Tennessee medical malpractice cases can be among the most challenging cases to litigate because of the complexity of the subject matter.  Many people presume that medical malpractice, which leads to the injury or death of a patient, is a fairly rare event.  There are, in fact, many good doctors practicing medicine. However, in reality, it is estimated that as many as  (Please check facts. My sources suggest about 98,000.) people die each year from preventable medical errors.  The attorneys at the law firm of Nahon, Saharovich & Trotz (“NST Law”) have the experience and the resources needed to aggressively seek compensation for those who have been injured by the negligence of medical professionals.

Statistics show that only one malpractice claim is made for every 7.6 hospital injuries, according to a Harvard study. Further, plaintiffs drop 10 times more claims than they pursue, according to Physician Insurer Association of America data.  One of the most challenging issues in a medical malpractice case is establishing that the negligent act of the medical professional was the “cause” of the patient’s injuries.  Several factors contribute to the challenge in establishing this “causal connection” including the following:

• The complexity involved in understanding the scientific medical details of disease and treatment
• The need for a medical expert to analyze the facts and testify to the judge or jury
• The difficulty of separating the negative outcome from the ordinary result of the condition or disease
• The frequent lack of tangible evidence of what caused the patient’s injury

At NST Law, we will use our experience in addressing the complexities of medical malpractice cases and proving that a medical error “caused” a patient’s injury to help you or your family seek just compensation.  A plaintiff seeking compensation for the injuries caused by a medical professional must establish the following: 1) the medical professional owed the patient a “duty of care”; 2) the medical professional failed to exercise the degree of care and skill of a similar medical professional under routine circumstances; 3) the medical professional’s mistake caused the patient’s injury; and 4) the patient suffered damage from the medical professional’s mistake.”

Actual vs. Proximate Cause

Causation in medical malpractice cases is made up of two components “causation in fact” and “proximate cause.”  Causation in fact refers to the mistake or misconduct of the medical professional being the “but for” cause of the patient’s injury.  If the medical professional’s error had not occurred, the patient would not have suffered the injury.  If the physician had not given the patient a drug to which the patient had a known allergy, for example, the patient would not have suffered an allergic reaction and died.

Proximate cause (sometimes called “legal cause”) is a complex legal term and a complete explanation is beyond the scope of this article.  Simply put, proximate cause is defined as a cause which in a natural and continuous sequence unbroken by any intervening event produces injury and without which the injury would not have occurred. In general, the concept of proximate cause reflects policy considerations that even when an event is the “but for” cause of any injury, sometimes an outcome is so remote and unforeseeable that it is considered unfair to hold someone accountable for the result.

A patient is re-admitted into a hospital because he suffers a heart attack, for example, which the physician in the hospital failed to diagnose or treat on a prior visit.  If the patient dies from a heart attack after being re-admitted to the hospital, this result may be deemed the “reasonably foreseeable” result of the patient not being properly diagnosed or treated on the prior visit.

By way of comparison, if a criminal burst into the hospital and shoots the patient in an attempted robbery to steal drugs from the hospital, the physician’s failure to properly treat and diagnose the patient on the prior visit may be the “but for” cause of the injury.  Nonetheless, a robber shooting the patient may be deemed to be too unforeseeable a result from a failure to diagnose and treat a heart attack to be considered proximately caused by the physician’s error.  The intentional act of the robber who injects himself into the chain of events between the failure to diagnose and the patient’s death is sometimes called a “superceding cause” or “intervening cause.”  As this example illustrates, the concept of proximate cause is rooted in the idea that the consequences of the physician’s error must be a reasonably foreseeable result of the mistake.

Expert Testimony

At NST Law, we have handled many medical malpractice cases and are familiar with working with medical experts to determine if a medical professional deviated from the appropriate standard of care and to determine how that deviation caused a patient’s injury.  The opinion of a medical expert is required under Tennessee medical malpractice law before a lawsuit may even be initiated.  Courts consider the subject matter of medical malpractice cases too complex for lay people to understand without a medical expert.  The medical expert is necessary to establish the appropriate standard of care and that the medical professional’s failure to comply with that standard of care was the “cause” of the patient’s injury.

The attorneys at NST Law understand the importance of effective expert testimony especially in cases where the underlying medical condition that motivated the patient to seek treatment ultimately results in the patient’s death.  A common example of this situation is the failure to diagnosis cancer.  The insurance provider for the medical professional will often argue that the cancer killed the patient and that the failure to diagnose the patient would not have made a difference.  At NST Law, we will work closely with medical experts to develop legal theories and present evidence to help communicate to the judge and jury in an understandable way that the injuries suffered by you or your loved ones were caused by the medical professional’s error.

Res Ipsa Loquitur

One of the reasons that proving causation in a medical malpractice case is difficult is that the defendants are often the ones who write the medical reports that frequently form the basis of a lawsuit. Since the defendants are often the only ones who are present and know what really occurred when the negligence happened, and they choose how to describe the event, records are often not descriptive of what truly happened.  Moreover, the medical provider may frame the report to protect against the appearance of misconduct.

If a patient is injured during a medical procedure but does not know exactly what caused his or her injury, but it is the type of injury that would not have occurred without negligence on the part of his or her medical professional, he or she may invoke a legal doctrine known as “res ipsa loquitur.” Translated, this Latin phrase literally means “the thing speaks for itself,” and implies that the plaintiff need only show that a particular result occurred and would not have occurred but for someone’s negligence.  The classical example of this doctrine is when a medical instrument is left in the patient after surgery.  Obviously, a medical instrument would not be left in a patient without negligence by the medical professional or a member of his or her team.

An injured patient must establish the following elements to invoke the doctrine of res ipsa loquitur:

• No evidence exists of the actual cause of the patient’s injury
• The injury is the type that would not ordinarily occur in the absence of negligence
• The patient was not responsible for his or her own injury
• The medical professional (team) had exclusive control over the instrumentality that caused the injury
• The injury could not have been caused by a different instrumentality

Where it is unclear exactly how a patient was injured during a medical procedure, it is obviously problematic to establish that the error in the procedure was the “cause” of the patient’s injury.  We at NST Law understand the unique challenges in proving that the negligence of a medical professional caused injury or death to a patient.  We will coordinate with medical experts who understand the appropriate medical procedures and treatments.  At NST Law, we will work closely with medical experts to review your medical records and investigate the circumstances of a patient’s medical care and resulting injury.