The trial court then ruled that neither Doctor Arumugam's testimony nor the other evidence proferred by plaintiff was sufficient to establish a causal relationship between the collision and her nasal injuries and instructed the jury to disregard all testimony and exhibits previously presented relating thereto. • 3 It is fundamental that liability in a personal injury action cannot be based on speculation or conjecture ( Tiffin v. Great Atlantic Pacific Tea Co. (1959), 18 Ill.2d 48, 162 N.E.2d 406), and that the burden is on the plaintiff to produce evidence, either direct or circumstantial ( Scholle v. Continental National American Group (1976), 44 Ill. App.3d 716, 358 N.E.2d 893), to show not only that injuries exist but also that they were the result of the occurrence at issue ( Bugariu v. Conley (1981), 93 Ill. App.3d 571, 417 N.E.2d 719). However, the plaintiff is not required to prove the case beyond a reasonable doubt or negate entirely that defendant's conduct was not the cause of the injury (Prosser, Law of Torts sec. 41 (5th ed. 1984)), and it is only where the evidence and all reasonable inferences which could be drawn therefrom, when viewed most favorably for plaintiff so overwhelmingly favors defendant that no reasonable person could find for plaintiff, that the decision as to causation should be taken from the jury, whose function is to weigh contradictory evidence, judge the credibility of the witnesses and make the ultimate conclusion as to the facts ( Finley v. New York Central R.R. Co. (1960), 19 Ill.2d 428, 167 N.E.2d 212; Scholle v. Continental National American Group (1976), 44 Ill. App.3d 716, 358 N.E.2d 893).
In re Union Drainage District (1976), 39 Ill. App.3d 862, 350 N.E.2d 865. The plaintiff draws our attention to the case of Scholle v. Continental National American Group (1977), 44 Ill. App.3d 716, 358 N.E.2d 893. In Scholle the decedent fell from a platform surrounding her swimming pool where she had been standing using a skimming net to remove floating leaves from the pool.
“[W]here the expert's opinion is the only evidence of proximate cause he must base his opinion on a reasonable degree of medical certainty.” Scholle v. Continental Nat'l Am. Grp., 44 Ill.App.3d 716, 721 (2d Dist. 1976).
Proof of a change in health following an injury is competent as tending to establish that the impaired condition was due to the trauma. ( Scholle v. Continental National American Group (1976), 44 Ill. App.3d 716, 722, 358 N.E.2d 893.) Scholle held that the change in its plaintiff's health after her injury was of sufficient weight to deny a motion for judgment n.o.v., even when the plaintiff's causation claim was not the only possible conclusion, as long as it was a reasonable conclusion. ( Scholle, 44 Ill. App.3d at 722.)
Under Illinois law, to serve as the sole basis for a conclusion that an act was the proximate cause of the plaintiff's injury, an expert must be able to testify with a reasonable degree of medical certainty that proximate cause existed. Scholle v. Continental Nat'l Am. Group, 358 N.E.2d 893, 898 (Ill.App.Ct. 1976) (citing Sommers v. American Economy Ins. Co., 289 N.E.2d 712 (Ill.App.Ct. 1972)). In light of Dr. Mangurten's statement on cross-examination that he was not stating with any degree of medical certainty that Jessica's problems had "at any time" been caused by bromide, we conclude that his equivocal statement during direct that there was a "suggestion" that the symptoms were "related" to bromide is insufficient, standing alone, to raise an issue of fact as to proximate causation of Jessica's short-term problems.
Causation can also be based on circumstantial evidence; however, if the causal relationship is based on circumstantial evidence, the facts and evidence must reasonably permit the inference of cause and effect. See Scholle v. Cont. Nat. Am. Grp., 44 Ill.App.3d 716, 721, 3 Ill.Dec. 350, 358 N.E.2d 893 (Ill.App.2d 1976). Consequently, the Court must determine if Perez presents evidence sufficient to create a genuine issue of material fact regarding whether Morales's heart failure was caused by an accident.
There is no other evidence from which a jury could infer that these injuries were proximately caused by the incident; Joyce had been suffering from degenerative disc disease and back and leg pain for years prior to the incident. Cf. Scholle v. Continental Nat. American Group, 358 N.E.2d 893, 898 (Ill.App.Ct. 1976) (holding that although plaintiff's medical expert could not give an opinion based on a reasonable degree of medical certainty that decedent's fall caused ruptured aneurysm which resulted in her death, medical evidence that fall could have caused rupture, along with circumstantial evidence that decedent had previously been in good health and that symptoms of ruptured aneurysm first appeared immediately after the fall presented jury question as to whether death was caused by accident). Thus, Defendant's Motion for Summary Judgment with respect to Joyce's claim for these injuries is granted.
A number of courts have found analogous deaths resulting from exertion induced ruptures of pre-existing aneurysms to be "accidents." See, e.g., Carroll v. CUNA Mutual Ins. Society, 894 P.2d 746, 753 (Colo. 1995); Scholle v. Continental Nat'l American Group, 44 Ill. App.3d 716, 3 Ill.Dec. 350, 355-56, 358 N.E.2d 893, 898-99 (1976); Zorn v. Aetna Life Ins. Co., 260 F. Supp. 730, 733 (E.D.Tex. 1965). This Court similarly concludes that Dale Mers' death was accidental (as that term is commonly understood), as it was triggered by unusual physical activity and it was not, and, indeed, could not, reasonably have been foreseen or expected.
) Negligence may be established by using either direct or circumstantial evidence ( Murphy v. Messerschmidt (1977), 68 Ill.2d 79, 85; Walsh v. Finley (1972), 51 Ill.2d 174, 176-77) and, contrary to defendant's assertion, the use of circumstantial evidence is not limited to those instances in which the circumstances support only one logical conclusion. Instead, circumstantial evidence will suffice whenever an inference may reasonably be drawn therefrom ( Walsh v. Finley (1972), 51 Ill.2d 174, 176-77; see also Finley v. New York Central R.R. Co. (1960), 19 Ill.2d 428, 436; Illinois Bell Telephone Co. v. Purex Corp. (1980), 90 Ill. App.3d 690, 697; Scholle v. Continental National American Group (1977), 44 Ill. App.3d 716, 721), and the facts established by such inferences are considered when an issue is decided as a matter of law or a verdict is directed. See Hayes v. Alsburg (1978), 72 Ill.2d 560, 567; Murphy v. Messerschmidt (1977), 68 Ill.2d 79, 86.
Royal Indemnity Company v. Hume, 477 S.W.2d 683 (Tex.Civ.App., 1972); O'Neill v. Cross County Hospital, App. Div., 402 N.Y.S.2d 633 (1978). See also Scholle v. Continental Nat. Am. Group, 44 Ill. App.3d 716, 3 Ill.Dec. 350, 358 N.E.2d 893 (1976). There must be evidence of the probability of surgery recommendation before the medical expert may testify about a possible need of a future operation.