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The Four D’s of Medical Malpractice

On Behalf of | Apr 28, 2021 | Medical Malpractice

In medical malpractice, there are four conditions that must be met in order for the plaintiff to have a chance to win their suit. These four conditions are Duty, Dereliction, Damages, and Direct Causation. Each of these conditions has its own respective requirements and they encompass the entire breadth of your time with the physician, from the moment you consulted them for medical help to the realization that you may have been injured and onwards. In this article, the experienced medical malpractice lawyers at Peter Angelos Law outline what the four D’s of malpractice mean so you can better understand if you might be a victim of medical negligence.


Appropriately, the first of the four conditions is the one that happens first – the establishment of a duty of care between the medical professional and yourself. A doctor taking a walk in the park does not have any legal duty of care to someone choking on the ground, as they have not established any relationship with this person, much less in their capacity as a doctor. The duty of care exists when there is an agreement by both parties to treat a medical issue. Medical records or testimony of consent are typically used to prove this duty of care was created between you and the doctor.


Sometimes called “deviation,” dereliction is referring to a dereliction of said duty in the course of your treatment. It means the doctor made a mistake somewhere in your treatment such that another doctor in the same field with similar resources would find the mistake inexcusable. This mistake would be called a violation of the “standard of care.” The standard of care is formed through a general consensus of commonly accepted methods of treatment as testified in court through expert witnesses. This standard can be subject to several mitigating factors including but not limited to the geographic locality, the area of medicine practiced by the doctor in question, and the available equipment and facilities. If a doctor neglected to properly inform you of the risks or effects of a particular treatment or medication before you consented to undergo the treatment, they have failed to obtain “informed consent,” which would also be a violation of the standard of care. In some cases, the hospital associated with the doctor can also be held liable for dereliction under “respondeat superior,” a legal phrase meaning “let the master answer.”


Damage is rather straightforward. You have to be able to show that you were actually injured by the physician in the course of your treatment. Even if there was a breach in the standard of care, if you did not suffer an injury, then there is no cause for remedy. However, it is important to note the injuries contested in the case can be physical or mental in nature. When you suffer an injury due to a doctor’s malpractice, it is likely that the injury is costing you much more than just medical bills. You may not be able to work or drive, special equipment might be needed to install in your home, your ability to work at all might be irreversibly hampered. Your mental state may be affected as well, be it losses in cognitive function or emotional anguish. The court or jury considers all of these when deliberating your case and the award amount you could receive.

Direct Causation

Direct Causation means that the doctor in question must be shown to have directly caused your injury. A surgeon failing to operate on your heart properly does not necessarily bear any reflection on the treatment done by the cardiologist. Direct causation is a crucial part of every malpractice suit. While proving causation can often be very straightforward, cases can become incredibly complicated, requiring hours of expert testimony and extensive review of medical records. It is important to have legal representation that has knowledge of the medical field and experience litigating these highly complex legal and medical problems. At Peter Angelos Law, we have highly experienced legal counsel prepared to help you navigate the complex world of malpractice.

Contact the Medical Malpractice Attorneys at Peter Angelos Law

Medical Malpractice can be a difficult area of law, but by using the Four D’s, you can come to a simple and approachable understanding of what is needed and considered when filing a malpractice suit. You must have established a duty of care with the doctor who was treating you who then fails to reasonably treat you according to the standard of care. The injury emanating from that breach of the standard can be proven and tied directly to that same doctor. If you think something like this has happened to you, you should contact us on our website or call us at 410-649-2000.