The Florida Supreme Court recently ruled that a physician who initially treats a patient cannot prevail on a lack-of-causation theory based on testimony from a subsequent treating physician that the subsequent treating physician would not have altered the treatment he or she provided, even if the defendant physician had done what the plaintiff contends the initial physician should have done to satisfy the standard of care.  “To do so would alter the long-established reasonably prudent physician standard where the specific conduct of an individual doctor in a specific circumstance is evaluated.”

The case, Saunders v. Dickens, SC12-2314, involved a defendant neurologist who examined a patient and then referred him to a neurosurgeon.  The neurologist was not as specific as plaintiff would have liked him to have been regarding communicating the numbness and tingling that the plaintiff was experiencing in his hands.  Plaintiff presented evidence to support that had the neurologist specifically and directly informed a neurosurgeon of these hand/upper-extremity issues – rather than just noting it on the chart – Plaintiff would not have later become a quadriplegic. The treating neurosurgeon testified, however, that even if the neurologist had specifically informed him of these symptoms, that would not have changed his subsequent diagnosis and treatment decisions.

Justice Lewis, writing for the majority, held that this was speculative and self-serving testimony by the subsequent treating physician (who was a former defendant, now a Fabre defendant, and who had settled before trial) and that this type of lack-of-causation defense improperly required the plaintiff to prove a negative – “that a subsequent treating physician would not have disregarded the correct diagnosis or testing” – rather than focusing on the standard of care for each doctor in the chain of treatment.  The majority further held that such testimony by a subsequent treating physician “is irrelevant and inadmissible and will not insulate a defendant physician from liability for his or her own negligence.”  Justices Polston and Canady dissented based on lack of conflict jurisdiction.