Wrongful Death Proximate Cause: Barton v. Advanced
The Baltimore Medical Malpractice Lawyer Blog features Maryland appellate opinions in medical malpractice cases and other personal injury cases in which similar issues arose. This post concerns one of the most common appellate issues: causation. The case is Barton v. Advanced Radiology, P.A., 248 Md. App. 512 (2020). Specifically, the issue concerns proximate cause in a wrongful death case.
Wrongful Death Proximate Cause in the Circuit Court
This case was a wrongful death case in the Circuit Court for Baltimore County based on a doctor’s failure to diagnose the deceased with stage 1 breast cancer. This misdiagnosis allowed the cancer to ultimately spread and afterward caused her death. After the patient found a lump in her breast, she then went to the defendants for a mammogram and ultrasound. The defendants read the tests as normal and benign. (Op. at 3).
One year and three months later, the patient returned for a follow-up, and tests revealed abnormalities. A biopsy the next month then revealed stage 3, triple-negative breast cancer. (Id.). She died from cancer at age 56. (Id. at 3-4).
During the trial, the plaintiff presented expert testimony. An expert radiologist opined that the defendants had breached the standard of care by not biopsying the lump they had initially found. The plaintiff also called an oncologist and hematologist, who testified that the patient’s cancer was likely at stage 1 during the initial tests. When the patient returned, her cancer had progressed to stage 3, a particularly aggressive form that is resistant to treatment.
The defense was that the cancer was so small in the original tests that it was undetectable at that time. (Id. at 8).
Defense Motions
At the close of evidence, the defense then moved for judgment based on causation. The defense cited the plaintiff expert’s testimony that the patient’s survival rate went from 80% when the cancer should have been diagnosed to 66% when it was. The defense argued this showed that the defense’s actions were not the probable cause of death. (Id.). The court reserved a decision on the motion. Afterward, the jury found for the plaintiff and awarded over $2.5 million. (Id. at 9).
The defense filed a motion for judgment notwithstanding the verdict on causation, and the court granted it. The plaintiffs appealed. (Id. at 10).
Wrongful Death Proximate Cause in the CSA
The plaintiffs argued that the circuit court improperly applied the loss of chance doctrine in granting the jnov motion. (Id. at 11). The loss of chance doctrine is a legal principle that allows a plaintiff to recover damages if the defendant’s negligence reduces the plaintiff’s chance of survival or recovery. The Court of Special Appeals (CSA) disagreed, finding that the circuit court applied proximate causation. However, the circuit court erred by focusing on the likelihood that the patient would die from cancer versus the negligence that proximately caused her death. The judge should have focused on whether the evidence was sufficient to find that negligence was a proximate cause of the death. (Id. at 20-21).
In examining the evidence, the Court of Special Appeals noted that the plaintiff expert’s reference to a 66% survival rate applied to all Stage III-A breast cancers and was not limited to the triple-negative type. (Id. at 24).
The court noted that the plaintiff’s expert also testified that triple negative meant that she would not respond well to treatment and had the lowest survival rate. In addition, when early-stage cancer spreads, the patient will die. Had the plaintiff not had metastatic breast cancer, she likely would have lived into her 70’s. (Id. at 24-25).
The CSA found that the totality of expert testimony was sufficient for the jury to conclude that had the defendants found the cancer initially, the plaintiff may have survived. This underscores the significant role of the jury in medical malpractice cases. As a result, the CSA reversed the circuit court’s decision and reinstated the jury award. (Id. at 26-27).
Commentary by the Baltimore Medical Malpractice Lawyer
The Barton opinion is a significant one for wrongful death cases, particularly those involving a delay in diagnosing cancer that leads to its spread and the plaintiff’s death. This case sets a precedent for such scenarios.
This opinion means that in wrongful death cases, plaintiffs are not necessarily required to present expert testimony that the delay in diagnosis reduced the chance of survival from above 50% to below 50%. Instead, the focus is on whether the evidence as a whole is sufficient for the jury to conclude that the delay was the proximate cause of the plaintiff’s death.
Mark Kopec is a top-rated Baltimore medical malpractice lawyer. Contact us at 800-604-0704 to speak directly with Attorney Kopec in a free consultation. The Kopec Law Firm is in Baltimore and helps clients throughout Maryland and Washington, D.C. Thank you for reading the Baltimore Medical Malpractice Lawyer Blog.