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What is 'Causation' and Why Do We Need to Show it in a Medical Malpractice Case Here in New York?

Causation is the link between someone's carelessness and your injury.

It is the bridge between their negligence and your damage.

It is the sequence of events that brought you here today.

If there is no link between what someone did and the injuries you suffered, you will be unable to bring a lawsuit seeking money here in NY.

Our American civil justice system begins hundreds of years ago.

Actually it has its origins thousands of years ago from the Biblical Talmud.

The common thinking through history was that if you caused someone harm, you now become obligated to repay that person for all of the harms, losses and damages you caused.

That type of thinking is firmly established in our civil justice system today.

If you suffer injury because someone was careless, you have a legal right to bring a lawsuit against them.

You have a legal right to try and get them to repay you for all of your damages, all of your harms and all of the losses you suffered because of their carelessness.

In a medical malpractice case here in NY, we are required to show (1) liability, (2) causation and (3) damages.

Those are the three legal requirements necessary to make out a valid case.

That's simply fancy legal talk for meaning we need to show that we are more likely right than wrong that what we are claiming is true.

It also means we need a qualified medical expert confirm that a doctor or hospital staff was careless.

We need to have our medical experts confirm that their carelessness was a cause of your injury.

We also need to have our medical expert confirm that your injuries are significant or permanent.

Only after our medical expert has confirmed all three of those things are we permitted to proceed forward with a lawsuit on your behalf.

Causation it's simply the second element that we must show in your case.

If we can only show that your doctor violated the basic standards of medical care and you suffered significant injury, that means we are missing a key element to establishing a valid case.

That second element is to show that your doctor's carelessness was a cause of your injury.

Let's say for example that your doctor has a horrible bedside manner.

Let's also assume that you suffered significant complications following a surgical procedure.

You can argue that your doctor has a terrible bedside manner.

You can argue your doctor has terrible communication skills.

However, your doctor's bedside manner did not cause or contribute to your surgical complications.

In that scenario, there is no direct link that connects your doctor's poor communication skills with your injuries.

In New York, there can be multiple causes for your injury.

We are not required to establish the specific cause when there are multiple possible causes.

The law only requires us to show that we are more likely right than wrong that your doctor's carelessness was a cause, not the cause. That's an important distinction.

Let's put it another way...

What was the sequence of events that brought you here today?

Let's say that you had surgery at a well-known hospital in Manhattan.

During the course of surgery your doctor inadvertently made a hole in your bowel.

Your doctor was careless and did not recognize that he made a hole.

Believing that there was no problem, your doctor closed you up and sent you to the recovery room.

Within 24 hours you began experiencing symptoms in your belly to suggest you had a life-threatening emergency.

The doctors call this having an acute abdomen.

Through clinical examination, CAT scans and MRI scans the doctors learn that you have free air and fluid in your abdomen.

They suspect you have a bowel perforation.

Two days later, you need emergency abdominal surgery to find out why you have an acute belly.

It turns out you had a significant hole in your bowel that needed to be repaired surgically.

You require part of your bowel to be removed and the two remaining ends put together.

Medically, this is known as an end to end anastomosis.

In order to allow your bowel to heal properly, your bowel contents need to be diverted and a hole must be made in your belly.

You now have a colostomy bag.

You will likely have that for three months sitting outside of your belly.

You must have this surgically reversed.

When we look at the sequence of events that brought you to the attorney's office we can now connect the dots and show first your doctor's carelessness.

His carelessness was failing to recognize the bowel perforation.

As a direct result of his carelessness, you developed a massive infection known as sepsis.

That meant that the contents of your bowel were now leaking out into your abdomen.

That meant that you continued to get sicker and sicker.

That meant you now needed additional diagnostic treatment to find out what the problem was.

Once the doctors recognized the problem and narrowed down the likelihood of what was going on, you then required emergency surgery to fix the problem.

That emergency surgery then led you to need a colostomy bag for three months.

That led to all sorts of disgusting efforts on your part to deal with your bowel contents being evacuated through a small hole in your belly and into a plastic bag that needed to be changed and removed every few hours.

That sequence of events led up to you needing to have surgery three months later in order to close that abdominal hole and to reverse the effects of the colostomy.

Our medical expert would then be required to determine how your injuries would have been different if your doctor had not been careless and had recognized this surgical complication during the course of your surgery.

Our medical expert would need to confirm that if your bowel injury had been recognized at the time of surgery, it could have simply been fixed with a few stitches across the bowel.

The doctors call this oversewing the bowel.

In this last example, we can clearly see the sequence of events that bring us from one point to the next to the next.

In that instance, not only can we show causation but our medical expert can detail for the jury exactly the sequence of events that led you to court and to bring this lawsuit.

The link between a doctor's carelessness and your injury is a specific requirement that must be confirmed by a medical expert in order to show that you're more likely right than wrong that you have a valid case.

To learn more about causation, I invite you to watch the video below...


Gerry Oginski
NY Medical Malpractice & Personal Injury Trial Lawyer