Where a surgeon fails to warn of a material risk of surgery and that risk eventuates, causation is established under Chappel v Hart even where the patient's evidence is that she would have sought a second opinion rather than a different surgeon. The evidentiary onus lies on the defendant to show that the risk would not have been reduced by an adequate warning. In assessing damages for failure to warn, the plaintiff's pre-existing condition and its propensity to develop must be taken into account, and the defendant bears the evidentiary onus of establishing that the plaintiff would have suffered the same injuries independently of the negligence. A trial judge errs in finding a surgeon negligent for failing to perform an on-table gastroscopy where the overwhelming medical evidence, including from the plaintiff's own expert, is that such a procedure was not usual practice outside emergency situations.
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