Meeting the Burden of Proof in a New Jersey Medical Malpractice Case

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When You Allege Medical Negligence in NJ, How Do You Prove it?

How to Meet the Burden of Proof in a Medical Malpractice Case in NJ

To recover your losses due to a medical professional’s or healthcare facility’s negligence, you must file a medical malpractice claim. When you do, you are the plaintiff and you have the burden to prove that the medical provider, hospital, or other medical professional or facility is responsible for your injury. This is true in standard medical malpractice cases; however, there are exceptions to the general rule, and the process to successfully meet the burden of proof is by no means simple. When you have been impacted by medical malpractice, understanding what is required and what is involved in effectively accomplishing the goal of establishing liability for a medical provider’s or facility’s negligent conduct is essential.

Standard of Proof for a Medical Malpractice Claim

In a medical malpractice case, you must convince a jury by a preponderance of the evidence of a defendant’s negligence that caused your damages. A preponderance of the evidence means when weighing the evidence, the jury concludes that it is more likely than not that a defendant caused your injury.

Meeting the Burden of Proving Medical Malpractice

When your doctor is negligent, you must prove it. More specifically, you must first establish the doctor breached their duty to practice medicine the way careful, skilled, and diligent practitioners do in the same community under similar circumstances. You must further prove that the breach caused severe injury and damages. Legally, a plaintiff needs medical experts to establish the community’s standard of care and connect the negligence to the cause of the injury. In most cases, a non-medical witness does not have the education or experience to prove the connection between the negligence and the injury. A lay witness may not convince a jury by a preponderance of the evidence, and New Jersey requires much more to establish liability.

When a medical expert testifies that your injuries occurred because your doctor did not do what other doctors would have done under the same conditions, the jury can believe that, more likely than not, the doctor’s negligence caused your damages. Nevertheless, that’s not the end of it. Without damages, a plaintiff has no claim. Doctors can make mistakes that injure you, but you might not have a legal claim if you did not experience physical, psychological, and/or financial losses. Therefore, a plaintiff must further prove that the negligence caused damages, such as medical bills, lost wages, and pain and suffering, among other economic and noneconomic losses.

In sum, proving a prima facie negligence cause of action, a plaintiff convinces a jury that negligent conduct falls below a legally recognizable standard that protects patients from unreasonable risks of injury. Further, providing substandard medical treatment and exposing a patient to harm is a breach of a provider’s duty not to expose a patient to such injury risk. When medical professionals breach that duty by causing injury, they are liable for any resulting damages and must compensate the injured party. Finally, an expert must establish and affirm the standard of care, breach, and causal connection to the injury.

Establishing that Negligence Occurred by a Healthcare Provider or Facility

A medical expert has the knowledge, training, and experience to give a credible opinion on the standard of care, breach, and reasonably probable cause of damages by examining what the defendant did, and given their training, education, and experience, what they should have done. For example, when an obstetrician fails to test a pregnant patient with a history of hypertension or symptoms for preeclampsia, an equally situated obstetrician who is called upon as an expert witness, can testify that the standard practice with this type of patient is periodic testing for preeclampsia and continuous monitoring throughout the gestational course. They can further testify that testing could have avoided the resulting birth injury for the baby or serious complications affecting the mother.

Exceptions to the General Rule

Notable exceptions to the rule requiring medical expert testimony are the common knowledge and res ipsa loquitur doctrines.

Understanding the Common Knowledge Doctrine

Expert testimony may be deemed unnecessary when a jury can understand the standard of care from a layperson’s common knowledge and experience. As such, self-evident or immediately apparent matters, such as doctors removing the left kidney when the right one was cancerous, do not generally need medical experts to establish the standard of care and breach. A jury could easily conclude that a surgeon did not act reasonably in failing to check the patient’s chart or mark the patient’s skin for the proper surgical target, an extreme surgical error that may be considered a “never event.”

Unpacking Res Ipsa Loquitur

Experts are not always necessary in res ipsa loquitur (“the thing speaks for itself”) cases, either. The plaintiff must only prove their injury and the surrounding circumstances but not the standard of care when negligence is apparent, the medical professional defendant had exclusive control over the method, practice, or procedure involved, and the plaintiff did not contribute to their injury. In other words, the plaintiff’s injury could not have reasonably occurred but for the medical professional’s negligence. In this case, the jury can conclude that it is more likely than not that the medical professional in charge was negligent since an injury like the plaintiff’s does not occur in the absence of negligence.

Res ipsa loquitur allows the jury to infer negligence and burdens the defendant with explaining what happened to cause the injury. In essence, these situations presume that the defendant is in a better position to do so, because they were in control of the means and conditions of medical treatment. The focus shifts to the defendant, for instance, when patients are unconscious and cannot know what transpired while they were non-cognizant.

Fundamentals of the Anderson v. Somberg Case

Similarly, the Anderson doctrine shifts the burden of proof to the defendant to show negligence did not occur. Derived from Anderson v. Somberg 67 N.J. 291 (1975), the Anderson doctrine requires defendants to prove they are not liable rather than merely explaining how an injury occurred. It is a more stringent burden shift than res ipsa loquitur. In Anderson, a patient was unconscious during laminectomy surgery when an instrument broke and lodged in the plaintiff’s spinal canal. As a result, the patient underwent several more surgeries and suffered permanent injuries. The jury found for the defendants, as the plaintiff could not pinpoint who was negligent.

On appeal, the court determined that clearly, someone was negligent and should be liable. The New Jersey Supreme Court took up the appeal and outlined what a plaintiff must prove to shift the burden of proof to the named defendants. The plaintiff must prove they are not responsible for the injury, that the injury results from negligence from one or more defendants, and all parties involved in the incident are named defendants in the lawsuit. Anderson applies to cases wherein plaintiffs are under anesthesia and are blameless in causing unforeseeable injury unrelated to the surgery. After proving those circumstances, all defendants possibly responsible face the burden of proving they were not negligent.

Anderson is critical to those alleging injuries due to medical negligence during a surgical procedure. For those patients injured under anesthesia, proof of what happened is difficult, but now medical providers must disprove negligence when the patient’s injury is not even remotely related to the patient’s procedure. Still, plaintiffs must rely on definitive evidence to prove negligence in other instances, such as medical records, test results, witness statements, hospital policies, and evidence of physical injury such as photos or videos, when the culprit is ascertainable.

Fronzuto Law Group is on Your Side

When you are seeking to initiate a medical malpractice lawsuit, it is critically important to have the assistance of an experienced medical malpractice attorney who understands the intricacies of the burden of proof, how to meet it, and who bears the burden of proof, depending on the circumstances. Our accomplished medical malpractice law firm has a vast background handling a myriad of different types of medical malpractice cases. We are uniquely focused in this area of law in New Jersey and equipped to take on the most complex cases, investigating the course of treatment, charting the sequence of events, calling upon medical experts, assembling the necessary evidence, and successfully meeting the burden of proof to establish medical negligence on the part of a healthcare facility or medical professional. In some cases, we establish liability for damages among multiple defendants who were responsible for our clients’ injuries.

No matter how challenging your malpractice claim may seem, our legal team has the knowledge and fortitude to assist you. Contact us for a free consultation online or by calling 973-435-4551.

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