Jury Charges on Causation in Medical Malpractice Cases

Komlodi v. Picciano, 217 N.J. 387 (2014).  Causation is often a key factor in medical malpractice cases.  And jury charges in such cases are, as in all cases, important to the result.  In this case, a unanimous Supreme Court, speaking through Justice Albin, today affirmed, as modified, a 2-1 decision of the Appellate Division that had reversed a jury verdict due to errors in the jury charge about causation.

The Law Division had given a “pre-existing condition” charge under Scafidi v. Seiler, 119 N.J. 93 (1990).  But Justice Albin ruled that the Scafidi charge was improper on the facts of this case and that, in any event, such a charge must be tailored to the particular facts even where the overall concept is appropriate.  The error regarding the Scafidi charge was, by itself, grounds for a new trial.

Justice Albin also provided a detailed discussion of other key causation concepts, including superseding and intervening causes and the distinction between “but for” causation and “substantial factor” causation.  Where, as here, there are multiple concurrent causes that were capable of resulting in the injury complained of, the “substantial factor” charge rather than the “but for” charge is called for, and the Court directed that “substantial factor” be used at the retrial of this case.

This is an important opinion for anyone who is involved with any tort trial, but especially complex medical malpractice matters where causation is often at the heart of the case.  The Court’s opinion well illuminates many of the most important causation issues that appear in such cases.

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