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The Armchair
06-12-2005, 07:58 PM
How would you rule?

This is copy/pasted from a real case. Be the judge:

The issue posed on this appeal is whether it is necessary to establish medical causation in a wrongful birth action that involves the prescription of drugs without adequate warning of the fetal risks posed by those drugs.

On July, 1, 1991, twenty-nine-year-old Melissa Canesi visited Dr. James A. Wilson, an obstetrician/gynecologist, because she had missed her period and wanted to determine whether she was pregnant. A urinalysis yielded the same negative results that a home pregnancy test had. Dr. Wilson prescribed Provera, a drug designed to induce menstruation. Dr. Wilson did not inform Canesi about the side effects and contraindications of Provera. At the time, the Physicians' Desk Reference (PDR) warned that if a woman was or became pregnant while on Provera, she should be informed that there was a risk that the fetus would suffer from congenital abnormalities, including limb reduction, and a risk that she would retain a defective ovum instead of spontaneously aborting it.

The Provera did not induce menstruation. On July 15, Dr. Wilson gave Canesi a blood serum test that resulted in positive for pregnancy. When Canesi learned she was pregnant with twins, she asked Dr. Wilson if her taking the Provera could have any deleterious effects on either the fetuses or the course of her pregnancy. Dr. Wilson told her not to worry. Because Dr. Wilson was not a participating doctor in her health insurance plan, Canesi sought prenatal care from Dr. Ronald Loewe. She told Dr. Loewe of her pregnancy with twins and of her ingestion of Provera. Dr. Loewe also told her not to be concerned that she had taken the drug.

Canesi had problems during her pregnancy. She began spotting, one of the fetal twins died, and amniocentesis revealed excessive amniotic fluid, an indication that the remaining fetus might be suffering from an abnormality. On March 18, 1992, Brandon Canesi was born with the congenital impairment of bilateral limb reduction.

Canesi and her husband sued Drs. Loewe and Wilson, alleging that Dr. Wilson was negligent in failing to diagnose Canesi's pregnancy in a timely manner, that both doctors were negligent for failing to inform her of the effect her ingestion of Provera would have on her fetus and for "otherwise" negligently caring for and treating her. Canesi claimed that had she known of the risk of congenital defects generally, or limb reduction specifically, that Provera posed to her remaining fetus, or if she had been told that she was at an increased risk of retaining a defective ovum, she would have terminated her pregnancy. Also included in the complaint was a claim brought on behalf of Brandon, alleging that Provera caused his bilateral limb reduction and that the doctors were negligent in prescribing the drug to his mother without warning of this risk.

Drs. Wilson and Loewe moved for summary judgment, dismissing the complaint against them. They noted that the Canesis had failed to present any expert testimony that Provera caused fetal limb reduction, and that the latest edition of the PDR no longer contained a warning that Provera was even associated with this defect. Construing the cause of action to involve the lack of informed consent, the doctors contended that because the Canesis could not prove medical causation, as a matter of law, the physicians could not be found liable.

bugstud
06-12-2005, 08:04 PM
Dr. Wilson did not inform Canesi about the side effects and contraindications of Provera. At the time, the Physicians' Desk Reference (PDR) warned that if a woman was or became pregnant while on Provera, she should be informed that there was a risk that the fetus would suffer from congenital abnormalities, including limb reduction, and a risk that she would retain a defective ovum instead of spontaneously aborting it.

am I missing something?

Talk2BigSteve
06-12-2005, 08:07 PM
More of my Tax Dollars for Breeders down the DRAIN!!!

Steve

The Armchair
06-12-2005, 08:09 PM
What you are missing is in the last paragraph:

[ QUOTE ]
[The doctors] noted that the Canesis had failed to present any expert testimony that Provera caused fetal limb reduction, and that the latest edition of the PDR no longer contained a warning that Provera was even associated with this defect.

[/ QUOTE ]

In short, the drug did not cause the birth defect -- it was a coincidence.

Number4
06-12-2005, 08:13 PM
[ QUOTE ]
In short, the drug did not cause the birth defect -- it was a coincidence.

[/ QUOTE ]

Not necessarily true. They did not put on expert testimony to prove that the drug caused the defect, but that does not mean it didn't. But without this type of testimony, I would have dismissed also.

The Armchair
06-12-2005, 08:16 PM
[ QUOTE ]
[ QUOTE ]
In short, the drug did not cause the birth defect -- it was a coincidence.

[/ QUOTE ]

Not necessarily true. They did not put on expert testimony to prove that the drug caused the defect, but that does not mean it didn't. But without this type of testimony, I would have dismissed also.

[/ QUOTE ]

As far as the court is concerned, it is absolutely true. Plaintiff didn't show it, therefore, it isn't.

Clarkmeister
06-12-2005, 08:22 PM
[ QUOTE ]
[ QUOTE ]
In short, the drug did not cause the birth defect -- it was a coincidence.

[/ QUOTE ]

Not necessarily true. They did not put on expert testimony to prove that the drug caused the defect, but that does not mean it didn't. But without this type of testimony, I would have dismissed also.

[/ QUOTE ]

It depends on what you are dismissing. They don't need to prove causation in order to prove negligence. Besides, with something as complicated as a human being, it's impossible to "prove" that any sort of medicine causes any specific side effects. Surely proving direct causation is not necessary to get those drugs removed from the market or to force the manufacturers to assume some responsibility.

The Armchair
06-12-2005, 08:27 PM
[ QUOTE ]
[ QUOTE ]
[ QUOTE ]
In short, the drug did not cause the birth defect -- it was a coincidence.

[/ QUOTE ]

Not necessarily true. They did not put on expert testimony to prove that the drug caused the defect, but that does not mean it didn't. But without this type of testimony, I would have dismissed also.

[/ QUOTE ]

It depends on what you are dismissing. They don't need to prove causation in order to prove negligence. Besides, with something as complicated as a human being, it's impossible to "prove" that any sort of medicine causes any specific side effects. Surely proving direct causation is not necessary to get those drugs removed from the market or to force the manufacturers to assume some responsibility.

[/ QUOTE ]

The suit is against the doctors, not the drug manufacturers. But while we're at it, in a suit against the drug's makers, would you find for the woman or the manufacturer?

bugstud
06-12-2005, 08:27 PM
[ QUOTE ]
What you are missing is in the last paragraph:

[ QUOTE ]
[The doctors] noted that the Canesis had failed to present any expert testimony that Provera caused fetal limb reduction, and that the latest edition of the PDR no longer contained a warning that Provera was even associated with this defect.

[/ QUOTE ]

In short, the drug did not cause the birth defect -- it was a coincidence.

[/ QUOTE ]

I honestly find it very hard to believe that they can't be held accountable for perscribing anything when someone is possibly pregnant without some warning. Isn't practiacally all medicine dangerous during pregnancy?

Number4
06-12-2005, 08:33 PM
[ QUOTE ]
They don't need to prove causation in order to prove negligence.

[/ QUOTE ]

This statement is wrong. You still have to prove causation, even in negligence cases.

I hate the result, and I think that the medication probably caused the injury here, but why wouldn't they just get an expert to testify?

Glenn
06-12-2005, 08:45 PM
The reduced burden of proof in civil court makes the lack of an expert even more conspicuous. In a criminal case it, it might be dangerous to put an expert on the stand because he would be forced to admit that there is no way to be certain that the drug caused the defect. With the reduced burden on the plantiff, though, the expert just has to say that it was more likely than not that the drug caused the defect, or that in his opinion, the drug probably caused the defect. The fact that they couldn't even get someone to testify to this makes their whole case look very shaky. Regardless, it is impossible to judge the merits of the case from a one page, possibly slanted summary.

The Armchair
06-12-2005, 09:07 PM
I took it from the syllabus. That's really all there is to it, other than how the lower courts ruled. But if you can't judge the case, judge the facts given /images/graemlins/smile.gif

OtisTheMarsupial
06-12-2005, 09:45 PM
[ QUOTE ]
It depends on what you are dismissing. They don't need to prove causation in order to prove negligence.

[/ QUOTE ]

That's not true. For negligence you must prove:
1. duty
2. breach of duty
3. causation of injury
4. injury

I think what you're confused about is that proof of causation here is not as strict as you're thinking. It's "clear and convincing" or "preponderance of the evidence."

OtisTheMarsupial
06-12-2005, 09:55 PM
So, my verdict is

Procedurally, they lose because they couldn't convince the judge there was enough evidence even to be examined, but they might get another chance to come up with more evidence.

Based on the limited evidence they did present it sounds like a question for the jury, that is, they deserve at least a trial so the evidence could be weighed.

From my personal, biased standpoint, I think bastard doctors and medicine company! It makes me wonder why the doc didn't make her take two tests a week apart - I think that's standard in this type of situation.

The Armchair
06-12-2005, 09:59 PM
[ QUOTE ]

Based on the limited evidence they did present it sounds like a question for the jury, that is, they deserve at least a trial so the evidence could be weighed.

[/ QUOTE ]

As it turned out, this did go to trial. The trial court ruled that they did not make out their prima facie case for negligence because of what I guess was a lack of proximate cause.

OtisTheMarsupial
06-12-2005, 10:23 PM
you said it was granted summary judgment. Did they appeal? What's the cite?

The Armchair
06-12-2005, 11:07 PM
I was going to wait until tomorrow, in hopes to get more replies.

OtisTheMarsupial
06-12-2005, 11:58 PM
New Jersey, 1999???

trying not to spoil your surprise... it's... sooo... dificult...

2+2 wannabe
06-13-2005, 12:20 AM
[ QUOTE ]
The issue posed on this appeal is whether it is necessary to establish medical causation in a wrongful birth action that involves the prescription of drugs without adequate warning of the fetal risks posed by those drugs.

[/ QUOTE ]

what the hell is an issue?

youtalkfunny
06-13-2005, 02:34 AM
My vote: case dismissed.

The Armchair
06-13-2005, 01:15 PM
The case is Canesi ex rel. Canesi v. Wilson 158 N.J. 490, 730 A.2d 805 (1999), available at this handy-dandy hyperlink (http://lw.bna.com/lw/19990706/a4697.htm).

youtalkfunny
06-13-2005, 04:41 PM
How about a brief translation for us non-lawyers?

Not the whole thing, just the decisions by each court.

TY.