Establishing causation in a Maryland nursing home case can be difficult, particularly because residents are often sick when they enter the home. With residents that were already sick, it can be difficult to prove that the nursing home’s neglect or abuse caused the resident’s injuries or death or accelerated them. Additionally, residents also may be unable to testify because they lack competency or have already passed.
A plaintiff in a nursing home negligence case in Maryland must prove that the nursing home’s negligent act or failure to act was both a cause-in-fact of the resident’s injuries and a legally cognizable cause. Proving the cause-in-fact means showing that but-for the nursing home’s negligent conduct, the resident’s injuries would not have resulted. In cases where more than one factor may have caused the resident’s injuries or death, Maryland courts use the substantial factor test. Under this test, a court will consider whether the nursing home’s conduct was a substantial factor causing the plaintiff’s injuries.
Proving that the defendant’s conduct was a legally cognizable cause means demonstrating that the defendant’s conduct was sufficiently related to the injuries that the defendant should be held liable. Courts may consider whether the resulting injuries were a foreseeable consequence of the defendant’s conduct and whether holding the defendant liable would be fair under the circumstances. A plaintiff must prove causation (and other elements of the claim) under the preponderance of the evidence standard, which requires showing that it is more probable than not that the defendant’s negligent act caused the plaintiff’s injuries. It is insufficient that it is a mere possibility that the defendant’s conduct caused the resident’s injuries.