What Are the 4 Ds of Medical Negligence?

What Are the 4 Ds of Medical Negligence?

Fort Lauderdale Medical ErrorsWe go to the doctor to treat our ailments. But, if we are honest, we are not always happy with the care we receive. Sometimes doctors are busy or .rushed, or they just do not seem to have the time. Sometimes they do not take our concerns seriously. And still, other times, they get it completely wrong. When this happens, it can be frustrating. But when do a doctor’s actions go from annoying to negligence?

You may have a medical malpractice case if you suspect negligence from your doctor or another care provider. To have a medical malpractice case, you must meet the four Ds—duty of care, deviation of duty, direct cause, and damages. For more information, contact an experienced medical malpractice attorney. Below, we discuss the 4 Ds and what they mean for your case.

Table of Contents

Understanding the 4 Ds of Medical Negligence

You must meet a particular standard to have a medical malpractice case. This standard is in place to ensure patients do not sue simply when they are dissatisfied with the quality of care and that doctors are given grace when accidents happen outside of their control.

These rules are also designed to provide clear guidance to patients and care providers regarding the standard of care and to hold care providers accountable. Let’s take a closer look at what the 4 Ds mean when it comes to your care:

Duty of Care

The first and most important standard you must meet even to have a case is the duty of care. In essence, you must prove that the provider had a duty to provide care to you by showing that there was a professional relationship between you and the care provider. Additionally, you must prove that this relationship was active and ongoing and the time of the alleged malpractice.

Let’s look at two examples of when a doctor would and would not owe you a duty of care:

  1. Patient A goes to their physician, complaining of chronic headaches. Their doctor prescribes medication and suggests the patient comes back in six weeks. After six weeks, the headaches worsened, so the doctor increases the dose. The medication does nothing for the headaches. Finally, frustrated, Patient A finds a new doctor who runs some tests and discovers Patient A has a brain tumor. Patient A may have a claim against their initial doctor for failing to diagnose the issue after being given multiple opportunities to do so. 
  2. Patient B is in the ER complaining of chest pain. The attending physician diagnoses Patient B with anxiety and tells them to return if the pain worsens. Patient B is unsatisfied, sees a second doctor passing, and asks for their opinion. The passing physician is busy on their way to another patient and says they cannot provide a consult. Patient B. later has a heart attack. In this example, only the attending physician owed the patient a duty of care. The passing physician had no obligation to provide a consult and was therefore not open to a medical malpractice suit.

Deviation of Duty

Deviation of duty, sometimes called dereliction of duty or breach of duty, means that the doctor did not meet the expected standard of care. According to Cornell Law, the standard of care relies on the “reasonable person standard.” In essence, did this person act in a manner that the average person would, given the same circumstances?

Of course, every situation is different, but the basic expectations of a doctor include:

  • Listen to the patient’s symptoms and provide an exam that recognizes these symptoms.
  • Order tests when the patient’s symptoms or conditions merit.
  • Discuss any known risks of prescribed medications or procedures and provide reasonable alternatives.
  • Obtain written consent before treatment.
  • Provide referrals when necessary.
  • Disclose test results or diagnoses in a timely manner.
  • Provide appropriate follow-up care when necessary.

Direct Causation

Even if the doctor did not meet the standards expected of a qualified care provider, you must still show a direct connection between their actions and your injuries. For example, your doctor may tell you to keep your wound clean and dry if you have had surgery.

If you choose to go swimming and your wound later becomes infected, it may be hard to prove that the doctor’s actions were the cause of your injuries. On the other hand, if your doctor does not properly close or bandage the wound and you develop an infection at the hospital, you may be able to prove a direct connection between the doctor’s negligence and your injury.


The final element you must prove is that you suffered actual damages. This means that, even if your doctor made a mistake, you have no case unless you suffered an actual loss.

Common examples of damages include:

  • Medical bills: Did the doctor’s mistakes cause you to incur additional medical care? If so, any treatment related to the initial injury could be included in your case.
  • Lost wages: If you are out of work because you need time to recover from your injuries, you will need to replace this income. A medical malpractice claim can help you recover wages from the first day you have to miss work until you can return to work.
  • Loss of earning capacity: Did your injuries make it so you cannot return to your previous job? Are you only able to work a partial shift? When your injury prevents you from earning the wage you were able to before the medical mistake, you deserve compensation.
  • Mental anguish: Not all injuries are physical. Psychological trauma can be just as painful as a bodily injury. When a doctor makes a mistake, it is easy to feel fear, distrust, and anxiety. In some cases, you may experience flashbacks or symptoms of PTSD. This pain should be recognized.
  • Death: Unfortunately, some medical mistakes lead to death. Recent data suggests that approximately 251,000 people die yearly due to medical errors. When a medical mistake results in death, the victim’s family can make a case for medical malpractice.

You do not have a medical malpractice case if you cannot prove damages. For this reason, if you suspect your doctor made a mistake, you should immediately begin tracking how you are feeling, new symptoms, and any follow-up care.

What Is (and Is Not) Medical Negligence?

As patients, we would like to think of medical mistakes as rare occurrences. Unfortunately, the numbers say otherwise. A recent article from the World Health Organization cited patient safety as a serious global health concern.

You must meet a high standard to prove that a doctor committed medical malpractice. Doctors make mistakes. And in some cases, you will not get the results you are hoping for. So when does it cross the line from a negative outcome to a medical mistake?

Examples include:

  • Failure to read or adequately interpret lab results
  • Failure to inform the patient of negative lab results
  • Missed, delayed, or misdiagnosis
  • Failure to notify the patient of known risks
  • Improper follow-up care
  • Prescription interactions
  • Surgical errors
  • Failure to read or take into account the patient’s medical history

Remember, to have a medical malpractice claim, you must prove that the doctor acted outside of the reasonable standard of care and you incurred damages.

As such, the following do not typically constitute medical negligence:

  • Hurried or rushed appointments
  • Rude behavior
  • Limited appointment availability
  • Billing issues
  • Unexpected side effects
  • Interactions with medications not previously disclosed
  • Allergic reactions
  • Poor outcomes
  • Your condition is untreatable

If your injuries are not listed, that does not mean the doctor did not commit malpractice. Contact an experienced medical malpractice attorney for a thorough review of your case.

Medical Malpractice Covers More than Just Doctors

When most people think about medical malpractice, their mind generally jumps to doctors. However, medical malpractice is not just for doctors. All healthcare providers are responsible for upholding a minimum standard of care. When they fail, you may have a medical malpractice case.

Other professionals that can be found guilty of medical malpractice include:

  • Nurses (including nurse practitioners, midwives, CNAs, and certified nurse anesthetists)
  • Anesthesiologists
  • EMTs and paramedics
  • Radiology technicians (including sonographers, CT technicians, and MRI technicians)
  • Radiation therapists
  • Optometrists
  • Chiropractors
  • Dentists
  • Dental hygienists
  • Hospitals, doctor’s offices, and long-term care facilities

Again, you must prove you have an established relationship with the provider against whom you allege malpractice. In some cases, you may have a claim against more than one individual or entity.

Do I Need a Lawyer to Handle My Medical Malpractice Case?

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Gabriel Levin | Medical Malpractice Attorney

To win a medical malpractice case, the burden of proof is on you to prove that the provider deviated from the standard of care. Because the field of medicine is ever-changing and complex, this can be very difficult. However, an experienced medical malpractice attorney can review your case to evaluate its merits and help you build a solid case.

When you choose a medical malpractice attorney, one of the most important things you want to consider is their experience. It is almost always best to work with an attorney specializing in medical malpractice cases or with extensive experience in the area. It can also be helpful to work with a more prominent firm that has a team with diverse expertise and the time to handle your case properly.

Other factors to consider when choosing a medical malpractice attorney include:

  • Location: Is your attorney close enough that you meet with them in person if necessary? Are they licensed in the state where the injury occurred?
  • Resources: How big is your attorney’s support team? Are they connected to professionals in the area?
  • Personality: Do you feel comfortable with the attorney? Do you trust them to handle your case?
  • Litigation experience: Medical malpractice is one of the most highly litigious areas of personal injury law. While most cases settle out of court, it is good to have an attorney ready to fight in court if necessary.

How Long Do I Have to File a Medical Malpractice Case?

The time you have to file a medical malpractice case depends on where your injury happened and the exact details surrounding your case. In Pennsylvania, the statute of limitations for most medical malpractice cases is two years from the date of injury. However, there are a few exceptions.

In most cases, the statute of limitations begins from the date the doctor made a mistake. For example, if you had surgery and the doctor made an error, the clock would start that day.

If you went to the ER, they failed to read your records and gave you medicine causing an allergic reaction, the time limit would start immediately. However, suppose your injury was such that you could not discover it until a later date. In that case, the statute of limitations will not begin until you discover the injury or should have discovered the injury.

There are a few other exceptions, namely being:

  • The victim was a minor. In this case, the statute of limitations does not begin until the victim turns 18.
  • The doctor committed fraud or tried to hide their mistake.

Know Your Rights—Take Action Now

The best thing you can do to protect yourself is to understand your rights and know when to take action. You deserve fair and just compensation when a medical provider’s mistake leads to injuries. The most important thing you can do is surround yourself with people you trust. This includes your legal team.

An experienced medical malpractice attorney can help you understand whether you have a case and outline the next steps moving forward. If you have questions or need help, do not wait. Contact an experienced Pennsylvania medical malpractice attorney today to learn more about your legal rights.

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Gabriel Levin - Attorney

Gabriel Levin is a highly experienced and credible attorney with over 10 years of practice in Pennsylvania. Known for his tenacity, he has represented clients in a wide range of civil matters, trying hundreds of cases. He prepares each case as if it will go to trial, ensuring meticulous attention to detail.

Unlike many firms that delegate tasks, Levin personally handles every aspect of a case and maintains open communication with clients throughout. He has secured millions in compensation, making him a reliable choice for those seeking legal representation.

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