Weimer v. Hetrick
1987 Md. LEXIS 233, 309 Md. 536, 525 A.2d 643 (1987)
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Rule of Law:
In a medical malpractice action brought under Maryland's wrongful death statute, a plaintiff must prove by a preponderance of the evidence that the defendant's negligence was a proximate cause of the decedent's death. Proof that the negligence merely deprived the decedent of a substantial possibility of survival is insufficient to meet this burden of causation.
Facts:
- Jody Ann Hetrick was admitted to Anne Arundel County Hospital on September 2, 1978, under the care of Dr. Thomas Moeser with a diagnosis of severe gastroenteritis.
- Her condition worsened, and an exploratory laparotomy on September 9, 1978, revealed she was suffering from severe pre-eclampsia, a life-threatening condition for both mother and fetus.
- Within twelve hours, doctors determined the pre-eclampsia was uncontrollable and that termination of the pregnancy was necessary to save the mother's life.
- Hetrick consented to an emergency caesarean section, knowing that the 32-week gestation infant had a poor chance of survival.
- Drs. Moeser and Harris delivered a 3 lb., 6 oz. boy, Jason Michael Hetrick.
- Dr. Stanley R. Weimer, a pediatrician, received the infant in the operating room immediately after delivery and provided resuscitative and subsequent care.
- Jason Michael Hetrick died hours after his birth.
- An autopsy suggested that the most probable cause of the infant's condition was fetal anoxia resulting from a combination of the mother's eclampsia and general anesthesia during her surgeries.
Procedural Posture:
- Jody Ann and Michael Cary Hetrick filed a malpractice claim with the Health Claims Arbitration Office against Dr. Weimer and several other healthcare providers.
- The Health Claims Arbitration panel found no liability on the part of Dr. Weimer.
- The Hetricks rejected the panel's decision and filed a lawsuit in the Circuit Court for Anne Arundel County (a state trial court) against Dr. Weimer and others.
- The case proceeded to a jury trial against Dr. Weimer alone on a survival action count and a wrongful death count.
- The jury returned verdicts in favor of Dr. Weimer on both counts.
- The Hetricks, as appellants, appealed to the Court of Special Appeals of Maryland (an intermediate appellate court).
- The Court of Special Appeals reversed the trial court's judgment and remanded for a new trial, holding that the jury instruction on causation imposed an improper burden on the plaintiffs.
- Dr. Weimer, as appellant, successfully petitioned for a writ of certiorari from the Court of Appeals of Maryland (the state's highest court) to review the decision of the Court of Special Appeals.
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Issue:
In a medical malpractice action brought under Maryland's wrongful death statute, does a plaintiff satisfy the burden of proving causation by showing that the defendant's negligence deprived the decedent of a substantial possibility of survival, rather than proving by a preponderance of the evidence that the negligence was a proximate cause of death?
Opinions:
Majority - Menchine, J.
No. In a wrongful death action, a plaintiff must prove by a preponderance of the evidence that the defendant's negligence was a proximate cause of death, not merely that it destroyed a substantial possibility of survival. The plain language of Maryland's wrongful death statute, which is in derogation of common law and strictly construed, creates a cause of action against a person whose wrongful act 'caused the death' of another. Long-standing Maryland precedent requires proof of causation to a reasonable probability, meaning 'more likely than not' or a greater than 50% chance. The cases relied upon by the plaintiffs, Hicks v. United States and Thomas v. Corso, did not alter this standard; in those cases, the evidence was sufficient to prove that the defendants' negligence was, in fact, the proximate cause of death. The language from Hicks regarding the destruction of a 'substantial possibility of survival' did not create a new tort or a new standard of causation for wrongful death actions in Maryland. Therefore, the trial court's instruction requiring the plaintiffs to prove Dr. Weimer's negligence was 'better than 50%' the cause of death was a correct statement of the law.
Concurring - McAuliffe, J.
No. A claim for damages based on the loss of a substantial possibility of survival is fundamentally inconsistent with the element of proving causation of death that is required to successfully maintain a statutory wrongful death action. If a patient already has less than a fifty percent chance of survival, a subsequent physician's negligence cannot be proven, by a preponderance of the evidence, to be the cause of death. However, this opinion is written separately to emphasize that the Court is not rejecting the concept of a claim for loss of a substantial chance of survival in all contexts. Rather, the holding is limited to the conclusion that such a theory does not satisfy the causation requirement of a wrongful death claim. The question of whether loss of a substantial chance is a cognizable form of damages, perhaps in a survival action, is an issue that must await resolution in a future case where it is properly presented.
Analysis:
This decision reaffirms the traditional 'more likely than not' standard of causation for wrongful death actions in Maryland, explicitly rejecting the more plaintiff-friendly 'loss of a substantial chance' doctrine in this statutory context. The ruling solidifies a high bar for plaintiffs in medical malpractice cases where the patient had a poor prognosis prior to the alleged negligence, as they must prove the doctor's actions were the actual cause of death, not just a factor that eliminated a possibility of recovery. While closing the door on this theory for wrongful death claims, the court's majority and concurring opinions deliberately leave open the possibility that a 'loss of chance' could be a cognizable claim in a different context, such as a survival action. This creates a critical distinction for future litigation, channeling such claims away from the wrongful death statute and potentially toward a redefinition of damages for the decedent's own personal injury.
