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Medical Malpractice

What Are the Four Ds of Medical Negligence?

December 20, 2021

Duty, Deviation, Damages, and Direct Cause are the 4 Ds of negligence. These are the legal requirements that a person has to prove to bring a medical malpractice claim successfully. Getting a better understanding of the four Ds helps a person learn how they impact his or her case and establish whether his or her medical malpractice claim is valid.

The 4 Ds of Negligence in Medical Malpractice Claims

Duty of Care

A duty of care is an obligation imposed on medical professionals to provide reasonable and competent medical care to patients. Doctors, nurses, and other medical professionals who enter into a healthcare provider-patient relationship owe that patient a duty of care.

When a person is at a hospital, specialist’s office, or surgical center, every medical professional involved in the diagnosis or treatment owes that person a duty of care. It is one of the easy four Ds of negligence to prove.

Deviation From Duty

Deviation or breach of duty is one of the harder and resource-intensive Ds to prove. A victim will have to prove that the medical professional deviated from or failed to meet the standard of care that another similarly qualified professional would provide in the same circumstances.

Common examples of deviation include:

Proving deviation from duty usually requires the testimony of an expert witness. Medical negligence lawyers typically get testimonies from medical professionals or teachers in the same field as those who committed malpractice to show why a diagnosis, treatment, or prescription was irregular and dangerous.


A patient must prove that the error made by the doctor, nurse, or any other medical professional led to damages. For example, a doctor’s error may have led to the patient requiring further medical treatment to rectify the mistake and lost wages because of missing work. Damages can be physical, emotional, or financial.

Direct Cause

A patient must prove that the medical professional’s actions were the direct cause of the damages suffered. Proving direct causation as one of the four Ds of negligence can be challenging, and, like the breach of duty, it often requires the help of medical experts.

Healthcare providers can attempt to blame the injuries suffered by a person on his or her health choices, previous complications, or existing health conditions. Medical negligence lawyers usually carry out detail-oriented research and use their own medical experts to disprove such defenses and help patients win medical malpractice cases.

About The Author

Photo of Jeffrey  Goldberg
Attorney Jeffrey M. Goldberg has spent his entire professional career handling cases involving birth injury, medical malpractice, product liability and related accidents.