The Four Ds of Medical Malpractice

Every legal claim must meet certain criteria if the plaintiff hopes to prevail. In medical malpractice law, there are four basic legal requirements plaintiffs must prove: duty, deviation, damages, and direct cause. These are sometimes referred to as the “four Ds of medical malpractice.”

What Are the Four Ds of Medical Malpractice?

We’ll discuss each of these requirements below. If you believe you or a loved one were injured or made ill by a medical professional’s negligence, consult with a medical malpractice attorney for personalized support.

Duty of Care

The first requirement a medical malpractice plaintiff must prove is that a medical professional owed them a duty of care. In other words, the medical professional was charged with the patient’s care, which may have involved diagnosing and/or treating them. When that happens, a healthcare provider-patient relationship forms, legally binding the two parties.

Deviation from Duty

A deviation or breach of a healthcare professional’s duty of care occurs when they breach the medical standard of care.

The medical standard of care is essentially the notion that because all doctors receive a certain level of education and training, a doctor exercising reasonable care would make the same decisions as another doctor would. Deviation from the medical standard of care, then, can be a sign that a doctor might have engaged in medical negligence if it resulted in harming their patient.

A few examples of a deviation from duty include the following:

Because not all doctors are uniform in their beliefs on how to best treat patients, proving deviation of duty can be tricky. For example, some doctors may not agree with new ideas in the medical field, while others may subscribe to ideas that border on pseudoscience. Usually, it takes testimony from an expert witness to flesh out what the standard of care should have been in the plaintiff’s situation.


The damages in a lawsuit are what a patient lost as a result of the medical professional’s deviation from their duty.

Damages can include things such as these:

  • Unnecessary medical expenses
  • Wages lost due to missing work
  • Physical disfigurement
  • Emotional distress
  • Pain and suffering

New York doesn’t have any restrictions on damage caps for medical malpractice, making it one of only 15 states where a plaintiff can be awarded any amount a jury deems appropriate beyond compensatory damages.

Direct Cause

Lastly, a plaintiff must prove that a medical professional’s negligence is directly responsible for causing the alleged damages. This is essential because the defendant in a medical malpractice lawsuit is surely going to look for alternative explanations for the damages that don’t directly implicate them.

Having an experienced medical malpractice lawyer on your side can help you overcome this and other hurdles you can face in attempting to recover compensation for damages incurred as a result of medical negligence.