Issues of remoteness of damage will unlikely feature in medical negligence, as virtually all physical and mental injuries including death are foreseeable in the setting of medical treatment, especially in patients with underlying vulnerabilities. Take as an example a diabetic with peripheral neuropathy and poor circulation. A negligently treated minor foot ulcer may cause the patient to end up with an amputation, whereas such a serious outcome would be unlikely in a nondiabetic. Under the "eggshell skull" rule, the negligent doctor will be liable for all injuries, including the amputation, although not for the preexisting diabetic condition itself.
The "eggshell skull" rule should be distinguished from the "crumbling skull" rule. The latter basically stipulates that compensation must discount the damage that can reasonably be expected to flow normally from any preexisting conditions even in the absence of tortious aggravation.
Dr. Tan is emeritus professor of medicine at the University of Hawaii and director of the St. Francis International Center for Healthcare Ethics. This article is meant to be educational and does not constitute medical, ethical, or legal advice. It is adapted from the author’s book, "Medical Malpractice: Understanding the Law, Managing the Risk" (2006). For additional information, readers may contact the author at siang@hawaii.edu.