In May 2010, the Michigan Court of Appeals ruled that a rare side effect of an anticonvulsant drug was foreseeable for the purposes of a medical malpractice action. The side effect, called Stevens-Johnson syndrome, wound up causing the patient’s death eight days later.
The appeals court upheld the trial court’s determination, stating “the issue is not whether defendants should have foreseen that Jamar would develop this syndrome, but rather whether they should have foreseen the possibility that as a result of taking the medication, Jamar, like any other patient being prescribed the medication, bore a risk of developing the syndrome.”
The court continued, “The evidence shows that [Tegretol] contained warnings that Stevens-Johnson syndrome may result. Thus it was foreseeable that the prescribing of [Tegretol] created a risk, albeit a small one, that Jamar could contract Stevens-Johnson syndrome.”
The court said the unlikelihood of developing the disease does not diminish that it was the proximate cause of the disease, comparing it to the foreseeability of speeding causing an auto accident.
“We are unfamiliar with any body of law that would allow a defendant to argue, let alone a jury to find, that because there are thousands of incidents of speeding that do not result in an auto accident, for each one that does, a defendant’s excessive speed in a given case cannot be considered a proximate cause of the given crash,” the court wrote.
Judge Joel Hoekstra dissented, arguing it should have been a jury question.
In a 4-3 order, the Michigan Supreme Court agreed, reversing the decision and remanding it back to the trial court.
The lower courts erred by granting partial summary disposition to plaintiffs on the issue of proximate causation here. The lower courts presumed that because the development of Stevens-Johnson Syndrome is a known risk of prescribing tegretol, proximate causation is per se established. After presuming that plaintiff could prove negligence, the lower court “collapse[d]” factual and proximate causation such that the two were “essentially indistinguishable,” Jones v Detroit Medical Ctr, 288 Mich App 466, 481 (2010), contrary to traditional standards for determining proximate causation. For a plaintiff to prevail on proximate cause at the summary disposition stage, it must be shown that reasonable minds cannot differ that injury was a foreseeable, natural, and probable consequence of the defendant’s negligence. Here, viewing the evidence in the light most favorable to defendants, there is a question of fact in this regard that should be submitted to the trier of fact rather than decided as a matter of law.
All three Democratic justices dissented. Justice Diane M. Hathaway argued the case was properly decided in the Court of Appeals.