Causation and material contribution in clinical negligence claims
Causation and material contribution in clinical negligence claims

The following PI & Clinical Negligence guidance note provides comprehensive and up to date legal information covering:

  • Causation and material contribution in clinical negligence claims
  • The scope of the defendant’s duty
  • The ‘but for’ test
  • Factual causation
  • Bolam test
  • Exceptions to the ‘but for’ test
  • The claimant has done something to cause the injury—an intervening act
  • Causation and apportionment

Causation and remoteness are the principles that the courts use to determine what should be recoverable in damages as a result of clinical negligence. The law, therefore, limits the damage for which the clinician will be liable by these two mechanisms. Reasonableness and foreseeability are the tools used to give effect to common sense and public policy and both are necessary parts of causation and remoteness.

Most clinical negligence cases involve claimants who were ill before the treatment and proving causation can therefore be complex.

The basic test for causation is the ‘but for’ test. If the claimant would not have suffered the injury but for the negligence of the doctor, the claim is made out. However, this test is subject to limits and exceptions which are considered in this Practice Note.

The scope of the defendant’s duty

Confusingly, it is sometimes said that the loss will not have been caused by the breach unless it was within the scope of the defendant’s duty. Furthermore, damages will not be recovered after a breach if it was not foreseeable at the time of the breach.

Therefore, an injury or loss that is within the ‘but for’ test may still be irrecoverable if it is not proved that the injury or loss was within the scope of the clinician’s duty.

In ABC v St George’s Healthcare,