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Click here for the full text of this decision FACTS:When pregnant with her first child, Ebeny Givens was diagnosed with a short cervix. A cervical cerclage procedure � sutures around the cervix � was used to strengthen her cervix, which allowed her to carry her baby to term. When pregnant with her second child, Ebeny Givens went to Dr. Gwendolyn Daigle for an ultrasound. Daigle allegedly produced a substandard ultrasound image of Givens’ uterus, cervix and fetuses and “superimposed her apparently incorrect measurement of Givens’ cervix, indicating the cervix was significantly longer than it really was.” A radiologist, in turn, transmitted an inaccurate ultrasound report to Givens’ obstetrician. The obstetrician did not recommend a cervical cerclage. Givens’ baby girl, Toni, was born prematurely. During her extended stay at the hospital, Toni developed a congestive lung disease. Toni was further hospitalized for treatment of the lung disease, which required insertion of a breathing tube. When she was finally released to go home, with the assistance of a home healthcare agency, Toni’s breathing tube became clogged and oxygen was temporarily denied to Toni’s brain. Toni suffered severe brain damage. Givens sued Daigle for medical malpractice, saying her negligently performed ultrasound caused the medical expenses incurred from Toni being premature and from her developing a lung disease, and that the negligently performed ultrasound caused Toni’s brain damage. The trial court granted Daigle’s motion for summary judgment. HOLDING:Affirmed. The court acknowledges the difficulty in determining where the line must be drawn when considering causation. On one end is a substantial factor between conduct and harm; on the other end there is conduct that is too attenuated from the resulting injuries to be considered a substantial factor in bringing the harm. The court notes that its precedents establish that merely creating the condition that makes harm possible falls short as a matter of law of satisfying the substantial factor test. Examining the essentially undisputed sequence of events in this case, the question is whether Daigle conclusively proved that her negligence (if any) was not a cause in fact of the damages alleged, or if Givens presented evidence of such a causal connection. The court says it is easier to rule out the causal connection between Daigle’s actions and Toni’s brain damage. Any negligence by Daigle during the ultrasound did not actively cause the brain damage from the clogged tube. “At most,” the court writes, “the ultrasound merely created a condition by which one or more subsequent acts of negligence could occur.” The court notes that there were several intervening factors and actors � the radiologist, the obstetrician and the home health agency, for example � in between Daigle’s involvement with Givens and Toni’s subsequent brain damage. The court says the harder issue is the connection between Daigle’s actions and Givens’ medical bills because there are not as many intervening factors. Nonetheless, Givens did not show that the radiologist’s failure to report Givens’ short cervix length to Givens’ obstetrician flowed in any way from Daigle’s negligence. The radiologist stated that he did not rely on Daigle’s measurements when he prepared the ultrasound report. “[W]hile Daigle’s alleged negligence may have contributed to the premature birth, her actions could not and did not control over the ultimate medical decisions by Givens’ doctors. The evidence shows that there were other assessments and opportunities where the shortened cervix should have been discovered and dealt with. Daigle’s acts, although arguably contributory, are too attenuated and remote from the premature birth to be deemed a cause in fact, and, as such, these defendants were properly granted summary judgment.” OPINION:Morriss, C.J.

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