Opinion ID: 1782594
Heading Depth: 1
Heading Rank: 9

Heading: Medical Malpractice Cases

Text: We have searched for an appropriate analogy to help us resolve the issue. In the context of a medical neglect case, for example, courts in this state have concluded that (1) the cause of an initial injury which may require medical assistance is not ordinarily considered as a legal cause of injuries resulting from the subsequent negligence of the medical-care provider; [11] and (2) an initial wrongdoer who causes an injury is not to be considered a joint tortfeasor [12] with a subsequent medical provider whose negligence enhances or aggravates injuries caused by the initial wrongdoer. In other words, in cases involving medical malpractice, the cause of the underlying condition that brought the patient to the professional, whether a disease or an accident, is not to be compared to the cause of the independent enhanced injury allegedly resulting from medical neglect. See Frank M. Stuart, M.D., P.A. v. Hertz Corp., 351 So.2d 703 (Fla.1977). In Hertz Corp. we held: Having finally decided the issue in favor of contribution among joint tortfeasors in Lincenberg v. Issen, 318 So.2d 386 (Fla.1975), the Court here finds itself faced with the question of whether to apportion the loss between initial and subsequent rather than joint or concurrent tortfeasors. This cannot be done. Id. at 706. In Hertz Corp. we held that an initial tortfeasor, upon being sued by the injured party, could not join a medical professional in the same action and seek indemnity for damages caused by medical negligence in the treatment of the injured party. However, this principle is to be distinguished from the principle that the initial tortfeasor may be held responsible for all subsequent injuries including those caused by medical negligence. See Hertz Corp.; see also Underwriters at Lloyds v. City of Lauderdale Lakes, 382 So.2d 702, 703 (Fla. 1980); Association for Retarded Citizens-Volusia, Inc. v. Fletcher, 741 So.2d 520, 524-25 (Fla. 5th DCA 1999); Dungan v. Ford, 632 So.2d 159, 162 (Fla. 1st DCA 1994); Rucks v. Pushman, 541 So.2d 673, 675 (Fla. 5th DCA 1989). In fact, the rule of complete liability of initial tortfeasors, if interjected into the trial of a claim for medical malpractice or secondary collisions based upon a product defect, would only serve to create additional confusion for a jury charged to resolve the secondary collision claim. See Hertz Corp., 351 So.2d at 706. [13] The circumstances considered in Whitehead v. Linkous, 404 So.2d 377 (Fla. 1st DCA 1981), further illustrate the medical malpractice analogy. In Whitehead, the plaintiff's decedent was brought to the defendant hospital after he attempted to commit suicide. While under the care of the treating doctor, Whitehead died. An expert testified that the care received by Whitehead deviated from the standard practice in the community and that but for the doctor's negligence, Whitehead would have survived. The jury was instructed that it could consider Whitehead's own conduct as a defense to the medical malpractice claim against the doctor and hospital and the jury returned a verdict for the defense. On appeal, however, the First District reversed, holding that Whitehead's conduct was too remote and could not be considered the proximate legal cause of his injuries from the alleged professional malpractice. The court reasoned: A remote condition or conduct which furnishes only the occasion for someone else's supervening negligence is not a proximate cause of the result of the subsequent negligence.... Since Whitehead's death would not have occurred but for the negligent acts or omissions of the hospital and the doctor, those acts and omissions must be deemed the cause of the injury. See Fellows v. Citizens Savings & Loan Association of St. Lucie County, 383 So.2d 1140 (Fla. 4th DCA 1980); Bryant v. Jax Liquors, 352 So.2d 542 (Fla. 1st DCA 1977). Stated differently, any conduct on Whitehead's part before he entered the hospital which contributed to his cardiac and pulmonary arrest and subsequent death was not a proximate, legal cause of the damages sought in this case. Accordingly, we find that the trial court erred in submitting the instruction on comparative negligence to the jury over the prior and timely objection of counsel. Id. at 379 (emphasis added). [14] The reasoning in Whitehead is similar to the rationale upon which the minority view of the application of comparative fault principles to the crashworthiness doctrine is based. Both focus on the particular cause of the damages sought in this case. Id. As noted above, unlike automobile accidents involving damages solely arising from the collision itself, a defendant's liability in a crashworthiness case is predicated upon the existence of a distinct and second injury caused by a defective product, and assumes the plaintiff to be in the condition to which he is rendered after the first accident. No claim is asserted, however, to hold the defendant liable for that condition. Thus, crashworthiness cases involve separate and distinct injuries-those caused by the initial collision, and those subsequently caused by a second collision arising from a defective product. We agree that when viewed in this light, crashworthiness cases may be analogized to medical malpractice cases involving a successive negligent medical provider who is alleged to have either aggravated an existing injury or caused a separate and additional injury. Thus, just as the injury-causing fault of the patient in Whitehead was held not relevant in assessing the doctor's subsequent and separate negligence, the accident-causing fault of the driver would not be relevant in crashworthiness cases in assessing a manufacturer's neglect in designing an automobile or its parts. The initial accident merely furnished the occasion for the manufacturer's fault to be tested. Hence, a primary collision, by whatever cause, is presumed to have occurred in crashworthiness cases, and it is further presumed that a manufacturer, like a physician, may not be held responsible for the injuries caused by the primary collision. Further, only the cause of the enhanced injury is at issue in crashworthiness cases such as those at issue here because the only damages sought are those caused by the defective products. Thus the focus in such cases against a manufacturer is not on the conduct that gave rise to the initial accident, but rather, on the conduct that allegedly caused the enhanced or secondary injuries. It will always be conceded in such cases that the fault of others was completely responsible for the happening of the first accident. However, as with medical negligence cases, the accident or event giving rise to the initial injuries merely creates the occasion for the second impact or action to occur. We agree that to automatically compare the fault of the driver in causing the accident with the fault of the automobile manufacturer for the subsequent enhanced injury would be, as Reichert explains, to confuse two different causes-the cause of the accident and the cause of the enhanced injury. See Reichert, Limitations on Manufacturer Liability in Second Collision Actions, supra, at 117-18. The essential point is that under the crashworthiness doctrine, as in medical malpractice cases, the initial collision and its separate cause is always presumed, and the cause of the initial collision is simply not at issue in the determination of the cause of the second collision. Instead, any analysis concerning the causal connection of the second collision to the separately claimed damages depends solely upon whether a defect existed and gave rise to the enhanced injuries suffered by the plaintiff.