Not all plaintiffs are the same, and there are many problems that can arise in injury litigation when a plaintiff with preexisting medical conditions is injured, since these preexisting conditions can make determining the exact source of symptoms exceedingly more complicated. Indeed, causation is a critical element for proving a negligence claim, and it follows that the existence of pre-existing conditions can pose trouble for establishing the necessary causal link between an act of negligence and the harm suffered. This dynamic is illustrated in a recent decision from the Northern District of Georgia, Bruce v. Classic Carrier, Inc., in which the court needed to determine whether a plaintiff needed to proffer expert testimony establishing causation for his neck injury, since he had pre-existing neck ailments from a prior motor vehicle accident.
The Bruce litigation involves not one but two auto accidents. The first of these accidents occurred on May 31, 2008, when the vehicle that the plaintiff in this action was driving was struck from behind by another motorist’s car. As a result of this accident, the plaintiff was sent to the hospital, where he was treated by physicians and injected with pain medication. The second accident occurred less than a month later, on June 11, 2008. On this day, a tractor-trailer being driven by an employee of one of the defendants in this action rear-ended another vehicle that, in turn, struck the back of the plaintiff’s vehicle. The plaintiff was again ushered to the hospital, where he was treated for neck, arm, and back pain, injected with more pain medication, and prescribed additional pain medication. To make matters worse, the plaintiff had a long history of spine-related medical ailments, which included psoriatic arthritis with spondylitis, radiculopathy of the cervical and lumbar vertebrae, post-cervical fusion syndrome, and post-lumbar laminectomy syndrome. He had been seeing a rheumatologist for these issues since 1999 and had undergone neck surgery in 2001. In addition, the plaintiff had been seeing a pain management specialist since 2005 to treat recurring pain and numbness in various regions of his body, including in his neck, back, hip, shoulder, and fingers. Following the aforementioned accidents, the plaintiff was referred to a spinal surgeon, who believed the plaintiff’s symptoms had been exacerbated by the two accidents, recommended physical therapy, and sometime thereafter, advised the plaintiff to undergo a second neck surgery.
In May 2010, the plaintiff filed a lawsuit in Dekalb County State Court against the driver of the vehicle involved in the first accident, the driver of the tractor-trailer, the employer of the tractor-trailer driver, and the employer’s insurer. There was some early procedural wrangling, which led to the driver of the vehicle involved in the first accident having his case severed, since he was not a joint tortfeasor under Georgia law, and the case being removed to federal court by the remaining defendants. The driver of the tractor-trailer died during the discovery process, and following the close of discovery the remaining defendants moved for summary judgment, arguing that the plaintiff had failed to show that the second accident was the cause of his alleged injures and damages. This motion, among others, was referred to a magistrate judge, who decided in favor of the plaintiff, and the defendants submitted objections to the magistrate judge’s determination, which the court addressed in this decision.
As noted above, a key issue when dealing with causation and preexisting conditions is providing sufficient evidence showing a causal link between the act of negligence and some additional harm suffered by the plaintiff. In the motion for summary judgment, the defendants argued that, pursuant to Georgia negligence law, the plaintiff needed to provide expert testimony establishing a causal connection to survive the motion for summary judgment. Georgia law does require expert testimony when there is a medical question about the cause of a plaintiff’s injury, and “the existence of a causal link between the defendant’s conduct and the plaintiff’s injury cannot be determined from common knowledge and experience and instead requires the assistance of experts with specialized medical knowledge.” Cowart v. Widener, 287 Ga. 622, 627 (2010). In Cowart, the Georgia Supreme Court noted that not every issue regarding medicine and causation falls beyond the ambit of resolution by a jury of laypeople. Id. at 628 (“most ‘medical questions’ relating to causation are perfectly capable of resolution by ordinary people using their common knowledge and experience, without the need for expert testimony.”) However, in cases involving preexisting medical conditions, Georgia court have generally held that “[a] causal connection, requiring expert medical testimony, must be established where the ‘potential continuance of a disease’ is at issue.” Jordan v. Smoot, 191 Ga. App. 74 (1989). This rule, however, does not apply when the symptoms of the preexisting condition have subsided prior to the injury such that causal connection between the injury and the re-onset of symptoms can be established without expert testimony. See Cox v. Rewis, 207 Ga. App. 832, 835 (1993) (holding that a jury could reasonably establish a causal connection between the plaintiff’s carpal tunnel symptoms and an automobile accident even though he had suffered from carpal tunnel earlier because the symptoms had subsided prior to the accident and recurred soon after the accident).
With respect to the current case, the defendants argued that the plaintiff needed to proffer expert testimony because he had not provided any evidence of symptoms that could be attributed to the second accident and not also attributed to either the previous accident or the plaintiff’s prior neck and spine maladies. However, the court noted that the plaintiff did complain of arm pain, which he had not experienced for years prior to the accident or following the first accident. Thus, a layperson could determine, given the temporal proximity between the accident and these particular symptoms, that such symptoms were attributable to the accident. In addition, the court noted that, even if expert testimony were required, a plaintiff can meet this burden by providing a combination of expert and non-expert evidence. See Rodrigues v. Georgia-Pacific Corp., 290 Ga. App. 442, 446 (2008). In this case, the plaintiff’s description of his physical condition prior to the accident, in combination with testimony from the plaintiff’s doctors corroborating his description of his condition, was sufficient to overcome summary judgment and create an issue of fact for a jury to determine. Accordingly, while an expert didn’t provide a definite statement linking the need for the second surgery to the accident, the doctors’ collective testimony regarding the plaintiff’s overall condition, paired with supplemental lay evidence related to temporal proximity and the plaintiff’s description of his condition, was sufficient to overcome summary judgment. In light of the foregoing, the court adopted the report and recommendation of the magistrate judge and formally denied the motion for summary judgment.
Indeed, establishing the cause of symptoms can be difficult when there are multiple acts of negligence or preexisting medical conditions. However, even when such issues are present, one can still overcome these hurdles by present a comprehensive case, including all available expert and non-expert evidence. The Atlanta negligence attorneys at Christopher Simon Attorney at Law have extensive experience with Georgia negligence law and can help you develop such a showing. If you have recently been injured as a result of a possible incident of negligence and would like assistance with understanding your options, feel free to contact us for a free case consultation.