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Smith v. Providence Health & Services

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Brief Fact Summary.

Plaintiff suffered permanent brain damage resulting from a stroke. He sued defendant-doctors, who allegedly failed to follow up on his stroke symptoms and thereby caused him to lose a 33-percent chance of recovering from the stroke.

Synopsis of Rule of Law.

Under Oregon law, a loss of a substantial chance of a better medical outcome is a cognizable injury in a claim of medical malpractice.

Points of Law - Legal Principles in this Case for Law Students.

Whatever the merits in the medical malpractice context, where the proof burden facing some plaintiffs otherwise would be insurmountable and where statistical evidence that can fill the void is readily available, the argument for its application in the legal malpractice context is less compelling.

View Full Point of Law

Joseph Smith suffered permanent brain damage resulting from a stroke. He alleged that the doctors at Providence Health & Services failed to follow up on his complaints of stroke symptoms. Smith also alleged that doctors’ negligence caused him to lose a chance for treatment that would have given him a 33-percent chance of recovering from the stroke with no or reduced complications. Smith sued for medical negligence. The trial court dismissed with prejudice plaintiff’s complaint for failure to state a claim. The court of appeals affirmed. Defendant appealed to the Supreme Court of Oregon, arguing that loss of chance is a legitimate cause of action.


Whether a person who has suffered an adverse medical outcome resulting in physical harm may sue for negligence by alleging that the defendant negligently caused a loss of his or her chance at recovery?


Yes, the court adopts a loss-of-chance theory of recovery in negligence cases involving medical malpractice. The trial court erred in dismissing plaintiff’s claim. The case is remanded for further proceedings.


There are four elements in a negligence claim that the plaintiff must prove: (1) a duty of care that runs from the defendant to plaintiff, (2) a breach of that duty, (3) resulting harm to the plaintiff, and (4) a causal link between the breach and the harm. Causation is proved by a “reasonable probability.” Here, Smith argues that his loss of chance was not an aspect of causation. Instead, Smith argues that his loss of chance was a distinct type of injury that other jurisdictions have recognized as a measurable harm that warrants recovery. After reviewing the history of the loss-of-chance doctrine in other jurisdictions, the court recognizes that loss of chance is a measurable injury in the context of medical negligence cases. Because Smith’s case was dismissed at the pleading stage, there are limited facts to judge his case on the merits. Therefore, the case is remanded to the circuit court.

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