Author: Allie Anderson
This article analyses the nature and meaning of causation in medical negligence matters. It looks at a recent case in which a hospital admitted it breached its duty of care but denied that this negligence caused the harm suffered by the Plaintiff.
Case study
A recent case of Alrifai v Australian Capital Territory [2022] ACTSC 48 https://jade.io/article/909218 highlights the challenges of proving causation in medical negligence cases.
In that case, the Plaintiff presented to Canberra Hospital in December 2017 with chest pain. Months after her presentation she underwent a number of scans and investigations which led to a diagnosis of pancreatic cancer 11 months later. The Plaintiff contended that scans taken between January – April 2018 showed a detectable mass in the pancreas that should have been referred for surgical opinion earlier and had that been done, there would have been a recommendation to remove tumour which would have been occurred before November 2018 and she would have avoided the injuries claimed.
The hospital admitted it breached its duty of care which led to a six-month delay in diagnosis and treatment. However, it denied that this delay caused any damage to the Plaintiff. To succeed, the Plaintiff needed to establish on the balance of probabilities (more likely than not) that:
- She would have undergone her surgery earlier but for the negligent delay in diagnosis; and
- Had she undergone earlier surgery, she would have avoided the pain and suffering of chemotherapy and the terminal diagnosis.
The Court preferred the evidence of the Defendant’s expert which was that that treatment six months prior was unlikely to have avoided the terminal diagnosis given the dismal prognosis associated with pancreatic cancer. The Plaintiff’s claim for pain and suffering resulting from the operation and chemotherapy was also rejected because the treatment – and therefore outcome – would have been the same regardless of when the operation took place.
Our thoughts
The issue of causation in cancer cases is often more difficult because it is often argued that the breach (delay in diagnosis and/or treatment) did not cause the adverse outcome – that is, that the cancer had already progressed and that earlier diagnosis would have made little difference to the outcome. However, that is not always the case and legal advice should be sought. If you have experienced a poor outcome because of a delay in diagnosis or treatment of cancer, our medical negligence team can help you assess the merits of your claim.
