To succeed in bringing a medical negligence claim, in addition to proving that the physician, treatment provider or hospital was negligent, you must also prove that the negligence caused injury. Proving causation is an essential element of a successful claim but is often the most difficult aspect of these claims and, in nearly all cases, will require expert evidence in support of the allegation.

The burden of proof in medical malpractice cases falls on the Plaintiff/claimant. The standard of proof to which the Plaintiff is held is on a balance of probabilities. In other words, they must prove that it is more likely than not that the medical provider’s negligence caused them injury.

One of the most difficult aspects of practicing in the area of medical malpractice is having to explain to individuals that while the treatment they or their loved one received was negligent in that it fell below the standard of care expected, the negligence did not cause the outcome.

For example, take a situation where a physician unreasonably misses or ignores signs of cancer, leading to a delay in diagnosis. Upon being diagnosed, it is confirmed that the cancer is at a late stage and the prognosis is poor. It will not always be the case that the physician’s negligence in failing to diagnose the cancer when they should have can be shown to have caused the poor prognosis. In some cases, the delay in diagnosis may have made little to no difference to the stage the cancer was at or the resulting prognosis.

On the other hand, there are cases where a missed or delayed diagnosis can be proven to have resulted in a bad outcome, in some cases death. For example, where a physician failed to take steps to test for cancer when they should have and as a result, the cancer went undiagnosed and the individual passed away, it may be possible to prove that had the disease been caught when it should have, the cancer would likely have been treatable and the individual would more likely than not have survived.

This of course is a determination that we as lawyers, not having been medically trained, are generally not able to make and so we rely on opinions from specialists in the area, such as Oncologists. Courts too rely on the opinions of experts in the relevant area in determining not only whether a medical provider was negligent, but whether there exists a sufficient causal link between the negligent act and the injury or outcome. While the circumstance may seem obvious or to require only common sense to connect the dots and prove a causal link, this is extremely rare. Medicine is a complex area, particularly to those without extensive and specific training, which is why the legal system generally requires expert opinion evidence on these complex and fact-specific questions.

Every medical malpractice case is extremely fact-specific, particularly when it comes to the issue of causation. Causation is a key consideration when determining whether or not there is a reasonable claim to pursue.