Tiffany Laslett talks Causation
The Importance of Causation Evidence
A recent District Court appeal decision (Cowie v Quinn, [2019] SADC 71) in a medical negligence claim involving cryotherapy illustrates the importance of having the right causation evidence for a successful claim.
On 19 March 2018, Mr Cowie, (the plaintiff) attended a medical practitioner, Dr Quinn and underwent cryotherapy, (which involves the use of liquid nitrogen), to remove some keratosis (a wart like growth) from his bottom lip.
The trial was heard in the Elizabeth Magistrates Court. Neither of the parties were legally represented. Mr Cowie’s evidence was that following the procedure he experienced extreme pain and a burning sensation to his lips. On 5 April 2018 he attended his GP, Dr George and reported those symptoms to him.
After the consultation he travelled interstate with his wife for a holiday. The holiday was intended to be a second honeymoon but his lips were extremely painful and so badly blistered and ulcerated that he spent much of the holiday in the hotel room, struggling to eat due to his lips being sore, cracked, bleeding and swollen. Upon return from holidays, he was unable to work for the following 2 weeks.
Mr Cowie asserted that prior to undertaking the procedure, the doctor failed to give him advice about the risks of complications associated with the procedure and that, had he been appropriately warned, he would have had the procedure later, not so close to his holiday.
At trial, both the defendant doctor and the plaintiff’s GP, Dr George gave evidence. Both of them said that they had never seen a patient develop the symptoms complained of by the plaintiff over 17 days following cryotherapy and that usually any blistering occurred in the first 2 -3 days, but resolved within 7 days.
In this case therefore, the plaintiff had no expert evidence to confirm that the symptoms he developed over 17 days following the procedure, and which interfered with his holiday, were, on the balance of probabilities, caused by the cryotherapy.
His claim failed both in the Magistrates Court and on appeal to the District Court.
The above case illustrates the importance of ensuring that appropriate evidence has been obtained to establish not only negligence, but also as to the medical and legal causation of the injury, loss and damage being claimed.
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