Andrea Plumb

Medical negligence trial arising from an emergency department assessment of a young adult who was discharged with a viral illness diagnosis, returned the next day in respiratory distress, and died from bacterial pneumonia complications.

The plaintiffs alleged the emergency physicians breached the standard of care by failing to investigate pneumonia with chest X-ray and bloodwork and that earlier diagnosis would have prevented death.

The court held the patient’s presentation on the first attendance was consistent with viral illness, did not objectively indicate pneumonia, and did not require those investigations.

Apart from a technical charting omission regarding the respiratory examination, no breach was established, and the plaintiffs failed to prove on a balance of probabilities that earlier testing or treatment would have changed the outcome.

The infant plaintiff suffered a severe and permanent brachial plexus injury during birth after encountering shoulder dystocia.

The plaintiffs brought a medical negligence action against the delivering obstetrician, alleging he applied excessive downward traction.

The defendant argued the injury was caused by maternal propulsive forces.

The court found that the defendant breached the standard of care by applying more than gentle downward traction, which caused the injury.

The court awarded $811,564 in total damages, including non-pecuniary damages, future care costs, future loss of income, and Family Law Act damages for the family.

The appellants appealed a summary judgment dismissing their medical malpractice action as statute-barred.

The Court of Appeal affirmed the motion judge's finding that the claim was discoverable no later than February 6, 2014, when the family met with a medical malpractice lawyer, and therefore the action, issued on April 11, 2016, was out of time.

The court rejected the argument that expert reports were necessary for discoverability, emphasizing that a claim is discovered when a plaintiff has knowledge of material facts for a plausible inference of liability, not necessarily when the merits are confirmed by expert opinion.

Following the dismissal of the plaintiffs' medical malpractice action on a summary judgment motion due to the expiry of the limitation period, the successful defendant sought costs of $117,413.06.

The plaintiffs did not dispute the presumptive entitlement to costs but argued for a reduction.

The court found the claimed 388 hours of lawyer time excessive, noting the action did not advance to trial preparation and the limitation issue was not novel.

Exercising its discretion under section 131 of the Courts of Justice Act, the court reduced the fees to ensure proportionality, fixing the total costs payable by the plaintiffs at $72,375.25 inclusive of disbursements and HST.

The defendant in a medical malpractice action brought a motion to compel the plaintiffs to re-attend examinations for discovery to answer questions they previously refused.

The questions related to when the deceased and the plaintiffs first retained counsel and requested medical records, which the defendant argued was relevant to their limitation period defence.

The court granted the motion, finding that facts regarding the date a cause of action arises and when counsel was retained are relevant to discoverability and are not protected by solicitor-client privilege.

The plaintiffs were ordered to re-attend at their own expense.

The Medical Officer of Health for Haldimand-Norfolk appealed a decision of the Health Services Appeal and Review Board (HSARB) that struck down a requirement limiting the number of migrant farm workers to three per bunkhouse during their mandatory 14-day COVID-19 self-isolation period.

The Divisional Court allowed the appeal, finding that the HSARB erred in law by applying too high a standard of proof, failing to consider that the directive was a class order, and incorrectly concluding that the three-person limit was arbitrary.

The court restored the original order, emphasizing the precautionary principle and the vulnerability of migrant farm workers.

Three groups brought motions for leave to intervene as friends of the court in an appeal from a decision of the Health Services Appeal and Review Board.

The underlying appeal concerned a medical officer of health's order limiting migrant farm workers to a maximum of three persons per bunkhouse to prevent the spread of COVID-19.

The court granted leave to intervene to the human rights organization and a coalition of legal clinics, finding they would make useful and distinct contributions regarding international human rights and the specific vulnerabilities of migrant workers.

The court dismissed the motion by the religious organization, finding it had not demonstrated a unique legal perspective or expertise.

The plaintiffs brought a medical malpractice action against a general practitioner and a specialist surgeon following complications from bowel surgery that resulted in a severe necrotizing soft tissue infection.

The plaintiffs alleged the specialist failed to follow up on PET scan results and the general practitioner failed to accurately communicate those results.

The court found that while the specialist breached the standard of care by failing to follow up, the plaintiffs failed to establish causation, as the patient's history of seeking alternative treatments and rejecting medical advice indicated he would not have complied with the recommended treatment plan.

The court found the general practitioner met the standard of care.

The action was dismissed.

The plaintiffs brought a medical malpractice action against the defendants after their newborn son developed kernicterus and suffered severe brain damage due to untreated hyperbilirubinemia.

The action against the physicians was settled, and the trial proceeded against the hospital and the nurse who cared for the infant overnight.

The court found that the nurse breached the standard of care by failing to report her observation of the infant's jaundice to a physician.

Applying a robust and pragmatic approach to causation, the court concluded that but for the nurse's negligence, a physician would have ordered a bilirubin test and initiated phototherapy in time to prevent the infant's injuries.

The hospital was held vicariously liable.

The plaintiffs (Moles) and defendant (Manwell) brought cross-motions regarding the admissibility and number of expert witnesses in a medical negligence case.

The Moles sought to restrict Manwell to one expert, while Manwell sought to preclude the Moles' expert (Schatzker) from testifying on a novel surgical technique or, alternatively, to allow all three of his experts to testify if Schatzker's evidence was admitted.

The court found Schatzker's novel evidence on the modified surgical technique to have sufficient threshold reliability for admission.

Consequently, the Moles' motion to restrict Manwell's experts was dismissed, and Manwell was permitted to call all three of his proposed expert witnesses.

During a medical malpractice trial involving a newborn who developed kernicterus from untreated jaundice, the plaintiffs sought to qualify a registered nurse as an expert in perinatal nursing.

The defendants objected, arguing she lacked specific recent experience in tertiary hospital nurseries and was a 'roaming expert.' The court applied the Mohan and White Burgess frameworks, finding the proposed expert possessed the requisite specialized knowledge and experience in newborn care and jaundice assessment.

The court admitted the expert evidence, concluding its probative value outweighed any potential prejudice.

A medical malpractice action arising from the treatment of a young patient presenting with neurological symptoms at a rural hospital.

The physician failed to recognize the possibility of stroke, lowered the patient’s blood pressure aggressively, and delayed consultation with a tertiary neurology centre.

The court held that the physician breached the standard of care by failing to include stroke in the differential diagnosis, lowering blood pressure despite neurological signs, and delaying transfer for specialist assessment.

Applying the “but for” causation test from Clements v. Clements, the court found that the precipitous blood pressure reduction and delayed administration of heparin promoted clot formation which caused the catastrophic stroke.

The plaintiffs established causation on a balance of probabilities and were awarded damages.

The appellants, three physicians, appealed a trial judgment finding them liable in negligence for the delayed diagnosis and death of a patient from infective endocarditis.

The trial judge found the emergency room resident breached the standard of care by failing to review a SARS form containing critical clinical history, and held the supervising physician vicariously liable.

The Court of Appeal allowed the appeal regarding the supervising physician, as vicarious liability was neither pleaded nor argued at trial.

However, the Court dismissed the appeal regarding the resident's breach of the standard of care and the trial judge's causation findings, concluding that the evidence supported the determination that a timely diagnosis would have prevented the patient's death.

During a medical malpractice trial, the defendants brought a motion under s. 12 of the Ontario Evidence Act seeking leave to call more than three expert witnesses.

The case involved allegations that an emergency room physician negligently failed to recognize stroke symptoms and delayed transfer for specialized care, allegedly resulting in quadriplegia.

The court considered factors relating to duplication, fairness between parties, necessity of additional expert evidence, and litigation cost.

Finding that the issues concerned only standard of care and causation and that three experts were sufficient to address them, the court concluded that allowing additional experts would create unnecessary duplication and disadvantage the plaintiffs.

Leave to call more than three medical experts was therefore refused.

The appellant physician performed ear surgeries using a new antiseptic introduced by the hospital, which caused profound hearing loss in two patients.

The hospital settled with the patients and sought contribution and indemnity from the appellant, arguing he was negligent in failing to inquire about the new antiseptic's properties.

The trial judge found the appellant 50% liable.

On appeal, the Court of Appeal reversed the decision, finding no evidence that the appellant breached the standard of care or that further inquiries would have revealed the antiseptic's ototoxicity prior to the surgeries.

The hospital's claim was dismissed.

The appellants appealed a trial judgment, arguing the trial judge erred in his findings of fact.

The Court of Appeal dismissed the appeal, holding that the trial judge's findings were amply supported by the evidence and there was no palpable and overriding error.

As a result, the court did not need to address the submissions on damages.

No costs were sought by the respondent.