Introduction to When is a Doctor Responsible for a Patient’s Injuries?
Medical malpractice lawsuits are frequently in the news. One news report may describe an injured patient who was awarded thousands of dollars for his or her injuries following a botched surgery. Another report may detail the multimillion dollar compensation award obtained by the family of a newborn who was permanently injured during delivery. Each time one of these stories surfaces, there are calls for medical malpractice reform coming from lawmakers. Many states have enacted “reforms” designed to limit the amount of compensation a medical malpractice plaintiff can recover and/or complicate the method whereby injured patients are able to recover compensation for their injuries.
It is quite common for injured patients to feel as if medical malpractice lawsuits are extremely complicated lawsuits that are unwinnable in many instances. However, what is the truth about medical malpractice cases? Can an injured plaintiff recover compensation for his or her injuries inflicted as a result of the negligent actions of a medical professional?
Recovering Damages in a Medical Malpractice Lawsuit
Patients who suffer injuries at the hands of a medical professional – a doctor, a surgeon, or a nurse, for example – may be able to bring a medical malpractice lawsuit against the professional in order to recover damages. Economic damages available include the cost of the patient’s medical bills and additional treatment costs, lost wages, prescription costs, and other expenses related to the injury. Noneconomic damages may also be available for the patient’s pain and suffering, loss of enjoyment of life, and loss of household services (for example). Depending on the age and/or preexisting conditions of the patient, damages in a medical malpractice case can, in fact, reach into the hundreds of thousands – or millions – of dollars.
Succeeding in a Medical Malpractice Lawsuit
In one sense, a medical malpractice lawsuit is like any other personal injury lawsuit in that the same general propositions must be proven by the plaintiff before he or she will be able to recover compensation. These propositions are as follows: (1) the defendant owed the plaintiff a duty of care; (2) the defendant breached this duty of care by engaging in negligent conduct; (3) the negligent conduct is the proximate cause of the plaintiff’s injuries; and (4) the plaintiff’s injuries can be compensated with an award of monetary damages. Each of these propositions must be proven by a preponderance of the evidence (that is, that the propositions are more likely than not true). If the plaintiff fails to prove any of these propositions – including failing to prove a number of damages that he or she suffered – the plaintiff’s case will fail and the plaintiff will not recover any compensation.
In another sense, however, medical malpractice cases are different from negligence cases. This is because when proving there has been a “breach” of the duty of care in a medical malpractice case, it is not sufficient to produce evidence that no reasonable person would have acted. Instead, the plaintiff must prove that no reasonable medical professional in the same discipline and geographic area as the defendant and with the same background, education, and experience as the defendant would have acted in the manner the defendant did act. For example, a general practitioner with fifteen years of experience will be found to have acted negligently if a similarly-situated general practitioner in the community would not have acted in the same manner as the defendant. If a similarly-situated professional in the community would have or could have acted as the defendant or would have been prone to making the same mistake as the defendant, then the defendant will not be found negligent and the medical malpractice case will fail.
Medical Experts in Medical Malpractice Cases
As a result, many medical malpractice plaintiffs find it necessary (as opposed to merely desirable) to retain the services of one or more medical experts. Even choosing an expert can be difficult, however. Whereas an accident reconstruction expert can come from anywhere in the United States – the principles applicable to car crashes is the same in Maine as in California – a medical expert testifying in a medical malpractice case must have a more specialized knowledge. The closer the experiences and qualifications of the expert are to the allegedly negligent professional, the more persuasive and powerful the expert witness’s testimony will be. Consider two separate scenarios:
- In Scenario A, the allegedly-negligent doctor is a general practitioner with five years of experience. He serves a mostly rural community and has not delivered many babies over his short career (his clients are usually admitted to the hospital in the capital city, about three hours away, to have children). There are no other doctors that serve this community, and the community has no emergency facilities. Late one night, the doctor is summoned to the home of a young couple. The wife has just gone into labor, and there is obviously a problem with the delivery. The doctor attempts to deliver the child safely, but the child’s airway is blocked during a portion of the delivery. The child suffers permanent brain damage as a result.
- Scenario B is the same as Scenario A except that the doctor has been practicing for nearly twenty years and has delivered thousands of babies over his career. He also practices in a large city with multiple hospitals and emergency facilities nearby (the young couple also lives in the city).
In each scenario, an appropriate medical expert should be one who is a general practitioner and/or who has some experience in delivering children. A cardiologist would not be expected to have the type of experience and knowledge necessary to comment on whether another doctor acted appropriately in delivering a baby. However, the appropriate expert for each scenario will differ regarding:
- Amount of experience: The medical expert for Scenario B should have as much, if not more, experience as the doctor so that the expert can testify as to what knowledge the doctor should have possessed. Unless the expert is experienced in supervising younger doctors, it may be difficult for an expert with 30 years of medical experience to render an opinion as to what a doctor with only five years’ worth of experience could reasonably be expected to know.
- Location of practice: Practicing medicine in a rural setting is much different than practicing medicine in a large city. Whereas doctors and patients in large cities may have easy access to hospitals, patients in rural settings usually do not. Getting someone to a hospital in a timely fashion may require helicopter or plane transportation (which themselves are dependent upon the weather). Whereas the doctor in Scenario B may have had time to summon an ambulance to get the woman to the hospital, the doctor in Scenario A may very well have had to attempt the delivery in the home of the couple.
Medical malpractice cases often involve “battles of the experts” in which the experts retained by the injured plaintiff and the experts retained by the allegedly-negligent medical professional each attempt to advance their own opinions while attempting to undermine the credibility of the other professional’s opinion. For additional information see the article “Do I Have a Medical Malpractice Case?”
Special Considerations in Medical Malpractice Cases
Medical malpractice cases are also unique because there are special considerations that must be contemplated before filing such a case and during the pendency of the case. For example:
- Noneconomic damages are usually limited: In an effort at “reforming” medical malpractice cases and reducing the incidence rate of multimillion dollar awards, some states may limit the amount of noneconomic damages a plaintiff can recover. Noneconomic damages include pain and suffering and loss of enjoyment of life. While plaintiffs in such states can recover as much economic damages as they are able to prove (lost wages, medical bills, etc.), their recovery of noneconomic damages will be limited.
- Medical malpractice tribunals: In another effort at reforming medical malpractice cases, some states will require the plaintiff and defendant to submit their case to a “tribunal” before being able to take their case to court. In the states that do have them, the tribunal consists of at least three experts, including (usually) doctors and lawyers. The tribunal hears the evidence of the case and determines whether sufficient evidence exists that shows the medical professional was indeed negligent. The losing party before the tribunal would have the opportunity to proceed to trial in court, but will usually be responsible for paying a bond prior to doing so and/or would be held responsible for the costs of the other party in the event the losing party before the tribunal also lost in court.
- Expert certifications: As an alternative to tribunals, some states require that a medical professional who meets certain qualifications review and “approve” the plaintiff’s medical malpractice claim before the case can be filed. The expert must have reviewed the evidence available to him or her and be able to state truthfully under oath that in his or her opinion the allegations contained in the plaintiff’s complaint would support a claim for medical malpractice. In states that impose this requirement, a plaintiff who files a medical malpractice case without this certification will usually have his or her case dismissed.
Medical malpractice cases have a reputation for being complicated and challenging, and this reputation is well-deserved. The law does permit patients who are injured by their doctors, surgeons, nurses, and/or other medical professionals to bring suit against these individuals and recover compensation for their economic losses (like lost wages and medical bills) and noneconomic losses (like pain and suffering). While the propositions that must be proven by the plaintiff in a medical malpractice case are similar to the propositions to be proven in other negligence cases, the applicable standard is different. Whereas a plaintiff in a negligence case must prove, among other things, that the defendant acted in a manner that no reasonable person would have acted, a medical malpractice plaintiff must show that no reasonable medical professional with a similar background and placed in a similar situation would have acted in the way that the defendant acted. This is a much more difficult burden to meet and often requires the use of one or more expert witnesses.
Because of reform laws enacted by many states, medical malpractice plaintiffs often must contend with considerations that plaintiffs in other personal injury cases do not need to contend with. For example, many states have limitations on the amount of noneconomic damages that plaintiffs can recover. In addition, some states require the plaintiff to either have his or her case evaluated by a medical expert prior to filing the case or submit his or her case to a tribunal of professionals before the case may proceed to trial. Nonetheless, with persuasive expert witness(es) to assist in explaining the facts and circumstances of the plaintiff’s injuries, a plaintiff can nonetheless prevail in a medical malpractice case.