A recent case from Division I Court of Appeals of Washington contains yet another interesting discussion of proximate cause. Causation is a necessary element in all tort actions, and so this concept is central to our practice.
In the case Department of Labor and Industries v. Shirley (288 P.3d 390), the dispute arose over the spouse of a deceased man, who claimed survivor benefits under a worker’s compensation policy.
In this case, the worker was injured in an industrial accident in 2004, resulting in chronic back pain. Based on this accident and the back pain, he was prescribed various medications for pain management. In 2007, he was found dead, and doctors concluded that his death was caused by a lethal combination of various pain medications along with alcohol. Further exacerbating the problem (for legal purposes) was the fact that the medications alone, as well as the alcohol alone would not have been lethal. His widow claimed death benefits, alleging that the industrial injury caused the death, reasoning that if he would not have had to take the medications caused by the injury, the death would never have occurred.
As one would expect, the Department of Labor and Industries disputed coverage, arguing that the decision to drink alcohol concurrently with these medications served as a supervening cause, which had the effect of breaking the chain of causation between the industrial accident and the death.
Central to this dispute is how one analyzes proximate cause. The court recognized that under the statutes governing this insurance coverage, if the injury was a proximate cause of the death, then benefits were in order. This concept is called “multiple proximate cause analysis.” In other words, it was not necessary that the industrial injury was the singular cause or the primary cause. It merely had to be a cause, possibly among many others. Here, the court held that the necessary chain of causation existed such that the industrial injury was a proximate cause. The claimant had shown that the worker injured his back while working, that the injury caused chronic lower back pain, and that the prescriptions implicated in the death constituted necessary treatment for that injury. The court was satisfied.
However, this opinion had a dissent, where Judge Grosse discussed other interesting points relating to proximate cause analysis. First, he asserted that the concept of proximate cause actually contains two discrete concepts, both of which must be shown. The first is cause-in-fact and the second is legal causation.
Cause-in-fact is the tradition notion of cause, similar to the concept of proximate cause discussed above. It simply means that but for the presence of something, a later result would not have occurred. If this “but for” test is met, you have a cause-in-fact. Legal cause, by contrast, is the concept whereby a court must examine the causal link between two things, and determine, in light of common sense, public policy, precedent, and reason, that the one thing should be considered the cause of the other thing. In other words, should a line be whereby a defendant is no longer liable? The dissent notes that legal causation was not discussed whatsoever in the majority opinion. Possibly the majority meant to imply that it was a non-issue. The dissent argued that it is a bad policy to consider the industrial accident to be a legal cause, because of the intervention of the worker drinking alcohol in combination with pain medications.
On top of everything, the dissent further noted that even if the majority held oppositely on the legal causation issue, cause-in-fact is also unsatisfied. There is case law that suggests that even if something is a “but for” cause of a result, that an intervening act or omission may break the chain of causation such that the earlier cause is legally considered to be a non-cause.
In sum, this court employed a more liberal construction of causation, which on its face seems like a win for plaintiffs, and a more difficult precedent for defendants.