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Woodward v. Research Medical Center8/23/2005
have caused cardiac arrhythmia; and (ii) Ms. Woodward's pre-existing medical conditions had not put her at risk of a cardiac arrhythmia before the fall occurred.
The instruction has also been used in the case of a "thin-skulled" plaintiff. The instruction has also been used in the case of a "thin-skulled" plaintiff. Callahan, 863 S.W.2d at 858-60 (MAI 19.01 modification not at issue, but tacitly approved in case with "thin-skulled" plaintiff). It is unclear in Callahan whether the approved modification was due to the fact that there were joint tortfeasors or that the infant was susceptible to the polio virus from a previously administered vaccine, a pre-existing condition. But see Wailand v. Anheuser Busch Inc., 861 S.W.2d 710, 717-18 (Mo. App. E.D. 1993) (court rejects use of MAI 19.01 modification where pre-existing condition, arteriosclerosis, made plaintiff more susceptible to the stroke that resulted from a trip and fall incident; court indicates modification is limited to cases where more than one party's actions contribute to cause damage).
Research argues that Ms. Woodward is a "thin-skulled" plaintiff and that a defendant is generally responsible for all of the injuries that a "thin-skulled" plaintiff sustains as a result of the defendant's negligence. Thus, Research claims, the 19.01 modification is redundant in such a case. What Research overlooks, however, is that liability in tort is premised on the foreseeability of the harm caused by a defendant's negligence. The "thin-skulled" plaintiff doctrine was developed, however, to extend liability where the result of a defendant's negligent act was not foreseeable due to the plaintiff's physical condition, which is unknown to the actor. K EETON ET AL., Section 43, at 290-92; R ESTATEMENT (S ECOND) OF T ORTS Section 461 cmt. a (1965) (the rule applies where peculiar physical condition which makes injuries greater than actor expected is not known to actor, actor could not have discovered it by exercise of reasonable care, or even if unknown to person suffering it or to anyone else until after harm is sustained). This is not a "thin-skulled" plaintiff's case; Research knew that Ms. Woodward had pre-existing medical conditions that had the potential to result in injury far greater than broken bones if it negligently failed to prevent her from falling. Thus, the fact that a woman with a weak heart, diabetes, and renal dysfunction sustained heart arrhythmia and cardiac arrests after the fall and was, because of these conditions, simply unable to recover from the broken hip and cardiac arrests was entirely foreseeable.
Instructional Error - Committee Notes
The committee comment to MAI 19.01, discussing the legal principles the modification is intended to embody, refers to the "general rule" that a defendant can be negligent and liable for injury even though his or her negligence was not the sole negligence or the sole proximate cause, and although his or her negligence, without such other independent, intervening cause, would not have produced the injury. MAI 19.01 Committee Comment (1995 New) (6 th ed. 2002) (citing Gaines v. Prop. Servicing Co. , 276 S.W.2d 169 (Mo. 1955)).
Research contends that a pre-existing injury, itself, can only entitle a plaintiff to the 19.01 modification if there were other persons or events that caused the pre-existing injury. There does not appear to be any logic supporting this assertion. While the law is usually concerned with determining where the responsibility for harm lies, it is clear that any number of occurrences or conditions can be a proximate cause of harm, including natural phenomena like lightning, flooding or an animal that happens to be in the wrong place at t
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