Can a Pre Existing Condition Affect a Wrongful Death Claim

TL;DR

A pre-existing condition does not automatically prevent a family from filing a successful wrongful death claim. The core of the case rests on proving that the defendant’s negligent act aggravated the existing medical issue or accelerated the death. A legal principle known as the “eggshell skull rule” is often applied, which states that a defendant is responsible for all harm caused, even if the victim was more susceptible to injury due to a prior condition. While the claim itself is valid, the pre-existing condition can influence the calculation of damages, especially those related to the decedent’s life expectancy and future earning potential.

Key Highlights

A pre-existing medical condition is not a legal barrier to a wrongful death lawsuit.
The “eggshell skull rule” holds a negligent party liable for the full extent of the damage, regardless of the victim’s prior health status.
The central legal question is causation: Did the defendant’s actions significantly contribute to or hasten the death?
Damages awarded may be adjusted to account for how the pre-existing condition impacted the deceased’s life expectancy and earning capacity before the incident occurred.
Expert medical testimony is essential to connect the defendant’s negligence to the death and distinguish its impact from the natural progression of the pre-existing illness.

When a family loses a loved one due to someone else’s carelessness, the grief is often compounded by legal questions. This is especially true when the deceased had a prior health problem. According to the Centers for Disease Control and Prevention (CDC), six in ten adults in the U.S. have a chronic disease. This statistic highlights a common reality: many victims of negligence are not in perfect health. Defendants and their insurance companies frequently scrutinize a victim’s entire medical history, hoping to find a pre-existing condition they can use to deny responsibility or reduce the value of a claim.

In any wrongful death action, the surviving family members (the plaintiffs) must establish a clear link of causation. They need to show that the defendant’s conduct was a direct and proximate cause of their loved one’s death. This is precisely where a pre-existing condition becomes a focal point of legal debate. The defense will often argue that the illness, not their client’s action, was the true cause of death. However, the law provides a framework for these situations, most notably through the “eggshell skull rule,” which holds that a defendant must take their victim as they find them, frailties and all.

Understanding how the legal system addresses these complexities is the first step toward seeking justice. A pre-existing condition introduces specific challenges, but it does not close the door on accountability. The success of such a claim depends on a careful analysis of medical evidence, the application of established legal principles, and the ability to demonstrate precisely how the defendant’s negligence turned a manageable health issue into a fatal one. This requires a detailed look at how causation is proven, how damages are calculated, and how to counter the inevitable defense strategies that will arise.

Understanding the “Eggshell Skull Rule” in Wrongful Death Cases

When a wrongful death claim involves a victim with a pre-existing condition, the “eggshell skull rule” becomes one of the most important legal doctrines. It is a fundamental principle of tort law designed to protect vulnerable victims from being unfairly penalized for their prior health status.

What is the Eggshell Skull Rule?

In simple terms, the eggshell skull rule means that a defendant who commits a wrongful act is liable for all the damages that result from that act, even if the extent of the harm was unforeseeable due to the victim’s unusual frailty. The name comes from a classic hypothetical scenario: if a person has a skull as thin as an eggshell, and a defendant negligently taps them on the head, causing the skull to shatter and leading to death, the defendant is responsible for the full consequence of the death. They cannot argue that a person with a normal skull would have only suffered a minor bump.

The core idea is that a defendant “takes their victim as they find them.” They are not entitled to a healthy, robust victim. If their negligence acts upon a pre-existing weakness and causes a catastrophic result, they are responsible for that result. This prevents at-fault parties from escaping liability simply because their victim was more susceptible to injury than the average person.

How It Applies to Pre-Existing Conditions

This rule applies directly to a wide range of pre-existing medical conditions. The defendant’s negligence does not need to be the sole cause of the injury or death, but it must be a substantial contributing factor that set the chain of events in motion.

Consider these examples:

Heart Disease: A person with a stable heart condition is involved in a minor car accident. The stress and adrenaline from the collision trigger a massive, fatal heart attack. The defendant who caused the accident is liable for the death, even though a person with a healthy heart might have walked away unharmed.
Diabetes: An individual with well-managed diabetes is struck by a negligent driver and suffers a leg fracture. The injury and subsequent surgery disrupt their blood sugar control, leading to a severe infection and, ultimately, fatal sepsis. The driver is responsible for the death because their actions initiated the sequence of medical complications.
COPD: A factory worker with chronic obstructive pulmonary disease (COPD) is exposed to a chemical leak due to the employer’s negligence. The chemical irritates their lungs, causing a severe exacerbation of their condition that leads to respiratory failure and death. The employer is liable because the exposure turned a chronic condition into an acute, fatal event.

In each case, the pre-existing condition made the victim more vulnerable, but the defendant’s wrongful act was the catalyst for the death.

Limitations and Defense Arguments

While the eggshell skull rule is a powerful tool for plaintiffs, defense attorneys will work hard to counter it. They cannot directly dispute the rule itself, but they will try to argue around it. A common defense tactic is to claim that the death was inevitable and already in progress due to the natural progression of the disease.

The defense might argue:

The victim’s condition was so severe that they would have died within a similar timeframe regardless of the defendant’s actions.
The defendant’s negligence was so minor that it could not have been a substantial factor in the death.
The victim’s own failure to manage their condition (e.g., not taking medication) was an intervening cause that breaks the chain of causation.

Successfully overcoming these arguments requires a robust legal strategy supported by irrefutable medical evidence. The focus must be on showing that the defendant’s action was the “trigger” that either worsened the condition or caused a new, fatal injury.

Proving Causation: The Link Between Negligence and Death

The central challenge in any wrongful death case involving a pre-existing condition is proving causation. The family’s legal team must build a clear, convincing narrative that connects the defendant’s negligent act to their loved one’s passing. This is more than just a suggestion; it is a legal standard that must be met with evidence.

The Burden of Proof

In a civil case like a wrongful death claim, the burden of proof is on the plaintiff. This standard is known as a “preponderance of the evidence,” which means showing that it is more likely than not (a greater than 50% chance) that the defendant’s actions were a substantial factor in causing the death.

It is crucial to understand that the negligence does not have to be the only cause of death. Many factors can contribute to a person’s passing, especially when a chronic illness is involved. The law recognizes this. The plaintiff only needs to prove that the defendant’s actions played a meaningful role. For instance, if a person’s pre-existing cancer gave them a 40% chance of dying within the next year, but a post-surgical infection caused by medical malpractice made that death a certainty, the malpractice is a substantial factor.

The Role of Medical Experts

Medical experts are the most important figures in establishing causation. A jury of laypeople cannot be expected to understand the complex interplay between a traumatic injury and a chronic disease. An expert witness serves as a translator and an authority, explaining the medical science in understandable terms.

A qualified medical expert will:

Review All Medical Records: They will conduct a thorough review of the decedent’s entire medical history, including records from before the incident, treatment records from the injury, and the autopsy report.
Establish a Baseline: The expert will first establish the decedent’s health status and prognosis before the defendant’s negligent act. This baseline is critical for showing how the incident changed the trajectory of their health.
Provide a Professional Opinion: The expert will offer a formal opinion, to a reasonable degree of medical certainty, that the defendant’s negligence caused an aggravation of the pre-existing condition or set in motion a new process that led to death.
Testify in Depositions and at Trial: They must be able to defend their opinion under cross-examination from the defense’s attorneys, clearly explaining their reasoning and refuting opposing theories.

Without a credible, articulate medical expert, proving causation in these cases is nearly impossible.

Case Example: Aggravation vs. Natural Progression

Imagine a 65-year-old man with stable, well-managed osteoporosis. He lives an active life but must be careful to avoid falls. One day, he slips and falls on a wet floor in a grocery store that failed to put out a “wet floor” sign. The fall, which might have only bruised a younger person, shatters his hip. He undergoes emergency surgery but develops a blood clot (deep vein thrombosis) during his recovery, which travels to his lungs and causes a fatal pulmonary embolism.

The defense attorney for the grocery store will argue that the man’s osteoporosis was the real cause of the injury and that blood clots are a known risk of his age and condition.

The plaintiff’s legal team, with their medical expert, will counter this by showing:

Negligence: The store created a dangerous condition and failed to warn customers.
Causation: While osteoporosis made his bones fragile (the “eggshell skull”), the fall itself was caused by the store’s negligence. The fall directly led to the hip fracture.
Chain of Events: The hip fracture necessitated surgery and immobilization, which are known risk factors for developing blood clots. The fatal pulmonary embolism was a direct, foreseeable consequence of the treatment required for the injury caused by the fall.

The expert would conclude that the store’s negligence was the initiating event in a direct and unbroken chain that led to the man’s death.

How Pre-Existing Conditions Impact Damages and Compensation

While a pre-existing condition does not bar a wrongful death claim, it almost always affects the calculation of damages. Damages are the monetary compensation awarded to the surviving family members for their losses. They are typically divided into two categories: economic damages (tangible financial losses) and non-economic damages (intangible personal losses). The defense will use the decedent’s prior health to argue for a reduction in both.

Calculating Economic Damages

Economic damages are meant to compensate the family for the financial support and services they have lost. This is where the pre-existing condition is most heavily scrutinized.

Lost Earning Capacity: This component covers the income the deceased would have earned and contributed to the family over the remainder of their working life. If the decedent had a pre-existing condition that limited their ability to work or was likely to force them into early retirement, the defense will argue that their future earning potential was already diminished. An economist may be needed to project future earnings based on the decedent’s health, career path, and the limitations imposed by their condition before the incident.
Life Expectancy: Life expectancy is a key variable in calculating all future damages. Standard actuarial tables provide an average life expectancy for a person of a certain age and gender. However, the defense will hire a medical expert to argue that the decedent’s pre-existing condition (e.g., heart disease, cancer, diabetes) would have significantly shortened their natural lifespan, regardless of the defendant’s negligence. This argument, if successful, can dramatically reduce the value of a claim, as it shortens the period for which the family can claim lost income and services. The plaintiff’s experts must counter this by presenting evidence of how well-managed the condition was and providing a more optimistic, yet realistic, prognosis.
Medical Expenses: The family can claim compensation for all medical bills incurred between the time of the injury and the time of death. The defense will carefully review these bills to argue that some of the treatment was for the pre-existing condition, not the injury caused by their client. Clear documentation is needed to separate these costs.

Calculating Non-Economic Damages

Non-economic damages compensate the family for the profound, personal losses they have suffered. These are harder to quantify but are just as real.

Loss of Companionship, Guidance, and Consortium: This is compensation for the loss of love, society, comfort, and moral support the deceased provided to their spouse, children, and other family members. The defense may subtly imply that because the person was ill, their “value” to the family was somehow less. This is a cynical and often offensive argument, but it is one that must be prepared for. The plaintiff’s attorney can counter this with powerful testimony from family and friends about the quality of their relationship with the deceased, their role in the family, and the deep emotional void their death has created. The fact that a person was sick does not diminish the love their family had for them.
Pain and Suffering (Survival Actions): In some jurisdictions, the family can file a “survival action” on behalf of the deceased’s estate. This allows them to recover damages for the conscious pain and suffering the decedent endured from the moment of injury until their death. A pre-existing condition can sometimes strengthen this part of the claim. For example, an injury might have caused significantly more pain for someone with a pre-existing nerve condition or made breathing excruciating for someone with a lung disease.

The Defense Strategy: Using Medical History Against Your Claim

When a wrongful death claim involves a pre-existing condition, the defense team and the insurance company have a predictable playbook. Their goal is to shift blame from their client to the victim’s health. Understanding these common tactics is essential for building a case that can withstand them.

Scrutinizing Every Medical Record

The first step for any defense team is to request a complete copy of the decedent’s medical records, often going back many years. They are not just looking for the diagnosed pre-existing condition; they are on a fishing expedition. They will search for any note, lab result, or doctor’s comment that could be used to their advantage. This could include evidence of smoking, poor diet, occasional non-compliance with medication, or mentions of other undiagnosed symptoms. They will use this information to paint a picture of a person in a state of inevitable decline.

Arguing “Inevitable Death”

This is the most common defense argument. The defense arizona wrongful death attorney will contend that the decedent’s pre-existing condition was so severe that their death was imminent. They will argue that their client’s actions were, at best, a minor and insignificant factor in a process that was already well underway. They might say the accident simply coincided with the final stages of the illness. To support this, they will hire their own medical experts to testify that the victim had a very short life expectancy and that the death was consistent with the natural progression of their disease.

Blaming the Victim’s Lifestyle or Non-Compliance

Another tactic is to shift the blame to the victim themselves. This is a form of comparative negligence. The defense might argue that the decedent made their own condition worse through their actions or inactions.

Examples of this argument include:

A diabetic who did not consistently monitor their blood sugar.
A person with heart disease who continued to smoke against medical advice.
A patient who occasionally missed follow-up appointments with their specialist.

The defense will argue that this “non-compliance” was an intervening cause of death, breaking the chain of liability from their client’s negligence. They suggest that if the victim had taken better care of themselves, the defendant’s actions would not have been fatal.

How to Counter These Arguments

Anticipating these strategies is key to defeating them. A proactive approach is necessary.

Full Transparency with Your Attorney: Be completely honest with your legal team about your loved one’s medical history from the very beginning. Hiding information only gives the defense an advantage when they discover it later.
Hire Superior Experts: Your medical expert must be more credible, more experienced, and a better communicator than the defense’s expert. They need to be able to clearly explain to a jury why the defense’s theory is medically unsound.
Focus on the Change: The case should focus on the decedent’s condition before versus after the incident. Use medical records and testimony from family and friends to establish a clear baseline of their functional ability and quality of life. Show that the defendant’s act caused a sharp and sudden decline that was not part of the disease’s natural course.
Humanize the Victim: The defense wants to reduce your loved one to a set of medical charts. Your job is to show the jury who they were as a person: a spouse, a parent, a friend, a colleague. Testimony, photos, and videos can be powerful tools to show the life that was lost, not just the medical condition that was present.

Essential Evidence for a Wrongful Death Claim with a Pre-Existing Condition

A successful wrongful death claim is built on a foundation of strong, credible evidence. When a pre-existing condition is involved, the quality and presentation of this evidence become even more critical. The entire case hinges on demonstrating the precise impact of the defendant’s negligence.

Comprehensive Medical Records

The starting point for any investigation is gathering every single medical record related to the decedent. This is a painstaking process but is absolutely necessary.

This collection should include:

Primary Care Physician Records: These provide a long-term overview of the decedent’s health, including the management of any chronic conditions.
Specialist Records: Notes and reports from cardiologists, oncologists, pulmonologists, or any other specialists who treated the pre-existing condition.
Hospitalization Records: All records from any hospital stays, both before and after the incident.
Imaging and Lab Results: X-rays, CT scans, MRIs, and blood test results can provide objective data about the decedent’s health baseline and the specific injuries sustained.
Prescription Histories: A list of all medications can help establish how the condition was being managed.

These records are used by your medical experts to form their opinions and are also the documents the defense will scrutinize for weaknesses.

Expert Witness Testimony

As discussed, expert witnesses are indispensable. The right experts can make or break the case. Beyond the primary medical expert who opines on the cause of death, other experts may be needed:

Life Care Planners: If the decedent had a long-term prognosis before the incident, a life care planner could have projected the future medical costs associated with their condition. This can be compared to the costs incurred after the injury to show the financial impact.
Economists: An economist is needed to calculate the total financial loss to the family, including lost wages, lost benefits, and the value of household services. They will use the medical expert’s opinion on life expectancy to create their projections.
Accident Reconstructionists: In cases involving car accidents or workplace incidents, these experts can establish exactly how the event occurred and prove the defendant’s negligence.

Autopsy Reports

The autopsy report is often the single most important piece of evidence. A detailed examination by a medical examiner or pathologist can pinpoint the physiological cause of death. A well-documented autopsy can directly link the death to the injuries sustained in the incident, providing a powerful rebuttal to defense claims that the pre-existing disease was the sole cause. For example, an autopsy might show that the cause of death was a pulmonary embolism that formed after a hip fracture, not a heart attack related to pre-existing coronary artery disease.

Witness and Family Testimony

While medical evidence is crucial, the human element cannot be overlooked. Testimony from family, friends, neighbors, and coworkers can paint a vivid picture of the decedent’s life before the incident. This testimony is vital for countering the defense’s attempts to portray the victim as frail and debilitated.

These witnesses can speak to:

The decedent’s activity level and hobbies.
Their involvement in family life and the community.
Their work ethic and professional standing.
Their general mood and outlook on life.

This evidence helps a jury understand the true extent of the loss. It shows them that the defendant’s negligence did not take a life that was already over; it took a life that was being lived, despite its challenges.

Types of Pre-Existing Conditions and Their Impact on Cases

Different pre-existing conditions present unique challenges and require specific medical expertise to link them to a wrongful death. Understanding how common conditions can be aggravated by negligence helps clarify the application of the eggshell skull rule.

Cardiovascular Conditions (Heart Disease, High Blood Pressure)

A person with coronary artery disease, congestive heart failure, or hypertension is particularly vulnerable to the physical and emotional stress of a traumatic event. The sudden release of adrenaline during a car accident or a violent fall can cause a rapid increase in heart rate and blood pressure. This can lead to plaque rupture in an artery, triggering a heart attack, or cause an already weakened heart to fail. The legal argument centers on showing that the traumatic event was the “trigger” for the acute cardiac event that led to death.

Respiratory Illnesses (Asthma, COPD)

Individuals with chronic respiratory conditions have compromised lung function. For them, an event that might seem minor to others can be fatal. For example:

A rib fracture from a fall can make it too painful to breathe deeply, leading to pneumonia.
Exposure to dust, smoke, or chemicals from a workplace accident can cause a severe and irreversible inflammatory response in the lungs.
The stress of surgery for an injury can put too much strain on the respiratory system, leading to failure.

In these cases, an expert pulmonologist is needed to explain how the defendant’s negligence created a situation that the victim’s lungs could not handle.

Diabetes and Metabolic Disorders

Diabetes affects the body’s ability to heal and fight infection. An injury, like a severe burn or a deep laceration, can be catastrophic for a diabetic. The stress of the injury can cause blood sugar levels to skyrocket, and impaired circulation can prevent the wound from healing properly. This creates a high risk for developing severe infections, gangrene, or sepsis, all of which can be fatal. The legal case would focus on how the initial injury, caused by the defendant, set off this deadly cascade of metabolic and infectious complications.

Cancer or Weakened Immune Systems

A person undergoing chemotherapy or whose immune system is otherwise compromised is extremely vulnerable. An injury that requires hospitalization exposes them to a high risk of hospital-acquired infections that their body cannot fight off. The physical stress of an injury and subsequent treatments can also weaken the body, making it less able to tolerate cancer treatments or fight the disease itself. The argument is that the defendant’s negligence introduced a fatal complication (like an infection) or weakened the victim to the point that their underlying disease could no longer be managed.

Degenerative Bone or Joint Conditions (Osteoporosis)

As seen in the earlier example, people with conditions like osteoporosis have extremely fragile bones. A slip and fall or a minor vehicle impact can cause multiple, complex fractures. These injuries often require extensive surgery and long periods of immobility, which carry their own set of fatal risks, including blood clots, pneumonia, and infections. The defendant is responsible for this entire chain of events because their initial negligence acted upon the victim’s specific vulnerability.

Conclusion

Losing a family member is a profound tragedy, and discovering that their death may have been hastened by another’s negligence adds a layer of deep injustice. When a pre-existing medical condition is part of the story, families often worry that they have no legal recourse. However, the law is clear: a defendant is responsible for the harm they cause, even if the victim was more susceptible to injury. A pre-existing condition complicates a wrongful death claim, but it does not invalidate it. The legal battleground shifts to the issue of causation, where the “eggshell skull rule” becomes a vital principle.

The success of such a case depends on meticulously proving that the defendant’s actions were a substantial factor in aggravating a condition or accelerating death. This requires a deep dive into medical records, the strategic use of top-tier medical experts, and a clear presentation of evidence that distinguishes the effects of negligence from the natural course of an illness. While the calculation of damages will be influenced by the decedent’s prior health and life expectancy, families are still entitled to seek compensation for their immense economic and emotional losses. The goal is to hold the responsible party accountable for cutting a life short, regardless of its existing challenges.

If your family is facing this difficult situation, it is critical not to assume that a pre-existing condition closes the door to justice. The complexities of these cases demand immediate and experienced legal guidance. An attorney who specializes in wrongful death claims can properly evaluate the medical evidence, anticipate the defense’s tactics, and build the powerful, evidence-based case needed to secure accountability. Taking the step to consult with a legal professional is the first move toward ensuring your loved one’s story is heard and that the party responsible is held liable for the life they took. Contact us for free consultation today.

Can a Pre-Existing Condition Affect a Wrongful Death Claim?