Mercury News reported this week on a large medical malpractice verdict involving a woman who suffered extreme disability as a result of a series of medical errors. The case represents both the serious consequences of medical malpractce as well as the sometimes unique causation issues in these cases.
According to the story, doctors at the defendant-medical foundation ordered the plaintiff to undergo an angiogram in October of 2006. An angiogram is an intrusive brain procedure that obviously involves risks and should only be undertaken when absolutely necessary. In this case, the doctors explained to the patient that the procedure was need to investigate an abnormal vein in her brain. She had originally visited the physicians to seek treatment for migraines.
Heeding her doctor’s advice, the woman was referred to a different medical clinic to have the procedure performed-the original medical foundation did not have the resources to perform the operation. Unfortunately, the operation caused problems. When the dye for the angiogram was injected into the patient’s brain blood vessels, the woman suffered a vasospasm (form of stroke). The stroke threw her into a coma for the next two weeks. When the woman awoke, to her horror, she found that she was a quadriplegic. She had lost use of both her arms and legs.
Later it was learned that the angiogram was completely unnecessary, because the vein sought to be investigated had nothing to do with the migraine complaints. The medical malpractice lawyers involved in the case explained that doctors at the medical foundation should have known this. Their mistake in ordering the test caused the stroke.
A medical malpractice lawsuit was filed. The case eventually went to trial, and, after several weeks, the jury handed down a $22 million verdict in the plaintiff’s favor. However, because of arbitrary damage caps in the state, the award will likely be significantly lower. The jury award was for a suit against the medical foundation alone. The medical team which performed the actual angiogram settled with the women before the end of the trial.
Each Illinois medical malpractice lawyer at our firm appreciates that this case demonstrates the sometimes complex rules of causation. Like any negligence case, to be successful a plaintiff must show that the defendant owed a duty, breached that duty, and the duty caused the harm. In this case, the defendant medical foundation did not actually perform the test. However, the rules of causation are such that even events before the procedure could have been a factor-namely the decision to have the test performed at all.
The causation element in these cases is best thought of as two separate elements: “but for” causation and “proximate” causation. Each has to be proven. “But for” causation is simply a chain of events idea. But for the actions of the defendant the harm would not have arisen. In this case, if the medical foundation had not ordered the test, then the harm would not have happened, regardless of whether or not the test was performed correctly. Proximate cause is a much less clear concept, but it generally refers to the fact that the conduct must have been “close” (in time or place) to the harm. This is a subjective judgment that is often debated in legal circles. For example, if the patient in this case had gotten into a car accident after driving home from the procedure, technically, the accident would not have happened had the doctors not recommended the test. However, the ordering of the test would likely not be considered a “proximate” cause of the car accident because its connection is too attenuated.
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