Elements of Proof - Proximate Cause

• Proximate cause consists of finding of causation in fact, i. e., substantial cause, and absence of public policy rule of law which prohibits imposition of liability. Duetsch v. Shein, Ky., 597 S.W.2d 141 (1980).
• In determining whether negligence was substantial factor in causing harm, substantial factor test applies to event which results in injury, not injury itself, and injury need only flow directly from event.
• Determination of proximate cause is a factual one, not a legal one, depending upon whether the evidence shows that the results of misconduct are reasonably foreseeable. Grayson Fraternal Order of Eagles v. Claywell, Ky., 736 S.W.2d 328, 334 (1987). 
• It is an accepted principle that in most medical negligence cases, proof of causation requires the testimony of an expert witness because the nature of the inquiry is such that jurors are not competent to draw their own conclusions from the evidence without the aid of such expert testimony. Jarboe v. Harting, Ky., 397 S.W.2d 775 (1965).
• CASES:
  • Duetsch v. Shein, Ky., 597 S.W.2d 141 (1980).
    Proximate cause consists of finding of causation in fact, i. e., substantial cause, and absence of public policy rule of law which prohibits imposition of liability.  In determining whether negligence was substantial factor in causing harm, substantial factor test applies to event which results in injury, not injury itself, and injury need only flow directly from event.
  • Morris v. Hoffman, Ky., 551 S.W.2d 8 (1997).
    Ordinarily, expert evidence is necessary to support conclusion of causation in medical malpractice actions, and medical testimony must be that causation is probable and not merely possible.
  • Bayliss v. Lourdes Hospital, Ky., 805 S.W.2d 122 (1991).
    It is an accepted principle that in most medical negligence cases, proof of causation requires the testimony of an expert witness  because the nature of the inquiry is such that jurors are not competent to draw their own conclusions from the evidence without the aid of such expert testimony. Jarboe v. Harting, Ky., 397 S.W.2d 775 (1965). While evidence of causation must be in terms of probability rather than mere possibility,  substance should prevail over form and that the total meaning, rather than a word-by-word construction, should be the focus of the inquiry.  Walden v. Jones, Ky., 439 S.W.2d 571 (1968);  Morris v. Hoffman, Ky.App., 551 S.W.2d 8 (1977). The standard of "totality of the medical testimony" was adopted for use in Workers Compensation cases by the Court of Appeals in  Stauffer Chemical Co. v. Greenwell, Ky.App., 713 S.W.2d 825 (1986), wherein the Court held that terms such as "distinct possibility" and "high likelihood" went beyond speculation and amounted to substantial evidence of causation, an inquiry not dissimilar to the question of proximate cause in malpractice action.

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