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The law will consider a tortfeasor’s act a proximate cause when that conduct is a significant contributor to the injuries incurred.

The substantial factor test for causation rather than a 'but-for' test should under Maryland law be applied in a case involving multiple causes of a particular harm. The critical question is whether the conduct or products of the defendant were independently sufficient causes of harm to the plaintiff(s). A cause must be sufficient before it can be substantial. See Restatement (Second) of Torts, § 432(2) ('if … each [force] of itself is sufficient to bring about harm to another, the actor's negligence may be found to be a substantial contributing factor'). As the Court of Appeals of Maryland observed, ''if two causes concur to bring about an event, and either one of them, operating alone, would have been sufficient to cause the identical result,' some test of proximate causation, other than 'but-for' is needed.' 326 Md. at 208 (quoting W. Keeton, Prosser & Keeton on the Law of Torts § 41 at 266 (5th ed. 1984) (emphasis added).)

Professor David W. Robertson has cogently noted in The Common Sense of Cause-in-Fact, 75 Tex. L. Rev. ...

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