How do causation and damages interplay in medical malpractice claims, and what is required to establish causation in fact and proximate causation?

• A. Causation in fact requires but-for breach; proximate causation links breach to foreseeable harm; damages must be proven.
• B. Causation in fact is about foreseeability; proximate causation is about but-for test.
• C. Damages are optional in causation.
• D. Damages determine causation; causation does not affect damages.

Answer: (A)

The main idea is that a medical malpractice claim rests on proving a chain of causation from the physician’s breach to the patient’s injury, and showing actual damages. Causation in fact uses the but-for test: the injury would not have occurred but for the breach. If the breach had not happened, the harm would not have arisen. Proximate causation then asks whether the breach is the legal cause of the harm—typically whether the injury was a foreseeable consequence or a substantial factor in producing the outcome. Distinct from causation, damages must be proven too: there must be actual loss (economic costs, pain and suffering, medical expenses, etc.) resulting from the breach in order to recover. So you need both causation (in fact and proximate) and damages to prevail.