140 F.3d 381 (2d Cir. 1998)
-A hospital instructed the P to take double the maximum dosage of Danocrine which caused her to develop primary pulmonary hypertension and, as a result she died.
-The evidence at trial court not establish a link between the excessive dose of the drug and PPH, because no studies had been done where women were given such high doses.
-An expert said that based on her history, the temporal relationship between the overdose and the onset of PPH and other possible causes, he believed that the overdose was responsible for the disease. -Another expert testified that the hormonal changes that the overdose caused likely cased the PPH.
-Must a plaintiff produce direct evidence that her harm was caused by the defendant’s negligence?
No, a plaintiff does not need to produce direct evidence that her harm was caused by the D's negligence.
-A reasonable inference of causation can be made when the D’s conduct is deemed negligent because it creates the particular risk of harm suffered by the P.
-The law of causation requires that the defendant’s conduct have been a substantial factor in bringing about the plaintiff’s injury
-To meet substantial factor requirement, P must prove:
- Defendant’s negligence was a but for cause of the injury
- The negligence was causally linked to the injury
- The defendant’s negligence was proximate to the injury
-Expert testimony makes the court believe that it is more likely than not that the drug was a but for cause of the injury
-The hospital challenged the admission of the expert testimony
-The proper standard was applied in this case, so it will be allowed by the court.
-Causation no longer has to be proven by direct evidence.
-The FDA does not approve prescription of dosages higher than those that have been subject to extensive study because there is the risk of unknown side effects
-Where the negative side effect is because of the drug and the drug was over prescribed, then the plaintiff has shown enough to permit the jury to conclude that the excessive dosage was a substantial factor in producing the harm.
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