(Please note: the names and locations of all parties have been changed to protect the confidentiality of this medical malpractice case and its proceedings.)
The following blog entries follow-up the previous two entries from July. These entries address the same issues, but do so from the defense side. By comparing the entries readers should get a good perspective as to how the parties present such issues to the court.
Defendant’s Trial Brief Re: Special Jury Instruction #1
IT IS UNDISPUTED THAT DEFENDANT’S SPECIAL INSTRUCTION #1 IS AN ACCURATE STATEMENT OF THE LAW FOR CAUSATION IN MEDICAL MALPRACTICE
Causation Must Be Proven Within A Reasonable Degree of Medical Probability
The law is well settled that in a personal injury action, causation must be proven within a reasonable medical probability based on competent expert testimony. Jennings v. Palomar (2003) 114 Cal.App.4th 1108, 1118. Defendant’s Special Instruction #1 states precisely the test for the jury to evaluate causation: Causation must be proven within a reasonable medical probability based upon competent expert testimony. Defendant’s Special Instruction #1 is thus well suited to advise the jury of the requisite standard, since it is a proper and accurate statement of controlling law.
CACI 430 Fails to Apprise the Jury of The Standard of Causation For Medical Malpractice
CACI 430 states in full that:
A substantial factor in causing harm is a factor that a reasonable person would consider to have contributed to the harm. It must be more than a remote or trivial fact. It does not have to be the only cause of harm.
First and foremost, the CACI jury instructions do not contain a specific causation instruction for medical malpractice actions. Rather, CACI 430 is designed for general negligence actions. Thus, the instruction fails to address the more specific causation standard required in medical malpractice cases. Under the 430 instruction, the trier of fact is permitted to draw upon ordinary human experience to determine whether a causal relationship exists. However, in medical malpractice actions the evidence of causation must be based on competent expert testimony,and must be shown to a reasonable medical probability. Alef v. Alta Bates Hospital (1992) 5 Cal.App.4th 208. CACI 430 thus leaves the jury without an understanding as to the nature of the causation that they must find in order to determine that the plaintiffs have proved their case.
The Osborn court explained that: If, as a matter of ordinary experience, a particular act or omission might be expected to produce a particular result, and if tat result has in fact followed, the conclusion may be justified that the causal relation exists. In drawing that conclusion, the triers of fact are permitted to draw upon ordinary human experience as to the probabilities of the case. Osborn v. Irwin Memorial Blood Bank (1992) 5 Cal.App.4th 234, 253.
Further, the plaintiffs do not dispute that Special Instruction #1 is the correct causation standard for medical malpractice, and yet they nonetheless seek to have the jury instructed as to causation for general negligence only. The plaintiffs are asking the court to misrepresent the applicable law to the jury, by using CACI 430 to give the impression that a reasonable person may judge whether certain conduct was a substantial factor in bringing about injury to the plaintiff, and completely disregarding the special standard for medical malpractice causation. (See Part 2 of 4.)
For more information you are welcome to contact Sacramento personal injury lawyer, Moseley Collins.