1

S T A T E O F M I C H I G A N

C O U R T O F A P P E A L S

LINDSEY PATRICK, and

CHRISTIAN PATRICK,

Plaintiffs-Appellants,

FOR PUBLICATION

January 16, 2018

9:00 a.m.

v No. 336061

Kent Circuit Court

VIRGINIA B. TURKELSON,

AUTO-OWNERS INSURANCE COMPANY,

and CITIZENS INSURANCE COMPANY OF 

THE MIDWEST,

LC No. 15-006324-NI

Defendants-Appellees,

and

HOME-OWNERS INSURANCE COMPANY,

 Defendant.

Before: METER, P.J., and BORRELLO and BOONSTRA, JJ.

BORRELLO, J.

In this automobile negligence action, plaintiffs, Lindsey Patrick and Christian Patrick,1

appeal as of right the trial court’s order granting defendant Virginia Turkelson’s motion for 

summary disposition pursuant to MCR 2.116(C)(10) and dismissing the action with respect to all 

defendants.2 For the reasons set forth in this opinion, we reverse the trial court’s order and 

remand this matter for further proceedings consistent with this opinion.

I. BACKGROUND

This case arises out of a car accident that occurred on February 12, 2013. Lindsey was 

driving on a service road as she was leaving a Spectrum Health parking lot when a vehicle driven 

 1 Christian is Lindsey’s husband. He was not involved in the automobile accident that is the 

subject of this case, and his only claim is for loss of consortium.

2 Defendant Home-Owners Insurance Company is not a party to this appeal.
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by Turkelson turned onto the road and struck the driver’s side of Lindsey’s vehicle. Multiple 

airbags deployed inside Lindsey’s vehicle, and the side curtain airbag above the driver’s side 

door hit Lindsey on the side of her face, her left ear, and the top of her head. Lindsey referred to 

the deployment of the airbags as an “explosion.” After the accident, Spectrum Security arrived 

at the scene, and Lindsey reported that the sound in both of her ears was “very muffled” and that 

her left ear was “ringing.” 

Following the accident, Lindsey was examined in the emergency room where she 

reported experiencing sharp pain in her left ear, ringing in both ears, and a headache. She also 

reported pain in her left shoulder, lower back, left hip, and left rib cage.

Lindsey was subsequently referred to an audiologist, Pam Keenan at MacDonald 

Audiology on February 21, 2013. Keenan noted in her report that Lindsey’s primary concern 

was sudden decrease in hearing and bilateral tinnitus. An audiogram test “revealed hearing to be 

within normal limits at 250-4000Hz with a slight dip at 6 and 8000Hz.” Lindsey’s word 

recognition was “Excellent bilaterally,” and her speech recognition was in accordance with her 

other testing. The record reflects that Lindsey was administered various hearing tests that 

measured her ability to hear pure tones and speech. Keenan also noted that there was no 

previous audiogram to provide a comparison. Further testing at a March 19, 2013 visit to 

MacDonald Audiology yielded similar results. According to Lindsey, she was told by the 

audiologist that the airbag explosion caused the ringing in her ears.

On November 11, 2013, Lindsey visited the University of Michigan Health System and 

was seen by Dr. Katherine Heidenreich, a specialist in otology and neurotology who treated 

patients with ear disorders and hearing loss. According to Dr. Heidenreich’s deposition 

testimony, Lindsey reported experiencing symptoms of hearing loss and tinnitus. Dr. 

Heidenreich explained tinnitus as being a “phantom sound that somebody perceives,” which is 

“something that is inside your head that you hear, not from the environment.” Dr. Heidenreich 

further explained that people experiencing tinnitus symptoms may describe the sound as ringing, 

a tone, or the sound of the ocean.

As part of Lindsey’s examination that day, Dr. Heidenreich conducted a physical 

examination, which typically includes examining the patient’s ears, nose, oral cavity, oral 

pharynx, and the cranial nerve function. The exam was “normal.” Lindsey was also given an 

audiogram to test her hearing, and Dr. Heidenreich reviewed these results during the examination 

as well. Dr. Heidenreich testified that components of an audiogram required a patient to 

acknowledge whether or not the patient heard a sound that was presented to the patient, and Dr. 

Heidenreich acknowledged that this kind of testing relied on the patient “subjectively reporting 

what they heard.” However, she testified that the testing also included “more objective 

components as well such as the movement of the eardrum and the acoustic reflexes.” Based on 

the results of the audiogram administered to Lindsey that day, Dr. Heidenreich determined that 

Lindsey had “a mild high frequency sensorineural hearing loss in both ears but with excellent 

word recognition scores.” Dr. Heidenreich testified that sensorineural hearing loss suggests 

problems with the inner ear or nerve. With respect to tinnitus, Dr. Heidenreich explained that 

this is a symptom that is often reported by people experiencing hearing loss and that there 

typically are not objective measures that can verify the existence of this symptom. Dr. 

Heidenreich also determined that Lindsey had “an acoustic reflex abnormality.” The acoustic 
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reflex “measures the contraction of the stapedius muscle,” and abnormalities can be associated 

with middle ear bone problems or tumors. According to Dr. Heidenreich, an acoustic reflex 

abnormality might not cause any symptoms, and this particular finding might not have had any 

bearing on Lindsey’s condition.

Dr. Heidenreich testified that the literature includes reports of hearing loss and tinnitus 

following airbag deployment due to the sound generated. According to Dr. Heidenreich, it is 

possible for exposure to loud noises to cause hearing loss and tinnitus, even if an individual does 

not suffer physical trauma. Dr. Heidenreich opined that Lindsey’s hearing issues were related to 

the car accident based on Lindsey’s audiogram results and her history, which included her 

reports of experiencing an immediate decline in hearing, muffled hearing, and tinnitus right after 

the car accident in which the airbags deployed. Dr. Heidenreich opined that this history 

suggested that Lindsey had experienced a negative change in her hearing as compared to her preaccident hearing capabilities and that Lindsey’s exposure to the loud sound from the airbags 

could have caused her symptoms. However, Dr. Heidenreich acknowledged that there was no 

audiogram for Lindsey from before the accident for comparison and that hearing can deteriorate 

due to age. Additionally, Dr. Heidenreich indicated that she did not know the cause of the 

acoustic reflex abnormality.

Lindsey testified at her deposition that the pain and muffling in her ears started 

immediately after the automobile accident and that she did not have any of these symptoms 

before the automobile accident. At the time of her deposition, she no longer suffered from 

muffled hearing, but she did still have ringing or tingling in both of her ears. Lindsey indicated 

that her hearing loss was in her left ear. Lindsey testified that she generally did not have trouble 

hearing people speaking during normal conversation unless there was a lot of background noise, 

but she had trouble hearing whispering. Lindsey was told by both the audiologist and Dr.

Heidenreich that the sound from the explosion of the airbag deploying near her ear caused her 

hearing problems.

According to Lindsey, her ear issues had a negative impact on her work because she was 

required to spend a significant amount of time in the car for work and the road noise made the 

ringing in her ears worse. She also testified that the ringing affected her ability to do her job 

because it was “distracting” and made her “very irritable.” Places with large groups of people or 

loud sounds also made the ringing worse. Before the accident, Lindsey worked approximately 

30 hours a week over the course of three days each week. At the time of her deposition, Lindsey 

was working one day a week for approximately eight hours because it was “harder to do the 

driving” and because she had small children.

Lindsey also testified during her deposition that before the accident, she had enjoyed 

outdoor activities such as kayaking, hiking, and bike riding. She also had a busy social life, 

enjoyed going to concerts, and liked to travel. Since the accident, Lindsey had been to two 

concerts, and they made the ringing in her ears worse. Lindsey also had not continued hiking or 

kayaking since the accident because she had tried these activities multiple times and found that it 

was “too quiet in the woods,” which made the ringing more noticeable. Lindsey further testified 

that her ear problems had affected her ability to take care of her children because she was less 

patient, more irritable, and more anxious.
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Lindsey’s husband, Christian, testified at his deposition that he and Lindsey had 

experienced difficulties communicating since the accident because Lindsey would speak either 

too softly or too loudly. Lindsey would also occasionally tell Christian that she was having 

trouble hearing him. According to Christian, he sometimes had to ask Lindsey to repeat herself 

because he had a hard time understanding or hearing her, and she would get frustrated during 

these interactions because she was having a hard time knowing how loud she was talking. 

Christian further testified that there were times when Lindsey did not hear questions that their 

children asked her or misheard a question and responded with an answer that was unresponsive 

to the actual question. Christian also indicated that Lindsey was “more irritable” than before the 

car accident. Christian testified that Lindsey had indicated that she could not go on road trips or 

go to concerts with him because of her hearing issues. He also had to keep music at a quieter 

volume inside the house. Lindsey could watch television without a problem but going to movies 

gave her trouble.

Lindsey filed this action on July 10, 2015. Lindsey specified in her deposition that her 

claim of injury resulting from the automobile accident involved her hearing loss and ringing in 

her ears. Defendant Turkelson moved for summary disposition under MCR 2.116(C)(10), 

arguing that Lindsey did not suffer a serious impairment of body function and that any injury 

was not caused by the car accident. Defendants Auto-Owners Insurance Company and HomeOwners Insurance Company concurred in Turkelson’s motion.

The trial court granted Turkelson’s motion for summary disposition and dismissed the 

action in its entirety with respect to all defendants, ruling that there was no genuine issue of 

material fact regarding whether Lindsey suffered a serious impairment of body function. 

Specifically, the trial court concluded that Lindsey had “not shown any objective manifestation 

of her subjective complaints of tinnitus or otherwise demonstrated any physical basis for those 

complaints,” that her hearing loss was “mild” and was “not a manifestation of or physical basis 

for tinnitus,” and that there was “no indication that plaintiff’s general ability to live her normal 

life is affected by that mild hearing loss.” As a result of its determination on the threshold injury 

issue, the trial court specifically declined to make a ruling regarding Turkelson’s causation 

argument. The trial court also stated that it would not address plaintiffs’ counter-motion for 

summary disposition regarding the issue of fault “because summary disposition is proper 

regardless of fault for the underlying accident.”

On appeal, plaintiffs argue that the trial court erred by concluding that her impairment 

was not objectively manifested and granting summary disposition on the ground that a serious 

impairment of body function had not been established.

II. STANDARD OF REVIEW

“This Court reviews de novo a trial court’s decision on a summary disposition motion to 

determine if the moving party was entitled to judgment as a matter of law.” Bergman v 

Cotanche, 319 Mich App 10, 15; 899 NW2d 754 (2017). “In making this determination, the 

Court reviews the entire record to determine whether defendant was entitled to summary 

disposition.” Maiden v Rozwood, 461 Mich 109, 118; 597 NW2d 817 (1999). “Courts are 

liberal in finding a factual dispute sufficient to withstand summary disposition.” Innovative 

Adult Foster Care, Inc v Ragin, 285 Mich App 466, 476; 776 NW2d 398 (2009).
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“A motion for summary disposition brought pursuant to MCR 2.116(C)(10) tests the 

factual support for a claim.” Id. at 474-475. “Summary disposition is appropriate under MCR 

2.116(C)(10) if there is no genuine issue regarding any material fact and the moving party is 

entitled to judgment as a matter of law.” West v Gen Motors Corp, 469 Mich 177, 183; 665 

NW2d 468 (2003). A motion pursuant to MCR 2.116(C)(10) is reviewed “by considering the 

pleadings, admissions, and other evidence submitted by the parties in the light most favorable to 

the nonmoving party.” Latham v Barton Malow Co, 480 Mich 105, 111; 746 NW2d 868 (2008). 

“A genuine issue of material fact exists when the record, giving the benefit of reasonable doubt 

to the opposing party, leaves open an issue upon which reasonable minds might differ.” West, 

469 Mich at 183. “[I]t is well settled that the circuit court may not weigh the evidence or make 

determinations of credibility when deciding a motion for summary disposition.” Innovative 

Adult Foster Care, 285 Mich App at 480. Moreover, a court may not “make findings of fact; if 

the evidence before it is conflicting, summary disposition is improper.” Lysogorski v Bridgeport 

Charter Twp, 256 Mich App 297, 299; 662 NW2d 108 (2003) (quotation marks and citation 

omitted).

III. ANALYSIS

Tort liability is limited under the Michigan no-fault insurance act. McCormick v Carrier, 

487 Mich 180, 189; 795 NW2d 517 (2010). However, a “person remains subject to tort liability 

for noneconomic loss caused by his or her ownership, maintenance, or use of a motor vehicle 

only if the injured person has suffered death, serious impairment of body function, or permanent 

serious disfigurement.” MCL 500.3135(1) (emphasis added). The issue in the instant case is 

whether there is a genuine issue of material fact regarding whether Lindsey suffered a serious 

impairment of body function. The other two types of threshold injuries are not implicated here.

The term “serious impairment of body function” is defined by statute as “an objectively 

manifested impairment of an important body function that affects the person’s general ability to 

lead his or her normal life.” MCL 500.3135(5). Under McCormick, the test for establishing a 

serious impairment of body function requires showing “(1) an objectively manifested impairment 

(2) of an important body function that (3) affects the person’s general ability to lead his or her 

normal life.” McCormick, 487 Mich at 195.

First, an objectively manifested impairment is one “that is evidenced by actual symptoms 

or conditions that someone other than the injured person would observe or perceive as impairing 

a body function.” Id. at 196. The inquiry focuses on “whether the impairment is objectively 

manifested, not the injury or its symptoms.” Id. at 197. Impairment means the state of (1) 

“being weakened, diminished, or damaged” or (2) “functioning poorly or inadequately.” Id. 

(quotation marks and citation omitted). Although mere subjective complaints of pain and 

suffering are insufficient to show impairment, evidence of a physical basis for that pain and 

suffering may be introduced to show that the impairment is objectively manifested. Id. at 198. 

Medical testimony is generally, but not always, required to make this showing. Id.

Second, the important-body-function inquiry is “an inherently subjective” one. Id. at 

199. The focus is on whether the body function “has great value, significant, or consequence,”

and the relationship of that function to the individual’s life must be considered. Id. (quotation 

marks and citation omitted).
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Third, the impairment to an important body function affects a person’s general ability to 

lead a normal life if it has “an influence on some of the person’s capacity to live in his or her 

normal manner of living.” Id. at 202. This is also a subjective inquiry. Id. The statute does not 

require the person’s ability to lead a normal life to have been destroyed or for the impairment to 

last a certain period of time. Id. at 202-203. The statute only requires that the impairment affect

the person’s ability to live in his or her normal manner of living. Id. at 202. The focus is not on 

whether a person’s normal manner of living itself has been affected, and “there is no quantitative 

minimum as to the percentage of a person’s normal manner of living that must be affected.” Id. 

at 202-203.

However, the issue of whether a serious impairment of body function has been incurred is 

a question of law to be decided by the court only if (1) “[t]here is no factual dispute concerning 

the nature and extent of the person’s injuries” or (2) “[t]here is a factual dispute concerning the 

nature and extent of the person’s injuries, but the dispute is not material to the determination 

whether the person has suffered a serious impairment of body function.” MCL 500.3135(2)(a)(i) 

and (ii). Accordingly, in McCormick, 487 Mich at 215, our Supreme Court instructed courts 

applying MCL 500.3135 to begin by determining “whether there is a factual dispute regarding 

the nature and the extent of the person’s injuries, and, if so, whether the dispute is material to 

determining whether the serious impairment of body function threshold is met.” When there is a 

genuine issue of material fact regarding the nature and extent of a person’s injuries, the threshold 

question of whether there was a serious impairment of body function is for the jury and may not 

be decided as a matter of law. Chouman v Home Owners Ins Co, 293 Mich App 434, 444; 810 

NW2d 88 (2011).

A. PLAINTIFF’S HEARING LOSS CONSTITUTES AN OBJECTIVELY 

MANIFESTED IMPAIRMENT.

On their motions for summary disposition, defendants argued that Lindsey’s hearing loss 

does not constitute an objectively manifested impairment. The trial court agreed. We disagree.

Review of the record evidence submitted in this matter reveals that Lindsey complained 

of problems related to hearing loss and ringing in her ears immediately following the car 

accident and that Dr. Heidenreich determined that Lindsey had mild high frequency 

sensorineural hearing loss in both ears and an acoustic reflex abnormality. Lindsey’s hearing 

loss was documented in the results of audiograms that tested her hearing as part of her 

evaluations by audiologist Keenan and Dr. Heidenreich. Defendants argue, and the trial court 

seemingly agreed, that because there exists a subjective component to the hearing tests, namely 

that Lindsey must indicate when she hears a particular sound, Dr. Heidenreich’s conclusions 

were not evidence of an objectively manifested impairment. Rather, defendants contend, the 

testing which revealed hearing loss was dependent on the subjective verifications of Lindsey and 

thus, her hearing loss does not constitute an objectively manifested impairment. However, the 

fact that there exists a subjective component to the hearing test does not negate a finding that 

Lindsey’s hearing loss is an objectively manifested impairment. Additionally, the record also 

reveals that in addition to Keenan and Dr. Heidenreich’s findings, Lindsey’s husband, Christian, 

testified that Lindsey had difficulties after the accident with speaking too softly or too loudly, 

which made it hard for him to understand her. Christian observed Lindsey experiencing 

frustration over her own lack of awareness about the volume of her voice. Christian also 
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testified that Lindsey sometimes did not hear questions that were asked of her and that Lindsey 

sometimes responded to questions in a way that showed that she did not accurately hear the 

question. Based on his observations of his wife’s actions, Christian testified that Lindsey was 

having difficulty hearing adequately in everyday situations. The evidence of Lindsey’s medical 

evaluations and Christian’s testimony supports finding that a question of fact exists as to whether 

Lindsey’s hearing was impaired. This impairment to her hearing was observable by others, 

which would satisfy the standard for showing an “objectively manifested impairment.” 

McCormick, 487 Mich at 196-198. “In other words, an ‘objectively manifested’ impairment is 

commonly understood as one observable or perceivable from actual symptoms or conditions.” 

Id. at 196.)

Keenan, Dr. Heidenreich and Christian testified as to their observations. All three

testified that Lindsey suffered a hearing loss. Additionally, Lindsay testified that her hearing 

was muffled after the accident3 and that she suffered from tinnitus. Dr. Heidenreich testified that 

while it is not possible to test for tinnitus, both symptoms Lindsey complained of are consistent 

with air bag explosions. Hence, examination of the entirety of the record in the light most 

favorable to plaintiff plainly reveals that Lindsey’s complained of symptoms and conditions were 

observed and perceived by Keenan and Dr. Heidenreich’s testing as well as the testimony of 

Christian. Consequently, plaintiff has demonstrated, in accord with McCormick, that there is a 

physical basis for her complaints. See, McCormick, 487 Mich at 198. 

Moreover, contrary to its role in deciding a motion under MCR 2.116(C)(10), the trial 

court weighed the evidence. While testing a person’s hearing necessarily involves self-reporting 

by the person being tested, the record reflects that this testing also includes objective components 

(such as examining the movement of the eardrum and acoustic reflexes) and is relied on by 

medical professionals. Both Keenan and Dr. Heidenreich examined Lindsey and considered her 

audiogram results, and they drew conclusions about the condition of her hearing based on their 

medical findings. The fact that Dr. Heidenreich used the word “subjective” in describing this 

self-reporting process does not completely negate the significance of her determinations. Nor 

does Dr. Heidenreich’s description of ringing in the ears as the hearing of a “phantom” sound 

dispositively affect the analysis: her description illustrates the entire problem that a person with 

this symptom experiences—hearing a sound that is not heard by anybody else because it is not 

generated in the external environment. According to Dr. Heidenreich, tinnitus is a symptom 

commonly experienced by people with hearing loss. The words used by Dr. Heidenreich in her 

explanations cannot be used out of context to render Lindsey’s claimed hearing impairment 

nonexistent as a matter of law. Yet the trial court essentially focused on these two words, to the 

exclusion of all the other evidence in the record, as providing dispositive proof that Lindsey’s 

hearing problems were somehow a figment of her imagination. As previously discussed, 

Lindsey’s hearing issues manifested themselves in ways that were observable by Christian and 

documented by medical professionals, and the record contains evidence of these medical 

findings. Lindsey clearly was not making unverifiable, subjective complaints of mere pain and 

suffering. Rather, she provided evidence which if believed would establish a physical basis for 

 3 It is unclear from this record whether Lindsey’s hearing is still, as she described it, “muffled.” 
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her complaints. See McCormick, 487 Mich at 198. In sum, an injury is an “objectively 

manifested impairment” if it is “commonly understood as one observable or perceivable from 

actual symptoms or conditions.” Id. at 196. Here, Lindsey produced evidence from medical 

professionals and others that create questions of fact as to the nature and extent of her 

impairment she alleges arose from her car accident. The fact that some subjective testing 

methods are incorporated into these medical findings does not negate her impairment as being an 

objectively manifested impairment. Rather, the trial court erred by failing to follow the factors 

set forth in McCormick when deciding whether Lindsey’s impairment is objectively manifested. 

Additionally, the trial court erred by making its own evaluations regarding the persuasiveness of 

the medical evidence related to Lindsey’s hearing. Innovative Adult Foster Care, 285 Mich App 

at 480. Accordingly, reversal of the trial court’s ruling on this issue is warranted.

B. HEARING IS AN IMPORTANT BODY FUNCTION.

“If there is an objectively manifested impairment of body function, the next question is 

whether the impaired body function is ‘important.” McCormick, 487 Mich at 198. As stated in 

McCormick:

The relevant definition of the adjective “important” is “[m]arked by or having 

great value, significance, or consequence.” The American Heritage Dictionary, 

Second College Edition (1982). See also Random House Webster’s Unabridged 

Dictionary (1998), defining “important” in relevant part as “of much or great 

significance or consequence,” “mattering much,” or “prominent or large.”

Whether a body function has great “value,” “significance,” or “consequence” will 

vary depending on the person. Therefore, this prong is an inherently subjective 

inquiry that must be decided on a case-by-case basis, because what may seem to 

be a trivial body function for most people may be subjectively important to some, 

depending on the relationship of that function to the person’s life. [487 Mich at 

199.]

On appeal, neither party disputes that hearing is a body function that has “great value,”

especially to someone who enjoys going to concerts like Lindsey did. Neither party raised an 

issue relative to whether hearing constitutes an important body function, nor did the trial court 

address this issue. We therefore turn to the third prong in the McCormick factors to determine if 

a question of fact exists relative to whether Lindsey’s hearing loss affects her general ability to 

lead a normal life. 

C. QUESTIONS OF FACT EXIST AS TO WHETHER PLAINTIFF’S HEARING LOSS 

AFFECTS HER GENERAL ABILITY TO LEAD A NORMAL LIFE.

As stated in McCormick, 487 Mich at 200-201, the test utilized to determine whether the 

impairment affects the person’s general ability to lead their normal life is:

[I]f the injured person has suffered an objectively manifested impairment of body 

function, and that body function is important to that person, then the court must 

determine whether the impairment “affects the person’s general ability to lead his 
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or her normal life.” The common meaning of this phrase is expressed by the 

unambiguous statutory language, and its interpretation is aided by reference to a 

dictionary, reading the phrase within its statutory context, and limited reference to 

Cassidy.

To begin with, the verb “affect” is defined as “[t]o have an influence on; 

bring about a change in.” The American Heritage Dictionary, Second College 

Edition (1982). An “ability” is “[t]he quality of being able to do something,” id., 

and “able” is defined as “having sufficient power, skill, or resources to 

accomplish an object,” Merriam-Webster Online Dictionary, 

<http://www.merriam-webster.com> (accessed May 27, 2010). The adjective 

“general” means:

1. Relating to, concerned with, or applicable to the whole or every 

member of a class or category. 2. Affecting or characteristic of the majority of 

those involved; prevalent: a general discontent. 3. Being usually the case; true or 

applicable in most instances but not all. 4. a. Not limited in scope, area, or 

application: as a general rule. b. Not limited to one class of things: general 

studies. 5. Involving only the main features of something rather than details or 

particulars. 6. Highest or superior in rank.” [The American Heritage 

Dictionary, Second College Edition (1982).]

MCL 500.3135 defines a “serious impairment of body function” as “an objectively 

manifested impairment of an important body function that affects the person’s general ability to 

lead his or her normal life.” MCL 500.3135(7). The Legislature also expressly provided that 

whether a serious impairment of body function has occurred is a “question[] of law” for the court 

to decide unless there is a factual dispute regarding the nature and extent of injury and the 

dispute is relevant to deciding whether the standard is met. MCL 500.3135(2)(a). McCormick, 

487 Mich at 190-191. In this case, the trial court erred by deciding whether a serious impairment 

has occurred because a factual dispute exists regarding the nature and extent of the injury. 

Our Supreme Court stated in McCormick, 487 Mich at 202, that “the plain text of the 

statute . . . demonstrate[s] that the common understanding of to ‘affect the person’s ability to 

lead his or her normal life’ is to have an influence on some of the person’s capacity to live in his 

or her normal manner of living . . . [which] requires a subjective, person-and fact-specific inquiry 

that must be decided on a case-by-case basis.” In order to make such a determination, we 

compare the plaintiff’s life before and after the incident.4

 4 This method of analysis purposefully differs from that employed by the trial court. The trial 

court seemed to quantify the impairment, calling it “mild” and “only in one ear,” despite the 

specific instruction in McCormick that: “there is no quantitative minimum as to the percentage of 

a person’s normal manner of living that must be affected.”
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There was record evidence to support a finding that Lindsey’s symptoms of hearing loss 

influenced her ability to live in her normal manner of living: she had trouble communicating 

with her family, and her tinnitus made it difficult to drive for long periods as required by her 

work, to attend concerts, and to engage in the outdoor activities that she enjoyed before the 

accident. We also note that the record reveals Lindsey could still hear normal conversation and 

that some of her hearing issues, such as her complaints of muffled hearing, may have been 

resolved. Dr. Heidenreich testified that Lindsey reported that her tinnitus was less intrusive 

while she was concentrating on caring for her young baby. Additionally, although Dr. 

Heidenreich testified that Lindsey had hearing loss in both ears, Lindsey testified that she noticed 

the loss of hearing in her left ear. There was also testimony that Lindsey had still participated in 

many of the activities that she enjoyed before the accident, even though she sometimes 

experienced heightened ringing in her ears afterward. 

Based on this record evidence, we conclude there was conflicting evidence directly 

related to determining whether Lindsey’s claimed injury qualified as a serious impairment of 

body function. Based on this conflicting evidence, there was a genuine issue of fact regarding 

the nature and extent of the impairment to Lindsey’s hearing and that was material to the 

threshold injury determination; thus, the trial court erred by ruling on this question as a matter of 

law and granting summary disposition in favor of defendants. McCormick, 487 Mich at 215; 

Chouman, 293 Mich App at 444; Lysogorski, 256 Mich App at 299. Accordingly, reversal is 

warranted on this issue.

D. CAUSATION.

Although the trial court did not rule on defendants’ causation arguments, defendants 

argue on appeal (1) that a plaintiff must still show under McCormick that the alleged impairment 

was caused by the motor vehicle accident and (2) that plaintiffs failed to establish that Lindsey 

suffered an objectively manifested impairment related to her ears that was caused by the car 

accident. To the extent that defendants’ argument implicates the issue of causation, we find it 

necessary to address this issue because of the possibility that defendants could be entitled to have 

the trial court’s ruling affirmed on alternate grounds if defendants were correct. See Adell 

Broadcasting Corp v Apex Media Sales, 269 Mich App 6, 12; 708 NW2d 778 (2005) (stating that 

a trial court’s ruling granting summary disposition may be affirmed on an alternate ground that 

was not decided by the trial court if the issue was presented to the trial court).

Proximate causation is a required element of a negligence claim. Loweke v Ann Arbor 

Ceiling & Partition Co, LLC, 489 Mich 157, 162; 809 NW2d 553 (2011). Causation is an issue 

that is typically reserved for the trier of fact unless there is no dispute of material fact. Holton v 

A+ Ins Assoc, Inc, 255 Mich App 318, 326; 661 NW2d 248 (2003).

“To establish proximate cause, the plaintiff must prove the existence of both cause in fact 

and legal cause.” Weymers v Khera, 454 Mich 639, 647; 563 NW2d 647 (1997). While the term 

“proximate cause” is also a term of art for the concept of legal causation, Michigan Courts have

historically used the term proximate cause “both as a broader term referring to factual causation 

and legal causation together and as a narrower term referring only to legal causation.” Ray v 

Swager, 501 Mich 52, 63; 903 NW2d 366 (2017). However, in Ray, the Michigan Supreme 

Court explained that “[a]ll this broader characterization recognizes . . . is that a court must find 
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that the defendant’s negligence was a cause in fact of the plaintiff’s injuries before it can hold 

that the defendant’s negligence was the proximate or legal cause of those injuries.” Id. at 63-64 

(quotation marks and citation omitted). The Ray Court also reiterated that “ ‘[p]roximate cause’

has for a hundred years in this state, and elsewhere, been a legal term of art; one’s actions cannot 

be a or the ‘proximate cause’ without being both a factual and a legal cause of the plaintiff’s 

injuries.” Id. at 83.

Establishing cause in fact requires the plaintiff to “present substantial evidence from 

which a jury may conclude that more likely than not, but for the defendant’s conduct, the 

plaintiff’s injuries would not have occurred.” Id. at 647-648 (quotation marks and citation 

omitted). Although causation cannot be established by mere speculation, see id. at 648, a 

plaintiff’s evidence of causation is sufficient at the summary disposition stage to create a 

question of fact for the jury “if it establishes a logical sequence of cause and effect, 

notwithstanding the existence of other plausible theories, although other plausible theories may 

also have evidentiary support.” Wilson v Alpena Co Rd Comm, 263 Mich App 141, 150; 687 

NW2d 380 (2004) (quotation marks and citation omitted).

“To establish legal cause, the plaintiff must show that it was foreseeable that the 

defendant’s conduct may create a risk of harm to the victim, and . . . [that] the result of that 

conduct and intervening causes were foreseeable.” Weymers, 454 Mich at 648 (quotation marks 

and citation omitted; alterations in original). Our inquiry “normally involves examining the 

foreseeability of consequences, and whether a defendant should be held legally responsible for 

such consequences.” Campbell v Kovich, 273 Mich App 227, 232; 731 NW2d 112 (2006) 

(quotation marks and citation omitted). “The general rule, expressed in terms of damages, and 

long followed in this State, is that in a tort action, the tort-feasor is liable for all injuries resulting 

directly from his wrongful act, whether foreseeable or not, provided the damages are the legal 

and natural consequences of the wrongful act, and are such as, according to common experience 

and the usual course of events, might reasonably have been anticipated.” Sutter v Biggs, 377 

Mich 80, 86; 139 NW2d 684 (1966). When judging the foreseeability of a risk of harm, “[i]t is 

not necessary that the manner in which a person might suffer injury should be foreseen or 

anticipated in specific detail.” Clumfoot v St Clair Tunnel Co, 221 Mich 113, 116-117; 190 NW 

759 (1922).5 In other words, “[w]here an act is negligent, to render it the proximate cause, it is 

not necessary that the one committing it might have foreseen the particular consequence or 

injury, or the particular manner in which it occurred, if by the exercise of reasonable care it 

might have been anticipated that some injury might occur.” Baker v Mich Central R Co, 169 

Mich 609, 618-619; 135 NW 937 (1912).

 5 Although the Clumfoot Court was discussing the concept of foreseeability in the context of 

examining the duty element of a negligence claim, this Court has recognized that “[t]he question 

of proximate cause, like duty, depends in part on foreseeability,” Ross v Glaser, 220 Mich App 

183, 192; 559 NW2d 331 (1996).
12

Similarly, 2 Restatement Torts, 2d, § 435, p 449 states:6

(1) If the actor’s conduct is a substantial factor in bringing about harm to 

another, the fact that the actor neither foresaw nor should have foreseen the extent 

of the harm or the manner in which it occurred does not prevent him from being 

liable.

(2) The actor’s conduct may be held not to be a legal cause of harm to 

another where after the event and looking back from the harm to the actor’s 

negligent conduct, it appears to the court highly extraordinary that it should have 

brought about the harm.

Comment a to 2 Restatement Torts, 2d, § 435, pp 449-450 further explains in pertinent part as 

follows:

The fact that the actor, at the time of his negligent conduct, neither 

realized nor should have realized that it might cause harm to another of the 

particular kind or in the particular manner in which the harm has in fact occurred, 

is not of itself sufficient to prevent him from being liable for the other’s harm if 

his conduct was negligent toward the other and was a substantial factor in 

bringing about the harm. . . .

Negligent conduct may result in unforeseeable harm to another, (1) 

because the actor neither knows nor should know of the situation upon which his 

negligence operates, or (2) because a second force the operation of which he had 

no reason to anticipate has been a contributing cause in bringing about the harm. 

In neither case does the unforeseeable nature of the event necessarily prevent the 

actor’s liability.

Here, the record reflects that there was no audiogram from before the accident to show 

Lindsey’s pre-accident hearing capabilities, and Dr. Heidenreich testified that hearing loss can

occur as part of the aging process. However, Lindsey testified that she began experiencing 

hearing problems and ringing in her ears immediately following the accident, and Lindsey 

further testified that she did not have these issues before the accident. Additionally, Dr. 

Heidenreich testified that there were studies in the literature showing a connection between the 

loud sounds of airbag deployment and hearing loss, and that exposure to loud sounds could cause 

hearing loss and tinnitus even if there has been no physical trauma. Dr. Heidenreich also opined 

that based on Lindsey’s audiogram results and her history of experiencing an immediate negative 

 6 We acknowledge that the Restatement is persuasive authority. See Rowe v Montgomery Ward 

& Co, Inc, 437 Mich 627, 652; 473 NW2d 268 (1991). However, we have located no Michigan 

cases expressly adopting or rejecting this section of the Restatement, and it is in accord with the 

jurisprudence of this state as expressed in the rules cited above from Sutter, Clumfoot, and Baker. 

Therefore, we find this principle expressed in the Restatement and accompanying comments to 

be persuasive.
13

change in her hearing following the accident, Lindsey’s hearing loss and tinnitus were caused by 

her exposure to the loud sound of the airbags deploying. Based on the above evidence, a jury 

could reasonably conclude that, more likely than not, Lindsey’s hearing loss would not have 

occurred but for the car accident because she did not have any problems with her hearing before 

the accident, was exposed to the loud sound of the airbags deploying in the accident, and then 

experienced sudden and persistent hearing loss immediately following the accident. Therefore, 

although it is possible that Lindsey’s hearing loss was due to aging, plaintiffs presented evidence 

demonstrating a logical sequence of cause and effect sufficient to create a genuine issue of 

material fact regarding cause in fact. Weymers, 454 Mich at 647-648; Wilson, 263 Mich App at 

150.

Additionally, injuries of various kinds, including injuries involving the head, are 

obviously a foreseeable result of negligently causing a motor vehicle accident. Although hearing 

damage may not be the first injury that might be expected to occur in a car accident, it is 

foreseeable that airbags may deploy during a crash and that a great deal of force and sound will 

be involved as the airbags must deploy quickly. Therefore, negligently causing a car accident 

may be considered a legal cause of hearing damage from the sound of the airbags deploying, 

even if this particular type of injury was not actually anticipated by Turkelson in the instant case. 

Sutter, 377 Mich at 86; Baker, 169 Mich at 618-619; 2 Restatement Torts, 2d, § 435, p 449.

Therefore, summary disposition also could not have been properly granted on causation 

grounds because there was a genuine issue of material fact on the current record regarding both 

the cause in fact and the legal cause of Lindsey’s hearing loss. West, 469 Mich at 183; Weymers, 

454 Mich at 647.

Reversed and remanded for further proceedings consistent with this opinion. Plaintiff, 

having prevailed, may tax costs. MCR 7.219(A). We do not retain jurisdiction.

/s/ Stephen L. Borrello 

/s/ Patrick M. Meter 

/s/ Mark T. Boonstra