Cooper v. Sisters of Charity of Cincinnati, Inc.
56 Ohio Op. 2d 146, 27 Ohio St. 2d 242, 272 N.E.2d 97 (1971)
Rule of Law:
In a medical malpractice wrongful death action, a plaintiff must prove that the defendant's negligence, in probability (more likely than not), proximately caused the death, rather than merely showing a loss of chance or a substantial possibility of survival.
Facts:
- Theodore Cooper, the plaintiff's decedent, received professional medical services from Dr. Hansen.
- Dr. Hansen did not take Cooper's vital signs during the encounter and was not present when they were taken, nor did he have knowledge of what they were.
- Cooper died from a medical condition that, if untreated, had practically a 100% mortality rate for patients with similar injuries.
- Expert medical testimony from Dr. DeJong indicated that if Cooper had received prompt surgical intervention, there was 'maybe * around 50%' chance of survival.
- Another medical expert, Dr. Cleveland, stated there was 'no possible way for a physician or anyone else to ascertain with any degree of certainty whether with medical intervention, the individual would have survived or died.'
- The trial judge made findings of fact supporting that Dr. Hansen's conduct did not satisfy the standard of care for a physician in the community.
Procedural Posture:
- Plaintiff sued Dr. Hansen, Emergency Professional Service Group (Dr. Hansen's employer), and Sisters of Charity of Cincinnati, Inc. (hospital) for wrongful death due to medical malpractice in a trial court.
- The trial judge made findings of fact indicating potential negligence by Dr. Hansen, but also determined that Sisters of Charity of Cincinnati, Inc. were not liable for the negligence of Dr. Hansen or Emergency Professional Service Group.
- The trial court implicitly directed a verdict or granted summary judgment in favor of Dr. Hansen and Emergency Professional Service Group on the issue of proximate cause, finding insufficient evidence to meet the legal standard.
- The plaintiff appealed the trial court's judgment to the Court of Appeals.
- The Court of Appeals affirmed the judgment of the trial court.
- The plaintiff (appellant) appealed the Court of Appeals' decision to the Supreme Court of Ohio.
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Issue:
Does a plaintiff in a medical malpractice wrongful death action, where the alleged negligence involves a failure to diagnose and treat, satisfy the burden of proof for proximate cause by showing that the defendant's actions eliminated a 'chance of survival' or a 'substantial possibility of survival,' or must the plaintiff demonstrate that the defendant's actions, in probability, caused the death?
Opinions:
Majority - Duncan, J.
Yes, a plaintiff in a medical malpractice wrongful death action must prove that the defendant's negligence, in probability (more likely than not), proximately caused the death, and cannot merely show a loss of chance or a substantial possibility of survival. The court reaffirmed its stance in Kuhn v. Banker that 'loss of chance of recovery, standing alone, is not an injury from which damages will flow,' rejecting the conflicting view expressed in Craig v. Chambers. The court found the 'substantial possibility' and 'chance of recovery' concepts to 'derogate well-established and valuable proximate cause considerations,' which require evidence that a result was 'more likely than not' caused by an act. The court analyzed the expert testimony, concluding that Dr. Cleveland's opinion offered no probability of survival, and Dr. DeJong's 'around 50%' chance of survival did not meet the 'more than 50%' threshold required for a 'probability.' Therefore, without expert testimony establishing a probability of survival (greater than 50% chance) with proper intervention, the plaintiff failed to prove proximate cause. The court also affirmed the trial court's finding that the hospital, Sisters of Charity, was not liable for Dr. Hansen's negligence, as he was an employee of Emergency Professional Service Group, and no agency by estoppel was established.
Dissenting - Herbert, J.
No, a plaintiff should not be required to prove that the defendant's negligence, in probability, proximately caused the death, as a lesser standard such as loss of chance or substantial possibility of survival may be appropriate. (No reasoning provided in the text beyond the statement of dissent).
Analysis:
This decision solidifies Ohio's strict interpretation of proximate causation in medical malpractice wrongful death cases, rejecting the 'loss of chance' doctrine. It establishes a demanding evidentiary standard, requiring plaintiffs to present expert testimony demonstrating that it was 'more likely than not' (i.e., greater than 50% probability) that proper medical care would have prevented the death. This high bar protects healthcare providers from liability in situations where causation is uncertain or where patients had a low chance of survival regardless of the alleged negligence, but it simultaneously makes it more challenging for plaintiffs to recover damages in cases where a doctor's actions clearly diminished a patient's survival prospects, even if those prospects were initially slim.
