Building a Case for Negligence: Key Elements and Evidence Required in Medical Malpractice Litigation

by vtaylor
4 lawyers posing for picture. Side banner says "Key Elements and Evidence Required in Medical Malpractice Litigation."

Trust is a key part of the relationship that patients have with their medical providers. People trust their providers to diagnose injuries and illnesses and deliver appropriate treatment. Unfortunately, many people suffer serious injuries because of medical mistakes each year. In a 2016 study, researchers at Johns Hopkins estimated that medical errors cause more than 250,000 deaths annually in the U.S. While medical mistakes have the potential for causing serious harm, not all medical mistakes involve medical malpractice.

For a successful malpractice claim, you must establish the legal elements of medical negligence and show that your healthcare provider delivered substandard care that caused your injuries and losses. If you are unable to prove each of the elements, you won’t have a viable malpractice claim. The medical malpractice attorneys at the Philadelphia law firm of Raynes & Lawn can analyze your case and explain whether you have grounds for a claim. If they accept legal representation, they will then work to build a strong case on your behalf and try to maximize your recovery.

Key Takeaways

  • To succeed in a malpractice claim, one must establish medical negligence legally and prove that substandard care from the healthcare provider caused injuries. Without evidence for each element, a viable claim is unlikely.
  • Various forms of malpractice include misdiagnosis, delayed diagnosis, failure to treat, surgical mistakes, birth injuries, prescription drug errors, and anesthesia errors. Consulting a malpractice attorney is advised for those suspecting provider-caused injuries.
  • To establish a medical malpractice claim, evidence is needed for the existence of a provider-patient relationship, the relevant standard of care, deviation from that standard, causation of injuries, and actual damages. Case-specific evidence is essential.

What Is Medical Malpractice?

Medical negligence is a legal term that refers to situations in which a healthcare provider delivers treatment or fails to treat a patient in a way that deviates from the standard of care. To rise to the level of medical malpractice, you must also show that the provider’s breach of the standard of care caused your injuries, and you must also have suffered calculable damages.

Being dissatisfied with the outcome of treatment does not mean that you have a viable malpractice claim. If your doctor followed the standard course of treatment and provided the care a reasonably competent physician in the same practice area would have provided, you won’t have a malpractice claim even if you are unhappy with the results.

Types of Medical Malpractice

Medical malpractice can take multiple forms, including the following:

  • Misdiagnosis
  • Delayed diagnosis
  • Failure to treat
  • Surgical mistakes
  • Birth injuries
  • Prescription drug errors
  • Anesthesia errors

These are only a few examples of medical malpractice. If you think your healthcare provider caused your injuries, you should consult a medical malpractice attorney to learn about your rights.

Establishing a Medical Malpractice Claim

To establish a medical malpractice claim, you must have evidence proving each of the following legal elements:

  • Existence of a provider-patient relationship
  • Relevant medical standard of care that applied
  • How your provider’s treatment deviated from the medical standard of care
  • Causation of your injuries by the deviation from the standard of care
  • Actual damages

Each of these elements will require you to present sufficient evidence to prove by a preponderance of the evidence.

Types of Evidence Used to Build a Medical Malpractice Claim

While your case will have case-specific evidence, some common types of evidence are commonly needed in a malpractice case. The following are a few common types of evidence used to prove malpractice:

  • Evidence you were injured
  • Medical records
  • Hospital policies and healthcare regulations
  • Hospital records
  • Video evidence
  • Diagnostic test results
  • Expert witness reports
  • Medical bills, income statements, and other records showing financial losses

Below is an overview of how different types of evidence might be used to prove the legal elements comprising medical malpractice.

Proving the Patient-Provider Relationship

Proving that you established a patient-provider relationship is typically straightforward. A relationship is established when a patient seeks treatment from a provider, the provider agrees to treat them, and the provider delivers care. You can show this by introducing copies of your signed informed consent documents, admission documents, and other evidence the provider took affirmative steps to deliver the agreed-upon treatment.

Proving the Standard of Care

Proving the standard of care can be more complex than simply showing a patient-provider relationship was formed. The duty of care providers owe to patients varies based on the type of provider, geographic area in which they practice, experience, education, training, and skills. The standard of care a doctor is expected to follow is determined by the quality of the care a reasonably competent doctor would have provided under the same treatment conditions. Doctors are also compared to other physicians in the same field of medicine with similar experience, training, and education, and they aren’t compared to doctors who practice medicine in different geographic areas.

For example, a general practice physician in Philadelphia would not be expected to meet the same medical standard of care that a competent pediatric oncologist would provide in Philadelphia. They also wouldn’t be expected to meet the standard of care a competent general practice physician in Los Angeles would have provided under similar conditions.

Determining the relevant standard of care can also be complicated when a patient is admitted to the hospital because there might be multiple doctors, nurses, and other medical staff members involved in their care. In some cases, a doctor who never physically saw a patient might be involved in the patient’s care by reviewing diagnostic imaging or providing phone consultations.

Evidence of Standard of Care

Teasing out these issues and the relevant standard of care requires the help of a medical expert. Pennsylvania law requires plaintiffs to file certifications that their cases have been reviewed by medical experts who are prepared to testify that the provider violated the standard of care and caused the patient’s injuries. The following types of evidence might be used to prove the standard of care:

  • Expert witness reports
  • Expert witness testimony
  • Medical and hospital records
  • Diagnostic imaging study results
  • Witness statements

The medical expert will determine the relevant standard of care and then review your medical records and other evidence to determine whether the provider deviated from it and caused your injuries. They will rely on the above-listed types of evidence along with information from professional journals and other evidence showing what is generally accepted in the medical community.

Proving the Provider Breached the Standard of Care

Once you have proven the formation of a patient-provider relationship and the relevant standard of care, you’ll need to prove that the care you received amounted to a breach of the standard of care. Once again, expert witness testimony is typically required to prove a breach of the medical standard of care. The expert will be another physician who can testify about what a reasonable doctor would do in the same situation vs. what the defendant did.

An expert witness will review the documentary evidence to determine whether a doctor breached the standard of care and rely on their training, education, and experience to determine what a reasonably competent doctor would have done.

Evidence Proving Breach in Standard of Care

The following evidence might be used to prove a breach of care occurred:

  • Medical records
  • Facility policies
  • Healthcare regulations
  • Hospital records
  • Test results
  • Expert witness reports and testimony
  • Improper prescriptions
  • Evidence of the injury
  • Witness statements

Medical records in a medical malpractice lawsuit are among the most critical types of evidence. Experts will need to review them to understand what occurred before, during, and after the patient’s treatment. Medical malpractice lawyers work closely with medical experts to determine liability and whether a breach occurred, which requires a thorough examination of the patient’s medical records.

In some cases, a provider’s treatment may have been delivered in a way that violated healthcare regulations or the facility’s policies. In that situation, the hospital’s policies and applicable healthcare regulations will be important.

Once the expert witness has completed their examination, they will write an expert witness report. This report will summarize the facts, explain the standard of care and what a reasonably competent doctor would have done, and give an expert opinion on whether the doctor’s actions amounted to a breach of the standard of care. In many cases, both sides will have more than one expert witness. At trial, the jury will listen to testimony from each expert to help them determine whether a breach of the duty of care occurred and whether it caused the patient’s injuries.

Evidence to Prove Causation

Even if you prove that your doctor’s care was negligent, you won’t have a claim for malpractice if the error didn’t cause your injuries or if you weren’t injured. For example, if you went to a doctor and received a misdiagnosis that you immediately doubted, you wouldn’t have a claim for malpractice if you then sought a second opinion and received an accurate diagnosis and proper treatment from a different doctor.

The cause must be both direct and proximately related to your injuries. Some examples of evidence that might be used to prove causation include the following:

  • Medical records
  • Expert witness reports and testimony
  • Witness statements
  • Test results
  • Evidence of your injury

Proving Damages

You must be able to show that you suffered calculable damages because of your doctor’s medical error. Damages include the economic and non-economic losses you suffered, including physical harm, wage losses, medical bills, pain and suffering, psychological harm, and others. To prove your damages, you might present the following types of evidence:

  • Medical bills to treat your injuries
  • Testimony by a vocational expert about how your injuries might affect your ability to earn an income in the future
  • Testimony by a forensic accountant about a reduction in your future earning potential
  • Wage statements from work showing your income losses
  • Testimony about the likely cost of future care you will need because of your injuries

Your out-of-pocket losses are your economic damages and include your past and future expected medical bills, wage losses, lost ability to earn an income, costs to modify your home for a disability, and more. These types of losses are more straightforward to prove than your non-economic or pain and suffering damages. However, you can present testimony from people who know you well about how your injuries affect your daily life and provide personal testimony about the pain and emotional trauma you have suffered. Bills from therapy appointments and others can also help to prove pain and suffering damages.

Hearing from the victim can help a jury understand how they have been affected by their injuries. Keeping a pain journal can help establish your pain and suffering damages. This is a journal in which you keep a daily record of how your pain has affected you so jurors can understand how your pain has affected you over time. At a trial, the judge will also give the jury instructions about how to calculate damages, including damages for pain and suffering.

Medical Malpractice Statute of Limitations

Like all other states, Pennsylvania has statutes of limitation that limit the time during which various types of legal actions can be filed. The medical malpractice statute of limitations is two years, which means you must file your lawsuit no later than two years after the date of injury. However, Pennsylvania also has a discovery rule, which means the deadline clock will not start to run until the date you discover or reasonably should discover your injuries resulted from malpractice. If you try to file your claim outside of the limitations period, the court will dismiss it upon the defendant’s motion. You should consult a malpractice lawyer as soon as possible after your injury to learn about your rights and options.

How Does a Medical Malpractice Lawyer Help Prove Your Claim?

A medical malpractice lawyer is instrumental in proving your claim by using legal insight and resources to navigate the intricacies of these cases. Here’s how they assist:

Case Evaluation

Medical malpractice attorneys assess the merits of your case, determining if there’s a valid claim. They consider factors like the standard of care, deviation from it, causation, and damages.

Legal Guidance

Lawyers guide you through the legal process, explaining your rights, potential outcomes, and the steps involved in pursuing a claim. They help you understand if your case is viable and the legal options available.


Attorneys conduct a thorough investigation, gathering evidence to support your claim. This may involve obtaining medical records, consulting professionals, and analyzing the circumstances surrounding the alleged malpractice.

Legal Research

Lawyers research relevant laws, statutes, and precedents to build a strong legal argument. They stay informed about changes in medical malpractice law and use this knowledge to strengthen your case.


Many medical malpractice cases are settled out of court through negotiation. Lawyers use their negotiation skills to reach favorable settlements, ensuring you receive fair compensation without the need for a lengthy trial.


If a fair settlement cannot be reached, your lawyer will represent you in court. They present your case, cross-examine witnesses, and argue legal points to establish the medical professional’s negligence and the resulting damages.

Calculating Damages

Medical malpractice lawyers help you quantify damages, considering both economic losses (medical bills, lost wages) and non-economic losses (pain and suffering). They ensure all relevant damages are accounted for in your claim.

Statute of Limitations Compliance

Lawyers are vigilant about filing within the statute of limitations. They ensure your case is filed within the specified timeframe or leverage the discovery rule when applicable.

Client Advocacy

Throughout the process, a medical malpractice lawyer serves as your advocate, protecting your interests and ensuring you are treated fairly by the legal system.

In essence, a medical malpractice lawyer is a legal advocate who combines legal knowledge, investigative skills, and negotiation prowess to build and present a compelling case on your behalf. Their goal is to help you secure the compensation you deserve for the harm caused by medical negligence.

Contact Raynes & Lawn Today

Pursuing a medical malpractice case involves analyzing trust-breaking medical errors. Building a strong case demands evidence for a patient-provider relationship, standard of care adherence, deviation, direct causation, and damages. Key evidence includes records, expert testimonies, and personal accounts. To learn more about your potential medical malpractice case, you should talk to the experienced medical malpractice lawyers at the Philadelphia law firm of Raynes & Lawn. Call us for a free case evaluation at 1-800-535-1797 or fill out the contact form.



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