What are the 4 "D's" of Medical Malpractice?
What are the 4 "D's" of Medical Malpractice?

What are the 4 “D’s” of Medical Malpractice?

Peter Olszewski
Peter Olszewski

Medical malpractice occurs when a patient is harmed by a doctor, or other medical professional, who fails to competently perform his or her medical duties. But it’s important to keep in mind that just because something goes wrong—or the patient’s condition goes from bad to worse—that doesn’t always mean the patient has a legitimate medical malpractice claim.

Let’s take a look at the four “D’s” of medical malpractice: duty of care, deviation from duty, damages, and direct cause. Each of these four elements must be proved to have been present, based on evidence, for malpractice to be found.

1. Duty

Duty refers to a healthcare provider’s duty of care. A patient must demonstrate they have an established relationship with their healthcare provider; this proves the healthcare provider owed them a duty of care.

Doctors, surgeons, nurses, and other medical professionals owe their patients a duty of care. This duty requires that professionals treat their patients in a manner that measures up to a generally accepted standard of care. In other words, they must provide the type of treatment and level of treatment as would a reasonably skilled and competent healthcare provider with a similar background in the same medical situation.

In the medical industry, a professional must follow protocols and exercise compassion when caring for a patient. If a specialist feels they lack the credentials to care for a patient properly, then it’s their responsibility to refer them to another medical professional.

Proving a duty of care is as easy as providing copies of your medical records, which contain your physician’s or healthcare provider’s information.

2. Deviation

Physicians and healthcare providers who deviate from an accepted industry standard can be held liable for medical malpractice. The patient must demonstrate the physician or healthcare provider didn’t follow medical standards, including those specific to their profession.

Some examples of deviation from the standard of care include:

  • Misdiagnosing a patient
  • Diagnosing a patient too late
  • Giving the wrong medicine
  • Prescribing a medication that has a dangerous interaction
  • Prescribing an incorrect dose
  • Using medication for external use
  • Doing unnecessary procedures
  • Committing a surgical error

3. Damages

The patient must also prove, using evidence, that the physician’s deviation from the standard of care resulted in damages. Said damages can be physical, mental, emotional, and financial.

Evidence includes:

  • Medical records
  • Prescription records
  • Statements from other physicians in the industry
  • Cost of corrective treatment the patient endured

Additionally, the evidence must show the breach of duty caused the injury, and the injury included physical and financial damages.

4. Direct Cause

Finally, a patient must prove the deviation by the healthcare provider was the direct cause of their injuries. For instance, a patient’s broken leg doesn’t heal correctly because the orthopedist didn’t put on the cast according to industry standards. In this situation, the patient can hold their healthcare provider accountable for their injuries.

On the other hand, if a patient went to the doctor for a fractured leg and was told to avoid physical activity, and instead the patient played football later that day and fractured it further, then the physician isn’t liable. Instead, the patient is responsible for not following the treatment protocol for their injury.

Contact Us

Medical Malpractice cases are complex. If you even suspect that your injuries were caused by a medical professional’s negligence or malpractice, contact our team of attorneys at Scartelli Olszewski, P.C. today for a free consultation. You can reach us via phone: 570-346-2600. We have decades of experience handling these types of cases.


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Peter Olszewski
Peter Olszewski

Peter Paul Olszewski, Jr., a shareholder and managing partner at Scartelli Olszewski, P.C., brings 37 years of litigation experience. He is a renowned trial lawyer in Pennsylvania, specializing in medical malpractice, personal injury, and criminal defense. Peter's notable achievements include securing multi-million-dollar verdicts and serving as District Attorney and Judge. He is committed to community involvement and is actively engaged in various legal associations.
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