In its opinion filed on May 31, 2016, the Court of Special Appeals of Maryland (“Maryland Appellate Court”), which is Maryland’s intermediate appellate court, held that it was not error for the trial court to admit evidence pertaining to the negligence of subsequent treating physicians in a Maryland medical malpractice case, stating, “Where the facts admit more than one inference, the determination of superseding causation is best left to the jury.”
The Maryland medical malpractice wrongful death case was filed by the wife, minor daughters, and mother of a man who was treated by the defendant physician who allegedly misread the man’s MRI/MRA six days before he suffered a massive, and ultimately fatal, stroke (the original Maryland medical malpractice lawsuit named four treating physicians as defendants; however, two of the defendants settled with the plaintiffs before trial and the third was voluntarily dismissed from the lawsuit the day after the trial began, leaving the one treating physician as the sole defendant).
The plaintiffs filed two pre-trial motions in limine, requesting that the trial court preclude the defendant physician from raising as a defense that the negligence of subsequent treating physicians was a superseding cause, and requesting the trial court to exclude all evidence relating to the two settling physicians’ prior status as defendants or pre-trial settlements. The trial judge denied both motions.
The trial court permitted the defendant physician to present evidence of negligence by subsequent treating physicians and instructed the jury on superseding cause. After a seven-day trial, the Maryland medical malpractice jury returned a verdict in favor of the defendant physician.The jury did not reach the question of superseding cause because they found the defendant physician’s reading of the MRI/MRA non-negligent (i.e., that the defendant physician was not an actual, much less a proximate, cause of the man’s death).
The plaintiffs appealed, arguing that the trial court committed error when it refused to grant their motions in limine because the defendant physician could not, as a matter of law, have been absolved of liability by the negligent acts of subsequent treating physicians.
A superseding cause is said to have arisen primarily when ‘unusual’ and ‘extraordinary’ independent intervening negligent acts occur that could not have been anticipated by the original tortfeasor. In cases involving acts of negligence by subsequent treating physicians, the liability of the initial treating physician can be cut off if subsequent negligence by another physician constitutes a superseding cause.
The Maryland Appellate Court held that the evidence of negligence by the two settling defendants and the defendant who had been voluntarily dismissed from the Maryland wrongful death lawsuit was relevant to whether the remaining defendant physician was a proximate cause of the man’s death (evidence of both negligence and causation attributable to a non-party is relevant where a defendant asserts a complete denial of liability). Furthermore, the negligent acts committed by subsequent treating physicians met the minimum threshold of evidence necessary to establish a prima facie case that would allow a jury to rationally conclude that the evidence supports the application of the superseding cause defense (the reason why evidence of third-party negligence was admissible is because without it, the jury would have been given a materially incomplete picture of the facts, which would have denied the defendant physician a fair trial).
The Maryland Appellate Court noted that it is well established that unless the facts admit of but one inference, the determination of proximate cause is for the jury. The Maryland Appellate Court stated that the reason why evidence of third-party negligence was admissible in this case was because evidence of both negligence and causation attributable to a non-party is relevant where a defendant asserts a complete denial of liability.
Therefore, the Maryland Appellate Court held that the trial court did not err in admitting the evidence of subsequent negligent acts and it did not err in generating the superseding cause instruction – where the facts admit more than one inference, the determination of superseding causation is best left to the jury.
Source Copsey v. Park, No. 2170.
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