Personal Injury Actions and Preexisting Conditions: the Eggshell Plaintiff Doctrine

February 01, 2019

By: Cody N. Guarnieri

"The plaintiffs are entitled to recover full compensation for all damage proximately resulting from the defendant's negligence, even though their injuries are more serious than they would otherwise have been because of pre-existing physical or nervous conditions."1

This statement, which is from a 1940 decision of the Connecticut Supreme Court, encapsulated a principle firmly established and incorporated into Connecticut personal injury law, known as the "eggshell plaintiff doctrine."

"The eggshell plaintiff doctrine states that [w]here a tort is committed, and injury may reasonably be anticipated, the wrongdoer is liable for the proximate results of that injury, although the consequences are more serious than they would have been, had the injured person been in perfect health...." The eggshell plaintiff doctrine … makes the defendant responsible for all damages that the defendant legally caused even if the plaintiff was more susceptible to injury because of a preexisting condition or injury…"2

The eggshell plaintiff doctrine essentially means that a defendant tortfeasor (i.e. the person at fault for the accident or negligent conduct) "takes the victim as he finds him." Put another way, the eggshell plaintiff doctrine requires that a defendant who proximately (legally) caused injury to another person is responsible for new injuries, of course, but also for exacerbations or worsening of any pre-existing or prior health conditions that the victim was suffering from prior to the time they were newly injured.

Every person is physically and mentally a product of their life experiences. It is not often the case that someone who is injured due to the negligence of another driver, property owner, doctor or other person was a "clean slate," without any prior injuries or health conditions. For many people the eggshell plaintiff doctrine means that a defendant does not get off the hook for his or her negligent conduct merely by claiming that the victim had already suffered injury to the effected body part. Instead, the tortfeasor is responsible to compensate the victim fairly for the proximate consequences of their tortious conduct.

It is also noteworthy that the eggshell plaintiff doctrine is not a mechanism to shift the burden of proof to the defendant3. This means that the plaintiff is still legally responsible to prove his or her case, including nature and degree of damages that resulted from the negligent conduct as well as the causal connection between those damages and the negligent conduct of the tortfeasor. However, it allows a victim to present evidence that he or she was more susceptible to injury, or suffered otherwise unanticipated degree of injury, as a result of the preexisting health issue or condition. The plaintiff must also be sure to plead the aggravation or exacerbation of the preexisting condition, as a precursor to putting on evidence of the same at trial.

Where an exacerbation or aggravation of a preexisting condition is correctly plead and sufficiently established in the evidence at trial, the court will instruct the jury on the eggshell plaintiff doctrine:

  • The plaintiff is entitled to full compensation for all injuries and losses proximately caused by the defendant's negligence even though those injuries and losses are more serious than they otherwise would have been because of a pre-existing condition. You may not compensate the plaintiff for the pre-existing injury itself. However, the aggravation of such an injury, proximately caused by the defendant's negligence, is a proper item of noneconomic damages.
  • The plaintiff alleges that, before the accident occurred, (he/she) had a preexisting medical condition but that condition was not causing the plaintiff to suffer any symptoms. If you find that the plaintiff had a preexisting condition from which (he/she) was suffering no symptoms and that the condition was aggravated by an injury caused by the defendant's negligence, the plaintiff is entitled to recover full compensation for those symptoms, even though the symptoms are greater than if the plaintiff had not suffered from this preexisting condition.4

This jury instruction, which is derived in part from the 1997 Connecticut Supreme Court case Tuite v. Stop and Shop Companies, Inc., takes into account both the preexisting condition, which is not compensable to the victim, and the exacerbation or aggravation of that condition, which is compensable.

By way of example: Joe was in a car accident in 1994 that resulted in a significant injury to his lumbar (lower) spine, including a bulging. He underwent physical therapy and chiropractic care throughout the 1990s whenever his back would "go out" or he was uncomfortable. In the late 1990s and early 2000s Joe’s pain and discomfort in his back became worse and persistent and started to radiate from his back into his buttocks and left leg and foot. In 2001 he could not take the pain and discomfort and decided to undergo a lumbar discectomy and fusion operation in an attempt to alleviate his pain. Joe’s surgery went well and he followed a typical post-operative course, with further physical therapy in 2001 and 2002. His surgery was a great success and he was generally asymptomatic for many years.

Unfortunately, Joe was stopped at a stoplight in South Windsor in 2019 when he was rear-ended by another car. While the impact was not high velocity, and the damage to the vehicle was not extensive, the impact and bracing for impact jarred Joe’s lower back, causing him immediate pain and discomfort. Joe has to return to his orthopedic doctor for injection therapy, physical therapy and a further possible surgery.

Joe brings a claim and then a lawsuit against the driver who rear-ended him. Both sides agree that Joe was only injured to such an extent because of his pre-existing lumbar back issues from the 1990s and early 2000s. Nevertheless, the eggshell plaintiff doctrine applies in Joe’s case. Joe cannot recover from the driver who rear-ended him in 2019 any damages related to his 1994 car accident. However, Joe is entitled to fully recover damages, including pain and suffering, from the driver who rear-ended him in 2019 causing his exacerbation injury despite the fact that his damages are greater or more serious than they would have been if he had not been in the car accident in 1994.

This example is relatively straightforward. However, oftentimes the intersection of preexisting medical conditions or prior injuries and new injuries that are the result of another person’s negligence can be blurred and nuanced. If you, a family member, or friend have questions or concerns about how a preexisting injury or condition affects an injury you suffered because of someone else’s negligence, do not hesitate to contact me, Attorney Cody N. Guarnieri, for answers to your questions.

1. Flood v. Smith, 126 Conn. 644, 647 (1940).

2. Iazzetta v. Nevas, 105 Conn. App. 591, 593, FN4 (2008)(Citation omitted; internal quotation marks omitted.) citing Rowe v. Munye, 702 N.W.2d 729, 741 (Minn.2005); see also W. Prosser & W. Keeton, Torts (5th Ed.1984) § 43, p. 292.

3. Id.

4. Connecticut Judicial Branch Civil Jury Instructions, § 3.4-1.