All medical practitioners are legally obliged to provide a safe, adequate and reliable level of care to their patients. Indeed, when you go to the…
Causation in medical negligence claims
This guide explores what causation in medical negligence claims means, how it can be proven and the importance of establishing causation when making a claim.
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What is causation in medical negligence claims?
When making a medical negligence claim, it is not enough to prove that a healthcare professional made an error in your care and treatment. You must also prove that this error directly caused or significantly contributed to the harm you suffered. In medical negligence claims, this is known as causation.
Even if a doctor, nurse or dentist acted negligently, you cannot win a claim unless you can establish that this negligence directly caused you avoidable harm. For example, your condition worsened due to a delayed diagnosis, or a surgical error caused you a new injury.
To find out if you are eligible for compensation and how you can prove causation in medical negligence, do not hesitate to seek specialist advice. Feel free to call 0800 470 0474 today or request a call back for a no-obligation consultation.
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Table of Contents
Can I make a medical negligence claim?
To be eligible to make a claim for clinical negligence, you need to establish the following:
- A duty of care – this applies to all patients who are under the care of a healthcare professional.
- A breach of duty of care – you received care that did not meet the standard expected of a reasonably competent healthcare professional in the same field, under the same circumstances.
- Causation – you suffered harm as a direct result of the negligence, such as a new injury or the worsening of your condition.
- Damages – the negligence has caused you damages such as pain, suffering and financial losses.
If these can be proven and you are within the legal time limit, you can typically make a medical negligence compensation claim.
What does causation refer to in medical negligence cases?
In legal terms, causation refers to the direct link between the defendant’s actions (or lack thereof) and the resulting harm and damage.
In medical negligence, it means proving that the substandard care provided by a medical professional was the actual cause of your new injury, the worsening of your condition or any unnecessary suffering.
For example, a doctor has failed to diagnose cancer, and it has progressed to a more advanced stage, with a worse prognosis. In this case, the breach of duty is the misdiagnosis, and the causation is the worsening of the condition, which may have been prevented with a timely diagnosis.
If your condition is misdiagnosed but you suffer no consequences, causation cannot be established, and you will not be able to proceed with a claim.
What are the different types of causation in clinical negligence claims?
Two main types of causation could apply to a claim for medical negligence:
Factual causation
The ‘but for’ test is applied in this case, asking whether the harm would have still happened if the negligence had not taken place. But for the defendant’s negligence, would you still have suffered the same injury?
- If the answer is no, then factual causation can be established.
- If, on the other hand, the injury or harm would have happened regardless of the negligence, then factual causation is not met.
Example of factual causation:
If a doctor failed to diagnose an infection, and ‘but for’ that failure, it could have been treated and would not have progressed to sepsis, then causation is likely established.
Legal causation
Also known as the material contribution test, this is used in more complex situations where there are multiple potential causes for an injury.
To establish legal causation, it must be shown that a healthcare provider’s negligence had a significant contribution to the injury or worsening of the condition. This is particularly relevant in claims for delayed diagnosis or inadequate treatment.
Unlike the ‘but for’ test, it does not require the negligent act to be the only cause of the harm you suffered, just a significant one.
Example of legal causation:
If negligent treatment of diabetes led to a leg amputation that could have been prevented with proper care, the negligence may be found to have materially contributed to the outcome, even if other health factors were present.
Examples of causation in clinical negligence
Some common types of causation in clinical negligence cases include:
- A delay in diagnosing cancer that leads to a more advanced and untreatable stage of the disease.
- A surgical error that causes nerve damage, leading to permanent paralysis in your arm or leg.
- Incorrect medical treatment that results in an allergic reaction or severe adverse effects.
- Failure to monitor vital signs, resulting in preventable cardiac arrest.
- Failing to diagnose and treat a maternal infection, resulting in birth injuries to the baby.
- A delay in treating an infection that leads to sepsis and organ failure.
- Misdiagnosing a patient with cancer, leading to unnecessary aggressive treatment.
- Administering too much or too little anaesthesia, resulting in brain damage or anaesthetic awareness.
What are the challenges of proving causation in medical negligence claims?
There can be a few challenges when trying to establish the link between medical negligence and the harm you suffered:
- The complexity of medicine – injuries and medical conditions can have many contributing factors.
- Pre-existing conditions – if the claimant has a pre-existing illness, it will be more challenging to prove that medical negligence and not the condition itself caused the harm.
- Speculative claims – courts need strong evidence proving the link between the negligence and your injury, rather than mere speculation.
- Incomplete medical records – poor or incomplete medical records can make it hard to piece together the events and prove what happened.
- Conflicting expert reports – expert opinions may differ on whether the harm was caused by medical negligence or other factors.
In such cases, courts often rely heavily on expert witness reports and the principle of the balance of probabilities to determine causation.
What evidence could I use to prove a medical negligence claim?
To prove negligence and causation, your solicitor will help you gather comprehensive evidence, which typically includes:
- Your complete medical records, including all doctor’s notes, test results, scans and treatment plans.
- Independent medical reports from specialists in the relevant field (such as a neurologist for a brain injury or an oncologist for a cancer misdiagnosis). They will assess whether the care you received was below an acceptable standard.
- Photographs or videos of your injuries and the impact they’ve had.
- Statements from witnesses to your care and treatment, including from friends and family.
- A personal diary documenting your symptoms, pain levels and how your daily life has been affected.
- Evidence of financial losses, such as receipts, payslips, bank statements or invoices.
What is the Bolam test?
The Bolam test is a legal test used in the UK to determine whether a healthcare professional has breached their duty of care towards a patient.
It relies on peer review, meaning that other medical professionals with similar expertise will assess the care received and determine whether it fell within the acceptable standard.
Proving a breach of duty using the Bolam test is often an essential step in establishing causation in clinical negligence claims.
What if there are multiple causes for my injuries?
In some cases, an injury or illness may result from multiple contributing factors, such as pre-existing conditions, medical errors, and individual risk factors.
This is where the material contribution test often comes into play. Your solicitor will need to separate your medical history from the negligent care and prove that the latter played a significant role in your injury or worsening of your condition.
If it can be established that the medical negligence materially contributed to your injury, you may still receive compensation, even if other causes were involved. On the other hand, if the same outcome would have occurred regardless of the negligence, your claim will likely fail.
What is a break in the chain of causation?
A break in the chain of causation, also known as novus actus interveniens, occurs when an intervening event happens after an initial negligent act, and it is so significant that it breaks the chain of causation between the original negligence and your injury. This could be:
- Negligent medical treatment.
- Your own actions or choices.
- A third party’s actions.
For example, let’s say you fell from a scaffolding at work and suffered a leg fracture. At the hospital, the doctors fail to identify that you are developing compartment syndrome.
As a result of the delayed diagnosis, your condition worsens so much that you need to have the leg amputated, which could have been avoided with timely treatment.
In this case, the medical negligence is so severe that it may break the chain of causation between your employer’s original negligence and the final outcome.
What are the key points for causation in medical negligence?
The key points for establishing causation in medical negligence cases are:
- The ‘but for’ test – proving that the harm would not have occurred but for the negligence of your healthcare provider.
- The material contribution test – if various factors could have contributed to the injury, you must prove that the negligent medical act is more than 50% likely to have caused the damage.
- Supporting evidence – robust medical expert evidence is often crucial to proving causation.
What to do next
We understand how devastating it can be when medical treatment goes wrong. That’s why we’re here to help you get the justice and support you deserve.
If you believe that you suffered avoidable harm due to medical negligence, do not hesitate to contact a specialist solicitor. They will offer you a free consultation to discuss your case and explain to you how causation can be proven to make a successful claim.
If you can proceed and choose to do so, your solicitor will offer you a no win no fee service and guide you through all the steps of the claims process.
For free legal advice, call 0800 470 0474 today or use our contact form to request a call back.
