Opinion ID: 2108736
Heading Depth: 2
Heading Rank: 1

Heading: statutory and common law background

Text: In order to establish a cause of action for medical malpractice, a plaintiff must establish four elements: (1) the appropriate standard of care governing the defendant's conduct at the time of the purported negligence, (2) that the defendant breached that standard of care, (3) that the plaintiff was injured, and (4) that the plaintiff's injuries were the proximate result of the defendant's breach of the applicable standard of care. [44] These common-law elements have been codified in MCL 600.2912a, which requires a plaintiff alleging medical malpractice to show that [t]he defendant, if a specialist, failed to provide the recognized standard of practice or care within that specialty as reasonably applied in light of the facilities available in the community or other facilities reasonably available under the circumstances, and as a proximate result of defendant failing to provide that standard, the plaintiff suffered an injury. Furthermore, the plaintiff in a medical malpractice case must establish the proximate causation prong of his prima facie case by a preponderance of the evidence. [45] Proximate cause is a legal term of art that incorporates both cause in fact and legal (or proximate) cause. [46] We defined these elements in Skinner v. Square D Co : The cause in fact element generally requires showing that but for the defendant's actions, the plaintiff's injury would not have occurred. On the other hand, legal cause or proximate cause normally involves examining the foreseeability of consequences, and whether a defendant should be held legally responsible for such consequences.[ [47] ] As a matter of logic, a court must find 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. [48] Generally, an act or omission is a cause in fact of an injury only if the injury could not have occurred without (or but for) that act or omission. [49] While a plaintiff need not prove that an act or omission was the sole catalyst for his injuries, he must introduce evidence permitting the jury to conclude that the act or omission was a cause. [50] It is important to bear in mind that a plaintiff cannot satisfy this burden by showing only that the defendant may have caused his injuries. Our case law requires more than a mere possibility or a plausible explanation. [51] Rather, a plaintiff establishes that the defendant's conduct was a cause in fact of his injuries only if he set[s] forth specific facts that would support a reasonable inference of a logical sequence of cause and effect. [52] A valid theory of causation, therefore, must be based on facts in evidence. [53] And while `[t]he evidence need not negate all other possible causes,' this Court has consistently required that the evidence `exclude other reasonable hypotheses with a fair amount of certainty.' [54] In Skinner, for example, we held that the plaintiff failed to show that the defendant's negligence caused the decedent's electrocution. Skinner was a product liability action in which the plaintiff claimed that the decedent was killed because an electrical switch manufactured by the defendant had malfunctioned. [55] The plaintiff's decedent had built a tumbling machine that was used to wash metal parts, and had used the defendant's switch to turn the machine on and off. [56] Wires from the defendant's switch were attached to the tumbling machine with alligator clips. [57] Immediately before his death, the plaintiff's decedent was found with both alligator clips in his hands while electricity coursed through his body. [58] In order to find that a flaw in the defendant's product was a cause in fact of that electrocution, the jury would have had to conclude, in effect, that the decedent had disconnected the alligator clips and that the machine had somehow been activated again, despite being disconnected from its power source. [59] Not only was this scenario implausible, but there was no evidence to rule out the possibility that the decedent had been electrocuted because he had mistakenly touched wires he knew to be live. There was no evidence to support the plaintiff's theory of causation. [60] Consequently, we concluded that the trial court had properly granted summary disposition to the defendant. Mulholland v. DEC Int'l, [61] provides a useful factual counterpoint to Skinner. In Mulholland, the plaintiffs' herd of milking cows contracted mastitis, a bacterial infection of the udder, after the plaintiffs began to use a milking system built by the defendants. [62] Key expert testimony was provided by Sidney Beale, an expert in agriculture and dairy science. Mr. Beale had observed a milking at the plaintiffs' farm and deduced that the mastitis was related to the improper configuration of the milking system. [63] He suggested that the plaintiffs implement certain changes, and, indeed, once these were put into practice, the plaintiffs noticed a decrease in mastitis and an increase in milk production in the herd. [64] We held, on the basis of this expert testimony, that the trial court improperly granted a directed verdict to the defendant. [65] Because Mr. Beale's testimony was based on his direct observation of the milking machinery, its use on the plaintiffs' herd, and teat inflammation in the plaintiff's herd following milking, a jury could have reasonably concluded, on the basis of this testimony, that the milking machinery caused mastitis. [66] While Mr. Beale's testimony did not rule out every other potential cause of mastitis, this fact merely related to the credibility of his testimony; his opinion was nevertheless admissible and sufficient to support a finding of causation. [67]