The Court of Appeals of North Carolina (“North Carolina Appellate Court””) held in its opinion dated January 21, 2020: “even if a third-party is not a party at trial, an instruction on intervening negligence may be given if the evidence at trial shows that the third-party’s conduct was a sufficient “intervening cause” … Therefore, Plaintiff’s contention that an expert witness was required to first establish [the subsequent surgeon’s] standard of care and whether he breached that standard of care in order to warrant an instruction on intervening negligence is without merit.”
The Underlying Facts
A dialysis patient had a stent placed in her innominate vein. The North Carolina medical malpractice complaint alleged that the “stent improperly placed in [Ms. Miles’] vein for better dialysis access, was broken during a subsequent procedure and went into [Ms. Miles’] heart causing severe, permanent and disabling injuries.” The plaintiff’s expert testified during trial that the stent was placed too far into the superior vena cava that “set the stage for it . . . being sheared in half causing it to migrate” during a subsequent procedure. The surgeon who performed the subsequent procedure was voluntarily dismissed from the lawsuit.
The defendant surgeon requested a jury instruction on intervening negligence, which the trial judge permitted over the objection of the plaintiff. The North Carolina medical malpractice jury returned a defense verdict, and the plaintiff appealed, arguing that it was improper to instruct the jury as to intervening cause because no expert witness directly established the standard of care the subsequent surgeon owed; that he breached that standard of care; and that his breach of the standard of care was the proximate cause of the patient’s injury.
North Carolina Appellate Court Opinion
An efficient intervening cause is a new proximate cause which breaks the connection with the original cause and becomes itself solely responsible for the result in question. It must be an independent force, entirely superseding the original action and rendering its effect in the causation remote. It is immaterial how many new elements or forces have been introduced, if the original cause remains active, the liability for its result is not shifted. If, however, the intervening responsible cause be of such a nature that it would be unreasonable to expect a prudent man to anticipate its happening, he will not be responsible for damage resulting solely from the intervention. The intervening cause may be culpable, intentional, or merely negligent.
The North Carolina Appellate Court explained in the case it was deciding, “In order to warrant an instruction on intervening negligence, there needs to be evidence tending to show an intervening cause, whether culpable, intentional, or negligent, broke the connection of the original wrongdoer and that the original wrongdoer had no reasonable ground to anticipate it … However, intervening negligence is an extension of proximate cause. Plaintiff points to no case that states a separate and heightened evidentiary showing is required regarding an alleged insulating cause. Instead, our case law demonstrates that if the evidence at trial, whether plaintiff’s own evidence or other evidence, reveals that a cause may have been a sufficient intervening cause of the injuries alleged, an instruction on intervening negligence is proper. As long as the intervening cause is “an independent force, entirely superseding the original action and rendering its effect in the causation remote,” an instruction may be warranted … even if a third-party is not a party at trial, an instruction on intervening negligence may be given if the evidence at trial shows that the third-party’s conduct was a sufficient “intervening cause” … Therefore, Plaintiff’s contention that an expert witness was required to first establish [the subsequent surgeon’s] standard of care and whether he breached that standard of care in order to warrant an instruction on intervening negligence is without merit.”
The North Carolina Appellate Court stated that “sufficient evidence demonstrates that [the defendant surgeon] could not anticipate [the subsequent surgeon’s] subsequent conduct … it was not foreseeable that the stent [the defendant] placed would be fractured.”
The North Carolina Appellate Court held: “Because two theories of proximate cause were presented at trial, the trial court did not err in instructing the jury to determine whether [the subsequent surgeon’s] intervening conduct insulated [the defendant’s] alleged original negligence.”
Source Hampton v. Hearn, No. COA19-378.
If you or a loved one may have been injured (or worse) as a result of medical negligence in North Carolina or in another U.S. state, you should promptly find a North Carolina medical malpractice lawyer, or a medical malpractice lawyer in your state, who may investigate your medical malpractice claim for you and represent you or your loved one in a medical malpractice case, if appropriate.
Click here to visit our website or call us toll-free in the United States at 800-295-3959 to find medical malpractice attorneys in your U.S. state who may assist you.
Turn to us when you don’t know where to turn.