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Massachusetts Supreme Judicial Court Holds that Traditional “But-For” Causation Is the Appropriate Standard in Most Negligence Cases

Causation is one of the essential requirements in proving a case of negligence in a Cape Cod personal injury lawsuit. Without the element of causation, a defendant’s breach of a duty of care toward the plaintiff will not result in a finding of liability, even if the plaintiff can prove substantial damages.

It works like this: the plaintiff must be able to prove, by a preponderance of the evidence, not only that he or she was owed a duty of care, that this duty was breached, and that he or she suffered harm but also that his or her damages were caused by the defendant’s actions or in actions. However, “cause” or “causation” is a term of art in the world of negligence law. Something can be the actual cause of harm without necessarily being the legal cause of such damages.

Public policy factors into the development of this area of the law. Would it be wise to hold a defendant liable for a “freak accident,” even if, technically, his or her breach of duty resulted in damages to the plaintiff? Probably not. Somewhere between such occurrences and conduct that is so likely to result in harm as to be considered intentional – and possibly subject to punitive damages – lies the type of conduct that the principles of negligence are designed to govern.

Facts of the Case

In a recent medical malpractice case considered on appeal by the Supreme Judicial Court of Massachusetts, the plaintiff was the personal representative of the estate of a woman who died from complications arising from chronic thromboembolic pulmonary hypertension (CTEPH), which she developed after being prescribed with a progesterone cream to treat symptoms of perimenopause. At the time of her death, the decedent was 43 years old. The plaintiff’s complaint alleged that the defendant medical providers (which included a nurse practitioner and the physician who employed her) were liable for the decedent’s death on several theories, including negligence, failure to obtain informed consent, and loss of consortium.

The case was tried to a jury and resulted in a verdict in favor of the defendants. The plaintiff filed a motion for a new trial. After the trial court denied the plaintiff’s motion, the plaintiff appealed. The Supreme Judicial Court transferred the case from the intermediate Appeals Court of Massachusetts on its own motion.

Decision of the Court

The court affirmed the trial court’s entry of judgment on the jury’s verdict in favor of the defendants. In so doing, the court clarified the law of Massachusetts with regard to the element of causation, concluding that the traditional “but-for” factual causation standard was the appropriate standard to be employed in most cases, including those involving multiple alleged causes. The court noted that this was the approach recommended by the Restatement (Third) of Torts: Liability for Physical and Emotional Harm (2010). In the court’s view, the “substantial factor” test  was unnecessarily confusing and should be discontinued, even in multiple sufficient cause cases.

Because the trial court below had instructed the jury using traditional but-for causation principles (which required that the harm complained of be within the scope of the foreseeable risk that might arise from the defendant’s breach of duty), the trial court’s entry of judgment upon the jury’s verdict was proper.

Speak to a Lawyer About a Cape Cod Medical Malpractice Case

Being the victim of a doctor or nurse’s mistake can be very costly, both in economic terms and in terms of one’s health and well-being. If a medical professional’s negligence has caused personal injuries or wrongful death to you or someone in your family, you need reliable legal advice about your potential claim. Call the Law Offices of John C. Manoog III at 888-262-6664 to schedule a free consultation with a helpful Cape Cod medical negligence attorney and learn more about legal rights.

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