the defendant.

A skilled personal injury lawyer can help identify the parties responsible for causing your injury and pursue damages on your behalf. At the Maryland firm of Foran & Foran, P.A., our capable medical malpractice attorneys have extensive experience representing clients in a variety of personal injury cases, from auto and motorcycle accidents to premises liability claims. To schedule a consultation with one of our dedicated attorneys, call Foran & Foran, P.A. at (301) 441-2022 or contact us online.

More Blog Posts:

Maryland Court Denies Expert Medical Testimony in Negligence Claim, Maryland Personal Injury Blog, published June 14, 2016

Maryland Court Rules Expert Testimony Required to Establish Plaintiff’s Claim for Lack of Informed Consent, Maryland Personal Injury Blog, published August 18, 2016

Contact Information