Proving Medical Malpractice and “The Four D’s”

When people need medical treatment, they tend to turn to a physician for assistance. Patients expect physicians to do everything in their power to cure their disease or heal their injury; however, sometimes, physicians fail to meet these expectations. 

While patients may want to hold every physician accountable for falling short, not every mistake will constitute medical malpractice. However, there are times when a physician’s failure does violate his or her professional obligations under the law. With this in mind, it is reasonable to ask what kinds of mistakes amount to medical malpractice? The answer to this question has to do with “The Four D’s.”


The first question is whether or not the doctor had a duty to the patient. For example, a doctor is expected to meet certain expectations and a required level of medical competence when they are providing medical care to patients; however, if the doctor isn’t the physician who is responsible for the medical care of the patient, they may not have a duty to that patient and would not be held accountable under medical malpractice law. Furthermore, if the doctor cannot provide the specialized care a patient requires, the physician has a duty to refer that patient to someone who can.


If the doctor has a duty to that patient, they could have been derelict in their duty to the patient. This means that a doctor has failed to meet certain expectations or overstepped their bounds. For example, a doctor may go beyond what the patient has authorized the physician to do, such as taking out an additional organ during surgery. This also encompasses medical mistakes, such as amputating the wrong limb. Doctors who perform surgeries in a non-sterile environment leading to an infection may also be derelict in their duty.


The next D stands for direct. Did the doctor’s dereliction of duty directly lead to the consequences? If a physician made a mistake but the mistake did not directly cause a negative outcome, a medical malpractice case may fall apart. A physician may argue that the outcome was poor; however, it was a last-ditch effort to save the patient’s life and they were going to pass away regardless of the outcome. On the other hand, if someone can prove that the mistake led directly to an adverse outcome, the doctor may be held responsible.


The final D that must be proven is damages. Did the physician with a dereliction in duty directly cause damages? What kind of physical or emotional damages resulted from the case? Does the patient has to deal with lifelong consequences as a result of the physician’s mistake? Does the doctor deserve to be punished for the error? This is where a medical malpractice case can cite pain and suffering, lost income, emotional pain, or even a wrongful death.

Medical malpractice cases are complicated and often require an expert witness to testify with relation to what a reasonable physician would have done. Anyone who is considering a medical malpractice lawsuit may benefit from contacting an experienced attorney for assistance.

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