What is causation in medical negligence and why is it important?

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It is not enough simply to establish that a medical professional has breached their duty of care and acted negligently to succeed in a claim for medical negligence.

To succeed in a claim, you must also prove that you were harmed as a consequence of such negligence.

The courts require the person bringing a claim to prove that the medical professional’s actions caused or materially contributed to their injury.

When does negligence cause harm?

This question is answered by applying the ‘but for’ test. But for the negligence, would the injury have occurred? This is a hypothetical but crucial question that must be considered as a central part of any claim. In the case of a negligent delay in diagnosis, the court will ask ‘but for the delay, would the harm still have occurred?’ If not, causation has been proved.

If, however, the court concludes that even in the absence of the negligence, the individual would have suffered the same harm, then there is no causation and the claim would fail, no matter how significant the negligence.

We must not forget that there is always a reason that a patient first receives treatment from a healthcare practitioner. The courts will always consider what their condition was prior to the alleged negligence. It may be the case that an underlying condition, even if treated non-negligently, would have left them with ongoing disabilities or care needs.

It is for the claimant side to prove that it was the negligence that was causative of the harm and not any underlying or pre-existing condition.

How is causation proved?

Arguments around causation often centre on complex medical issues. The effects of the illness or injury that required treatment initially must be disentangled from the effects of the negligent treatment. Therefore, as with considering if there has been a breach of duty, this is a matter to be determined by independent medical experts. Reports will be obtained from medical experts who specialise in the relevant fields to give their opinion on whether causation can be proved.

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