André Michael

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.

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.