Zuchowicz v. U.S. (2nd Cir. 1998)


Post hoc, ergo propter hoc – logical fallacy that one former thing caused the latter

Procedural History: This action arose under the Federal Tort Claims Act (FTCA) based on CT law. Defendant admitted doctors negligently directed plaintiff to ingest double the maximum dosage of Danocrine, and after her death, her husband continued the pending case on behalf of her estate. After a bench trial, the court awarded damages, and the Court of Appeals affirms.

Facts: Mrs. Zuchowiczwas prescribed Danocrine for endometriosis in twice the maximum amount for a month, continued taking the drug at the maximum amount for two more months and then ceased taking the drug. Shortly after, she was diagnosed with primary pulmonary hypertension, a rare and fatal condition. She was on the list for a lung transplant, but became pregnant, making her ineligible for a transplant and exacerbating her condition. One month after giving birth, she died.

Issue: Did the action for which the defendant is responsible, cause, in a legal sense, the harm which the plaintiff suffered?

Rules: The Federal Rules of Evidence permit the trial judge discretion in admitting expert testimony.

There is a requirement that the defendant’s behavior was a substantial factor in bringing about the plaintiff’s injury, and the plaintiff must show:

  1. That the defendant’s negligent act or omission was a but for cause of the injury
  2. That the negligence was causally linked to the harm
  3. That the defendant’s negligent act or omission was proximate to the resulting injury


  1. A negligent act was deemed wrongful because that act increased the chances that a particular type of accident would occur, and
  2. A mishap of that very sort did happen, this is enough to support a finding by the tirer of fact that the negligent behavior caused the harm.

Application: Because of the rarity of PPH and the fact that so few have ever been prescribed such a high dose of Donocrine, it is difficult to find other similar cases that provide evidence that the overdose was what caused her onset of PPH.

Conclusion: Although it is not ‘definite’ that the overdose caused the PPH, negligently giving a patient an overdose of a drug is wrongful because it often leads to increased chances of unexpected medical conditions, and a rare, unexpected medical condition indeed resulted, this is enough to show that the negligent behavior caused the harm.

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