Scafidi v. Seiler - 119 N.J. 93, 574 A.2d 398 (1990)

Rule:

The rationale underlying the use of a two-pronged jury instruction bears elaboration. Because the modified standard of proximate causation is limited to that class of cases in which a defendant's negligence combines with a preexistent condition to cause harm -- as distinguished from cases in which the deviation alone is the cause of harm -- the jury is first asked to verify, as a matter of reasonable medical probability, that the deviation is within the class, i.e., that it increased the risk of harm from the preexistent condition. Assuming that the jury determines that the deviation increased the risk of harm from the preexistent condition, the court uses the "substantial factor" test of causation because of the inapplicability of "but for" causation to cases where the harm is produced by concurrent causes.

Facts:

Respondents, estate representatives, filed a medical malpractice case against appellant physician alleging that appellant's failure to properly treat and arrest respondent mother's labor proximately caused the premature birth and death of respondents' infant child. At trial, respondents requested a jury instruction on increased risk doctrine. The trial court denied the request, and instead gave a jury instruction on causation. The jury determined that appellant was negligent, but found that appellant’s negligence was not the proximate cause of the infant's premature birth and death. On appeal, the appellate court held that the trial court erred in refusing to give the jury a charge based on the increased risk doctrine, and in failing to inform the jury that it was appellant's burden to prove that the damages were to be apportioned due to a preexistent condition. Appellant physician challenged the decision. 

Issue:

Did the trial court err in refusing to give the jury a charge based on the increased risk doctrine?

Answer:

Yes.

Conclusion:

The court affirmed the decision of the appellate court because a jury charge based on the increased risk doctrine was required. However, the court further pointed out that any damages awarded to respondents on retrial, assuming that respondents' proof included evidence that the infant's premature birth and death might have occurred even if appellant's treatment had been proper, were to be apportioned to reflect the likelihood that the premature birth and death would have been avoided by proper treatment. Thus, respondents' damages were limited to the value of the lost chance for recovery attributable to appellant's negligence. The court stated that this new rule of law more precisely confined physicians' liability for negligence to the value of the interest damaged, and in light of the significant change in the law, the effect of the holding was to be prospective only.