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Woodward v. Research Medical Center8/23/2005
he wrong time. And these occurrences or conditions to which no liability can attach, operating in combination with a defendant's negligence, can bring about an injury. Because defendants can be held liable even where their negligence without that other cause would not have produced the injury, Gaines , 276 S.W.2d at 173-74, the multiple causes modification gives a jury the tool it needs to understand and apply this principle.
Research also contends that a pre-existing condition cannot constitute an intervening cause. If its argument is time-based, it is wrong. According to the Restatement, "It is not necessary that an intervening force have been set in motion subsequent to the time when the actor's negligent conduct was committed." R ESTATEMENT (S ECOND) OF T ORTS Section 441 cmt. a (1965). In addition, while a patient may bring a medical condition to a given situation, as here, that condition only ripens into a cause of harm either at the time defendant's negligence occurs or some time thereafter. The evidence supporting the requested instruction was that Ms. Woodward's medical problems had not caused a heart arrhythmia until after hospital personnel allegedly overdosed her with nitroglycerin, failed to institute a fall protocol despite the confusion she exhibited in the middle of the night, and negligently allowed her to stand and walk without adequate assistance to the restroom.
Research also argues that the central issue in the case, in terms of alleged instructional error, is what caused the fall and not what caused Ms. Woodward's death. Research claims that the alleged negligence and pre-existing medical conditions constituted alternative theories of causation in relation to the fall and thus, that a multiple causes instruction was not supported by the evidence. Research further contends that Mr. Woodward cannot rely on its evidence and theories as justification for the modification instruction, claiming that Mr. Woodward advances for the first time on appeal his theory that the pre-existing medical conditions also combined with Research's negligence to cause Ms. Woodward's fall.
Causation is the nexus between negligent conduct and injury . Here, the injury was not the fall; rather, it was the broken hip sustained in the fall and the cardiac arrests and other complications that culminated in Ms. Woodward's death. According to the evidence presented to the jury, the fall alone would not have caused Ms. Woodward's heart attacks. Witnesses for both parties testified that Ms. Woodward's pre-existing medical conditions put her at risk of falling and that her pre-existing medical conditions compromised her body's ability to recover from the injuries that resulted from the fall. In addition, according to plaintiff's expert, Dr. Fox, Ms. Woodward Causation is the nexus between negligent conduct and injury. Here, the injury was not the fall; rather, it was the broken hip sustained in the fall and the cardiac arrests and other complications that culminated in Ms. Woodward's death. According to the evidence presented to the jury, the fall alone would not have caused Ms. Woodward's heart attacks. Witnesses for both parties testified that Ms. Woodward's pre-existing medical conditions put her at risk of falling and that her pre-existing medical conditions compromised her body's ability to recover from the injuries that resulted from the fall. In addition, according to plaintiff's expert, Dr. Fox, Ms. Woodward's body - due to age and pre-existing conditions - was unable to withstand the shock of the fall and broken hip, so her heart stopped and insufficient oxygen was supplied to her brain.
The wrongful-death instruction that was given required the jury to find liability only if R
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