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What Are the 4 Ds of Medical Negligence?

Medical negligence is a serious tort that exists within the halls of thousands of hospitals, doctor’s offices and medical centers in America. It can refer to medication mistakes, surgical slipups, misdiagnoses and other types of preventable errors in a health care setting that ultimately harm or kill a patient. Learning whether you have grounds for a medical malpractice claim in Richmond may take help from an attorney. In general, you will need evidence of the four Ds of medical negligence to bring a successful claim.


The first D is duty. The person or party you believe is responsible for causing your injuries will serve as the defendant during your medical negligence case. Common defendants are doctors, surgeons, nurses, pharmacies, hospitals and health care centers. To bring a medical negligence claim against a defendant, the party must have owed you a professional duty of care at the time of the alleged wrongdoing. A duty of care is something the medical industry places upon any physician or facility that accepts a patient.


Once you have established a physician-patient relationship with the practitioner, he or she will owe you certain duties of care according to the standards of the medical industry. These duties include properly diagnosing, treating and following up with you. Proving a defendant owed you a duty of care may require evidence such as your patient records.



The second D of medical negligence is dereliction. Dereliction refers to a failure to fulfill one’s obligations or duties of care. A dereliction of duty by a physician, nurse or someone else in the health care field could describe any act or omission a reasonable and prudent professional would not have made in similar circumstances.

  • Misdiagnosis
  • Failure to diagnose
  • Failure to treat
  • Prescription errors
  • Failure to warn of risks
  • Surgical mistakes
  • Wrong patient, site or surgery
  • Foreign object left behind
  • Medical device defects
  • Birth injury
  • Emergency room errors

Any failure to meet the expectations of patient care, such as a physician’s incompetence or a hospital’s dangerous premises, could constitute a dereliction of duty. Your lawyer may be able to prove this element using evidence such as medical records, eyewitness testimony and statements from medical experts in comparable fields.

Direct Cause

The third D is direct cause. Your medical malpractice lawyer must be able to prove a direct causal connection between the defendant’s dereliction of duty and your injury, illness or a loved one’s wrongful death. The physician or hospital must have directly caused the damages in question by breaching a duty of care owed to you as a patient. Without proximate cause, the defendant may not be liable for your damages. If you had a terminal illness, for example, and would have experienced a decline of health even with a timely diagnosis, a physician might not be liable for a delayed diagnosis. The defendant’s mistake must be the main cause of your damages.



The final D of a medical negligence claim in Virginia is damages. A defendant may not owe you compensation, even if he or she was negligent, if the breach of duty did not give you any compensable losses. Your lawyer must show proof of specific, quantifiable damages related to the defendant’s negligence, recklessness or default. Common damages in a medical malpractice claim include hospital bills, pain and suffering, lost wages, lost earning capacity, legal fees, lost quality of life, and punitive damages.


You do not have to file or prove your medical negligence claim alone in Virginia. A medical malpractice attorney in Richmond could help you fulfill your burden of proof by obtaining and presenting evidence of all four Ds to bring a successful medical negligence claim. Your Richmond medical malpractice lawyer can take care of complicated legal requirements, including the burden of proof, on your behalf while you focus on healing from your malpractice-related injuries.