## Facts

- Linda J. Mohr suffered a hypoglycemic event while driving and crashed into a utility pole at about 45 mph.
- She was taken to Kadlec Medical Center’s emergency department and evaluated by Dr. Dale C. Grantham.
- An initial neurological exam and a CT scan were reported as normal.
- After testing, Mohr showed neurological symptoms (including unsteadiness) and severe pain after receiving pain medication.
- Grantham indicated he would perform a repeat neurological assessment before discharge but did not; he prescribed Darvocet and discharged her without head-injury-specific discharge instructions.
- Mohr could not walk at discharge and was carried to bed at home.
- The next morning she returned by ambulance, was diagnosed with a trauma-induced stroke, and suffered permanent neurological disability.
- The Mohrs alleged negligent care reduced Mohr’s chance to avoid the stroke or lessen its severity, causing a loss of the chance of a better outcome.

## Issues

1. Whether Washington recognizes a medical malpractice claim for loss of a chance of a better outcome when the patient suffers serious permanent injury short of death.
2. Whether summary judgment was improper where plaintiffs offered expert evidence that negligence probably reduced the probability of a better outcome, even if traditional but-for causation could not be shown.

## Decision

- The Washington Supreme Court reversed summary judgment for defendants and remanded.
- The court held loss-of-chance is a cognizable injury in medical malpractice cases involving serious nonfatal harm.
- The court ruled plaintiffs need not prove proper treatment would more likely than not have prevented the stroke or disability to reach a jury on a loss-of-chance theory.
- The court concluded the Mohrs presented sufficient expert testimony to create a triable issue that defendants’ negligence reduced Mohr’s chance of a better outcome.

## Legal Principles

- A loss of chance of a better medical outcome is a compensable injury in Washington medical malpractice cases, even when the ultimate harm is severe disability rather than death.
- For loss-of-chance claims, causation may be shown by competent medical evidence that negligence probably caused a measurable decrease in the probability of avoiding or mitigating harm, even if the better outcome was less than 50% likely.
- Damages follow a proportional approach: the factfinder values the total harm and awards the fraction corresponding to the chance lost due to negligence.
- Summary judgment is improper where expert testimony supports breach of the standard of care and a quantifiable reduction in the patient’s probability of a better outcome.

## Conclusion

Washington recognizes loss-of-chance recovery for serious nonfatal medical outcomes, treating the diminished probability of a better result as the actionable harm and permitting proportional damages when expert evidence shows negligence probably reduced that probability.


Mohr v. Grantham, 172 Wn.2d 844, 262 P.3d 490 (Wash. 2011)