43. The administrator of the patient's estate thereafter filed a wrongful death action against the surgeon, claiming that the surgeon was negligent in having failed to consult a cardiologist prior to the operation. At the trial the plaintiff offered evidence that accepted medical practice would require examination of the patient by a cardiologist prior to the type of operation that the surgeon performed. In this action, the plaintiff should

To prevail in a claim for medical malpractice (negligence), the patient must prove the elements of duty, breach, causation (both actual and proximate), and damages. Standard of care is generally established through the expert testimony of a fellow practitioner in the same field of medicine, according to national «school of practice» standards. The patient will need to establish, through expert testimony, the surgeon's duty, the medical standard of care, and the fact that the surgeon's breach of that specific standard caused the patient's stroke.

C is correct. There is no evidence that a cardiologist would have provided advice that would have changed the outcome if one had examined the patient before the operation.

A is incorrect. This answer choice states a legal conclusion, that the surgeon was negligent, but that conclusion depends on establishing that the surgeon's actions were the but-for cause of the harm. There is no evidence that, even if the surgeon consulted a cardiologist, it would have prevented the stroke.

B is incorrect. It is true that the operation led to the patient's death. But the allegation is not that the surgery was negligently performed — it is that the surgeon's failure to consult a cardiologist caused the harm. But, as described above, there is no evidence that failure was the but-for cause of the harm.

D is incorrect. If the surgeon's breach of his standard of care resulted in the patient's stroke, then the permanent vegetative state and failure to survive, absent artificial means, would be a foreseeable result of that stroke. Legal (proximate) causation would not be superseded by the subsequent intervening decision to end artificial life support.