Yes. Medical treatment can raise a causation question, but a poor outcome or ordinary medical negligence does not automatically break the chain. Under CALCRIM 620, the accused act must be a substantial factor in the death—more than a trivial or remote cause—but it need not be the only cause. If the original injury remained a substantial factor, a doctor’s or medical staff’s failure to use reasonable care does not by itself remove legal responsibility.

The instruction describes a different result when the original injury was not a substantial factor and grossly improper treatment caused the death. In that situation, the original injury is not treated as the legal cause of death on that theory. The distinction depends on the evidence and the instruction given by the court. (Judicial Council of California Criminal Jury Instructions, CALCRIM 620)

Build the medical timeline

A useful review tracks the condition from the alleged act through death, rather than treating a complication as proof of causation one way or the other. Relevant records may include:

  • the person’s condition immediately after the alleged injury and during transport;
  • emergency intake, imaging, procedures, and surgeries;
  • vital signs, medications, cultures, infections, and other complications;
  • resuscitation efforts and decisions about continuing or withdrawing care;
  • the death certificate, autopsy, and records explaining the medical cause of death.

These are practical categories for counsel and qualified experts to evaluate. Not every record exists in every case, and access to protected medical records must follow lawful procedures. A chart records clinical observations and decisions; it does not necessarily resolve the legal causation question by itself.

Separate medical facts from the causation opinion

A death certificate and autopsy may describe events using different terms. An expert can review the underlying records and explain whether the initial injury remained a substantial factor, whether treatment complications contributed, and whether the facts meet the instruction’s narrower grossly improper treatment alternative. A bad result alone proves neither malpractice nor an intervening cause.

The instruction also addresses a person’s vulnerability. If an injury substantially contributed to death, the fact that a preexisting condition made death more likely or accelerated it does not itself defeat causation. The legal question remains whether the accused act was a substantial factor in the death. (CALCRIM 620)

Causation is only one part of a criminal case. For murder, Penal Code § 187 separately defines the offense in terms of an unlawful killing with malice aforethought; other charged offenses have their own elements. A causation dispute does not automatically resolve malice, degree, or any other issue. (Penal Code § 187)

For a case-specific review, a defense team can compare the medical chronology with the charges and consult an appropriate expert. The Law Offices of David S. Chesley handles homicide and serious criminal defense in Los Angeles. Call (800) 755-5174 to discuss a case.