Opinion ID: 2429561
Heading Depth: 3
Heading Rank: 1

Heading: But for Causation

Text: Plaintiff contends that because this injury resulted from multiple tortfeasors and more than one cause, the substantial factor causation test should be applied rather than the but for test. Therefore, we need to consider whether Missouri law still includes a but for causation test, and if so, when? Finally, we will consider whether causation was submissible under the evidence in this case. The but for causation test provides that the defendant's conduct is a cause of the event if the event would not have occurred but for that conduct. Prosser and Keeton on Torts, § 41 at 266 (5th ed. 1984). Put simply, but for causation tests for causation in fact. Mere logic requires causation in fact. There has been some confusion in the Missouri cases as to when the but for causation test applies. This confusion arose as a result of the recent trend among courts to describe causation as requiring that the defendant's conduct be a substantial factor in bringing about the plaintiff's harm. The substantial factor test has become popular because in the complex litigation of today, courts are often forced to deal with claims that the conduct of more than one tortfeasor caused the harm. When considering multiple causes it is misleading to talk about the cause, and changing the terminology to a cause is too insignificant an alteration to communicate to the jury the idea of contributing causes. The upshot is that lawyers and judges feel more comfortable using substantial factor language with multiple causes because it is consistent with and better communicates the idea of more than one cause. As this Court has moved to the use of substantial factor language, the cases have suggested that the substantial factor test does not include a but for test. See Jackson v. Ray Kruse Const. Co., 708 S.W.2d 664 (Mo. banc 1986). One reason for the confusion as to when a but for test is required is because the Restatement (Second) of Torts uses substantial factor in a different way than Prosser. Section 430 of the Restatement (Second) requires legal cause for liability. Section 431 provides that legal cause is present if the defendant's conduct is a substantial factor in bringing about the harm. Section 432 provides that the conduct is not a substantial factor unless it meets the but for test, which is always required except for the very narrow exception where there are two independent torts, either of which by itself would have caused the injury. The law school example of the latter type of case is where two independent tortfeasors set fires on opposite sides of the mountain, the fires burn toward the cabin at the top, and either is sufficient to destroy the cabin. Under these circumstances, the but for test fails to accurately test for causation in fact because the absence of either fire will not save the cabin. Applying the but for causation test to fire number one results in the conclusion that the cabin would have burned even if fire number one had not occurred because fire number two would have burned the cabin. For the same reason, applying the but for causation test to fire number two leads to the conclusion that the cabin would have burned even if fire number two had not occurred because fire number one would have burned the cabin. Nevertheless, it is obvious that both fires are causes in fact. This limited circumstance, hereinafter called a two fires case, is the only situation where the Restatement (Second) would not require a but for test. The confusion arises because the Restatement (Second) labels all cases where legal cause is present as substantial factor cases. Thus, under the Restatement's approach the vast majority of cases, although called substantial factor cases, are required to meet a but for causation test. Prosser's approach to causation uses different terminology. He calls the overall requirement proximate cause. Under proximate cause he would require that a but for test be met in all cases except in a two fires case, where he would replace the but for test with a substantial factor test. Thus, when Prosser refers to a substantial factor case, he refers to the narrow category of the two fires cases. In contrast, when the Restatement (Second) refers to a substantial factor case it is referring to all cases where legal causation is present, including the two fires cases. The danger of frittering away a meaningful causation test lies in confusing the substantial factor category under the Restatement, which basically includes all causation, with Prosser's narrow substantial factor case (two fires cases only). Such confusion would eliminate the use of the but for causation test to the point where, as a practical matter, causation in fact would no longer be required. Some lawyers and judges have come to look upon the but for test as a particularly onerous and difficult test for causation. Nothing could be further from the truth. But for is an absolute minimum for causation because it is merely causation in fact. Any attempt to find liability absent actual causation is an attempt to connect the defendant with an injury or event that the defendant had nothing to do with. Mere logic and common sense dictates that there be some causal relationship between the defendant's conduct and the injury or event for which damages are sought. Two causes that combine can be tested easily by a but for causation test. How would such a test for causation be applied to the negligent conduct of SLU in the present case? Assume that each of the following but for issues is supported by the evidence. If Dr. Venglarcik was informed by Nurse Schwarz of Danny's presence and condition at the hospital but failed to see Danny, or even if Dr. Venglarcik saw Danny but failed to incise and drain the abscess, then the jury could conclude that but for the doctor's negligent conduct, Danny would not have contracted paralytic polio. In this instance, Dr. Venglarcik's negligent conduct would meet the but for causation test and would be a contributing cause to Danny's paralytic polio. Likewise, if Dr. Venglarcik learned of Danny's condition at the hospital by reading the medical records, but he failed to see Danny, or even if he saw Danny but failed to incise and drain the abscess, then the jury could conclude that but for the doctor's negligent conduct, Danny would not have contracted paralytic polio. In this instance, Dr. Venglarcik's conduct would again meet the but for causation test and would be an independent sufficient cause of Danny's paralytic polio. If Cardinal Glennon was still a party to this case, how would the but for causation test be applied to Nurse Schwarz's negligent conduct? If Nurse Schwarz failed to inform Dr. Venglarcik of Danny's presence and condition at the hospital, and the doctor had no other source of this information, then a jury could have concluded that but for the nurse's failure to inform the doctor, Danny would not have developed paralytic polio. As such, her conduct meets the but for test and, in that respect, it is causal. This is the classic example of applying the but for causation test to two contributing causes. On the other hand, if the doctor had another source of information as to Danny's presence and condition at the hospital, such as the medical records, then the doctor's negligence would have been independently sufficient to cause the injury to Danny. In this circumstance, Nurse Schwarz's conduct would not have met the but for causation test because, if the doctor already knew of Danny's condition, then Nurse Schwarz's failure to tell the doctor something that he already knew would not be causal absent a convincing policy argument that this situation should be treated as a two fires case. This is essentially the same analysis this Court has applied in failure to warn product liability cases where the injured party already had full knowledge of the information contained in the warning. Arnold v. Ingersoll-Rand Company, 834 S.W.2d 192 (Mo. banc 1992). In summary, there is nothing inconsistent or different about applying a but for causation test to a circumstance involving multiple causes. The but for causation test operates only to eliminate liability of a defendant who cannot meet this test because such defendant's conduct was not causal. The fact that the conduct of a particular defendant either does or does not meet but for causation has no impact on the remaining defendants. The remaining defendants rise or fall on their own but for causation test. Our adoption of the substantial factor test of causation in Jackson v. Ray Kruse has been read by some to dispense with the requirement of but for causation. We attempted to clarify in Wollen v. DePaul Health Center, 828 S.W.2d 681 (Mo. banc 1992), that the but for test continues to apply to the vast majority of cases in Missouri. We now reiterate that the but for test for causation is applicable in all cases except those involving two independent torts, either of which is sufficient in and of itself to cause the injury, i.e., the two fires cases. [1] To the extent that Jackson v. Ray Kruse and the cases discussed therein are contrary, they are overruled. All of this discussion concerning the semantics of causation is less important in Missouri than in most jurisdictions because under MAI we do not use the terms 1) proximate cause, 2) but for causation, or 3) substantial factor when instructing the jury. We merely instruct the jury that the defendant's conduct must directly cause or directly contribute to cause plaintiff's injury. See MAI 19.01 [1986 Revision] Verdict Directing ModificationMultiple Causes of Damage. The debate as to whether and when Missouri requires but for causation has arisen almost exclusively in the sufficiency of evidence cases such as this one. This issue can also arise, however, in the context of what is proper closing argument on a causation issue. MAI contemplates that the lawyers may explain the precise meaning of the instructions in closing arguments. See MAI, Why and How to Instruct a Jury, p. LXVII at XCIV.