Section 12 Causation

• Library: Damages 2012

Courts must consider expert testimony on causation as an integrated whole. Fletcher v. Kansas City Cancer Ctr., LLC, 296 S.W.3d 474, 479 (Mo. App. W.D. 2009).

A medical malpractice plaintiff is not required to prove causation by direct evidence; indeed, causation may be established circumstantially. “A submissible case for causation is made if substantial evidence is presented that the injury is a natural and probable consequence of the defendant’s act or omission.” Sufficient evidence exists “if the logical conclusion from the evidence is that if certain things had been properly done certain results would not have occurred, and such results did occur.” As a result, [a] medical expert was not required to “directly state that [the negligent act] caused the injury.

Lake v. McCollum, 295 S.W.3d 529, 536 (Mo. App. W.D. 2009)(citations omitted) (quoting Laws v. St. Luke’s Hosp., 218 S.W.3d 461, 467 (Mo. App. W.D. 2007)).

An expert does not need to “rule out other potential causes of death in order to be able to state within a reasonable degree of medical certainty what [the expert’s] conclusion is as to cause of death.” See McBurney v. Cameron,248 S.W.3d 36, 50 (Mo. App. W.D. 2008).

“‘[W]hen a party relies on expert testimony to provide evidence as to causation when there are two or more possible causes, that testimony must be given to a reasonable degree of certainty.’” Sundermeyer v. SSM Reg’l Health Servs., 271 S.W.3d 552, 556 (Mo. banc 2008) (quoting Baker v. Guzon, 950 S.W.2d 635, 646 (Mo. App. E.D. 1997)).

In discussing the applicability of the “but for” test, the Missouri Supreme Court said that it “is the minimum causation because it merely proves that...