Rogers v. Moll: Kansas Affirms “Instructions as a Whole” Can Satisfy Causation Without a Standalone Definition—and Flags PIK’s “Fault” Framing in Single-Defendant Negligence Trials

1. Introduction

Case: Rogers v. Moll, No. 127,119 (Kan. Sept. 4, 2026).
Court: Supreme Court of Kansas (Walsh, J.).
Parties: Sharon Rogers and Robert Rogers (individually, as heirs-at-law of Aryn Rogers, and as co-administrators of Aryn’s estate) versus Matthew Moll, M.D.

This medical malpractice appeal arose from the death of Aryn Rogers, an adult patient with a history of hydrocephalus treated by a ventriculoperitoneal (VP) shunt. After Aryn presented to the emergency room with severe symptoms (including seizure), Dr. Moll evaluated her, ordered a head CT, did not consult neurosurgery, and did not order a “shunt series.” Aryn’s condition worsened and she died. The Rogers sued multiple providers and the hospital, but by trial only Dr. Moll remained.

The central appellate dispute was not the sufficiency of the evidence but whether the jury was properly instructed—particularly on causation—when the instructions tracked Pattern Instructions Kansas (PIK) and did not separately define causation, and when the verdict form asked simply which side the jury “find[s] for.”

Key issues: (1) Whether the challenged instructions and verdict form were legally appropriate despite the absence of a standalone causation definition; and (2) whether PIK’s heavy use of “fault” language, combined with PIK’s recommendation not to define causation, risks confusion in a single-defendant negligence case with no allegation of plaintiff fault.

2. Summary of the Opinion

The Kansas Supreme Court affirmed the Court of Appeals and the district court judgment for Dr. Moll. The court held that, read as a whole, the instructions sufficiently conveyed the necessary causal link—particularly because the contentions instruction stated that Dr. Moll “denies that he was negligent ... or that he was at fault in causing or contributing to her death.”

Although the court found no instructional error, it issued pointed guidance to the PIK Committee: the total omission of a causation definition may “omit a critical piece of information” for jurors, and repeated use of “fault” may be a poor fit—and potentially misleading—in single-defendant negligence cases where comparative fault is not in play.

3. Analysis

A. Precedents Cited

1) Biglow v. Eidenberg

The court relied on Biglow v. Eidenberg, 308 Kan. 873, 880-81, 424 P.3d 515 (2018), for the now-familiar four-step instructional error framework: reviewability/preservation; legal appropriateness; factual appropriateness; and harmlessness (if error). Although Rogers ultimately found no error (thus avoiding harmlessness), it used Eidenberg both procedurally (how to analyze the claim) and substantively (reciting malpractice elements).

The opinion also quoted Eidenberg for malpractice elements, emphasizing that proximate causation remains an element even if PIK discourages defining it.

2) State v. Hillard (313 Kan. 830) and State v. Hillard (315 Kan. 732)

State v. Hillard, 313 Kan. 830, 844-45, 491 P.3d 1223 (2021), was cited for the relationship between preservation and harmlessness standards—an issue the court noted but did not need to resolve because it found no instructional error.

State v. Hillard, 315 Kan. 732, 770, 511 P.3d 883 (2022), was cited (with an abrogation note) for the rule that instructions must be read together, not in isolation. That holistic reading was decisive: the court treated the “at fault in causing or contributing to her death” phrasing as supplying the missing causal connector across instructions.

The opinion noted that the 2022 Hillard decision was “abrogated in part on other grounds by State v. Barnes, 320 Kan. 147, 563 P.3d 1255 (2025),” but that abrogation did not undermine the “read as a whole” principle deployed here.

3) Burnette v. Eubanks

Burnette v. Eubanks, 308 Kan. 838, 842, 847-48, 852-53, 425 P.3d 343 (2018), performed two roles.

  • Method: It reinforced that appellate courts evaluate the combined effect of multiple instructions.
  • Substance: It supported the proposition that phrasing such as “caused or contributed to” can adequately communicate causation in context. The Rogers court analogized to Burnette in concluding that the instructions here, taken together, sufficiently linked negligence/fault to the death.

4) Wolfe Electric, Inc. v. Duckworth and Aeroflex Wichita, Inc. v. Filardo

To treat the verdict form challenge consistently with instruction challenges, the court cited: Wolfe Electric, Inc. v. Duckworth, 293 Kan. 375, 387, 266 P.3d 516 (2011), and Aeroflex Wichita, Inc. v. Filardo, 63 Kan. App. 2d 588, 614, 534 P.3d 610 (2023), for the proposition that the same review approach applies to alleged verdict form errors.

This mattered because the Rogers argued the verdict form should have asked whether Dr. Moll was “at fault,” while the district court used a simpler “find for Plaintiffs or Defendant” format.

5) State v. Ervin

The court adopted as a controlling yardstick the rule articulated in State v. Ervin, 320 Kan. 287, Syl. ¶ 4, 566 P.3d 481 (2025): if the instructions “properly and fairly state the law and are not reasonably likely to mislead the jury,” it does not matter that an alternative instruction might have been clearer or more thorough.

Ervin supplied the doctrinal “permission” to affirm even while acknowledging the Rogers’ concern had practical force and that a clearer causation instruction was easy to imagine.

6) Castleberry v. DeBrot

Castleberry v. DeBrot, 308 Kan. 791, 802-04, 424 P.3d 495 (2018), was cited (along with Burnette) for Kansas’ broader discussion of proximate cause and for the acceptability of “caused or contributed to” language in capturing the concept’s “gist.” The citation underscores that Kansas has not abandoned causation; rather, it has sometimes tolerated more general phrasing when the overall instruction set provides adequate guidance.

7) State v. Bernhardt and State v. Salts

These cases framed the court’s institutional relationship with PIK:

  • State v. Bernhardt, 304 Kan. 460, Syl. ¶ 1, 372 P.3d 1161 (2016): PIK use is not mandatory but is “strongly recommended.” The court invoked this to justify speaking directly to the PIK Committee’s design choices.
  • State v. Salts, 288 Kan. 263, 266, 200 P.3d 464 (2009): the court previously criticized and suggested removal of problematic PIK language. By citing Salts, the court signaled that it is willing not only to apply PIK but to prompt its revision where the pattern approach risks misleading jurors.

8) Simmons v. Porter (and K.S.A. 60-258a context)

Simmons v. Porter, 298 Kan. 299, 306-08, 312 P.3d 345 (2013), was cited for the background of Kansas comparative negligence/statutory comparative fault principles. This citation matters because the court’s concern is structural: PIK’s “fault” vocabulary and its deemphasis of proximate cause emerged in the comparative fault era, but those design choices may fit poorly when comparative allocation is irrelevant—i.e., one defendant and no plaintiff fault claim.

9) Rogers v. Moll (Court of Appeals)

The Supreme Court reviewed the Court of Appeals’ unpublished affirmance: Rogers v. Moll, No. 127,119, 2025 WL 2427624. While the Supreme Court agreed with the outcome, it wrote separately to spotlight systemic instruction-design concerns (causation silence; “fault” framing) that transcend this single appeal.

B. Legal Reasoning

1) The doctrinal baseline: causation is an element

The court reaffirmed Kansas’ medical malpractice elements (quoted from Eidenberg), including that the injury must “proximately result” from the breach. This sets a firm baseline: even if PIK recommends omitting a causation definition (PIK Civ. 4th 104.01), causation remains a required finding.

2) The “instructions as a whole” move

The Rogers attacked the absence of explicit causation guidance in Instruction No. 11 (standard of care) and the shaping of Instruction No. 13 (contentions), plus the simplified verdict form. The court’s answer was integrative:

  • Instruction No. 11 (tracking PIK Civ. 4th 123.01) correctly defined duty/standard of care and negligence as a violation of that duty.
  • Instruction No. 13 supplied the functional causal connector by stating that Dr. Moll denied being “at fault in causing or contributing to her death.” That phrasing, the court held, tied “fault” to the consequence (death) and thus communicated what jurors needed to decide.
  • The verdict form’s “find for Plaintiffs or Defendant” format was acceptable because—given the instruction set—it did not mislead jurors about what a plaintiff’s verdict required.

3) Why the court rejected the plaintiffs’ proposed “fault” and “causation” additions

The Rogers sought to add language to Instruction No. 11: “A party is at fault when he is negligent, and that negligence caused or contributed to the event which brought about the claims for damages.” The court did not adopt that approach and also noted that their excised contentions language arguably misstated “the relevant duty Dr. Moll owed to Aryn.”

Importantly, the court did not hold that such language is never permissible. Rather, applying Ervin, it held the omission was not legal error because the instructions already “properly and fairly state[d] the law” and were not likely to mislead.

4) The court’s guidance to PIK: a systemic caution

Even while affirming, the court validated the animating concern: PIK Civ. 4th 104.01 recommends no causation definition, and the PIK Committee suggested proximate cause is “almost, but not quite, obsolete” after comparative fault adoption. The court cautioned that silence “threatens to omit a critical piece of information from the jury’s consideration.”

Separately, the court questioned whether “fault” as used repeatedly in PIK Civ. 4th 106.01 may “lead both litigants and juries astray” in a single-defendant negligence case where no plaintiff fault is alleged. In effect, the court distinguished between:

  • Comparative-fault trials (where “fault” is a natural organizing concept tied to allocation under K.S.A. 60-258a), and
  • Single-defendant negligence trials (where jurors primarily need a clear negligence + causation + damages pathway, not an allocation-centered “fault” frame).

C. Impact

1) Litigation and trial practice

  • Affirmance pathway for defendants: Defendants can defend verdicts even where causation is not separately defined, so long as the instruction set includes language functionally linking breach/negligence to injury (e.g., “causing or contributing to” the harm) and is not misleading.
  • Drafting strategy for plaintiffs: Plaintiffs challenging PIK-based instructions should identify not just the absence of a causation definition but the absence of any clear connective language. If “causing or contributing” appears anywhere salient, Rogers makes reversal harder.
  • Trial judges’ discretion: The decision reinforces that trial courts have leeway to reject additional party-proposed phrasing—especially where it risks misstating duty—without committing reversible error.

2) Pattern instructions reform pressure

The opinion is a notable “affirm-but-warn” signal to the PIK Committee. By invoking Bernhardt (PIK strongly recommended) and Salts (court publicly urging PIK revision), the court increased the likelihood of future PIK reconsideration on:

  • whether to include an optional, plain-language causation instruction (especially in malpractice cases), and/or
  • whether to recalibrate “fault” terminology in single-defendant cases to reduce comparative-fault “spillover” confusion.

3) Appellate review doctrine remains conservative

By anchoring its holding in Ervin, the court reaffirmed a restrained approach: appellate courts will not reverse simply because instructions could be improved. This continues to place a premium on demonstrating a realistic likelihood of jury confusion or misdirection.

4. Complex Concepts Simplified

  • Standard of care (medical malpractice): The level of skill and learning ordinarily used by reasonably careful providers in the same field under similar circumstances. A violation is negligence (as stated in Instruction No. 11, consistent with PIK Civ. 4th 123.01).
  • Causation / proximate cause: The idea that the defendant’s breach must be sufficiently connected to the injury—often framed as whether the breach “caused” the harm (and, in Kansas formulations, sometimes whether it “caused or contributed to” the harm).
  • Comparative fault (“fault”): A system (K.S.A. 60-258a) where responsibility can be allocated among multiple actors (and sometimes the plaintiff). The court’s concern is that “fault” language—designed for allocation—can distract in a one-defendant case where allocation is not the task.
  • PIK (Pattern Instructions Kansas): Non-mandatory but strongly recommended model instructions drafted to reflect Kansas law. PIK Civ. 4th 104.01 recommends not defining causation; the court flagged that recommendation as potentially problematic in some settings.
  • “Instructions as a whole” doctrine: Appellate courts assess whether the entire package of instructions fairly states the law, rather than treating any single instruction’s omissions as automatically reversible.

5. Conclusion

Rogers v. Moll does not change the elements of Kansas medical malpractice—causation remains essential. But it clarifies that a verdict will be upheld even without a standalone causation definition when, viewed as a whole, the instructions supply a workable causal link (here, via “at fault in causing or contributing to her death”) and are not reasonably likely to mislead.

The opinion’s broader significance lies in its institutional guidance: Kansas’ highest court openly questioned whether PIK’s omission of causation definitions and its reliance on “fault” framing—products of the comparative fault era—fit cleanly in single-defendant negligence trials. Future Kansas instruction practice (and potential PIK revisions) may be shaped by this explicit caution.