Health Law

The appellant appealed the dismissal of his dental malpractice claim.

During a tooth extraction, the appellant exhibited signs of distress, prompting the respondent dentist to administer nitroglycerin under the belief the appellant was having a heart attack.

The appellant later suffered a bradycardic event at the hospital and claimed psychological injuries.

The Divisional Court upheld the trial judge's findings that the respondent met the standard of care in an emergency situation and that there was no factual causation between the administration of nitroglycerin and the subsequent hospital event.

The appeal was dismissed.

The applicant nurses' union sought judicial review of two directives issued by the Chief Medical Officer of Health regarding COVID-19 infection control and the use of N95 respirators.

The applicants argued the directives failed to account for aerosol and asymptomatic transmission and violated section 7 of the Charter.

The Divisional Court dismissed the application, finding the directives were reasonable as they expressly incorporated the precautionary principle and permitted nurses to access N95 respirators based on their professional judgment.

The College of Physicians and Surgeons of Ontario moved for an order sealing the patient records of a complainant in a physician's appeal of a Health Professions Appeal and Review Board (HPARB) decision.

The Divisional Court dismissed the motion, finding that the College had not sought a sealing order at first instance before the HPARB.

The court held that the HPARB should control its own processes and develop its own jurisprudence on protective orders, and declined to permit the issue to be raised for the first time on appeal, particularly where the records were not highly sensitive and the complainant raised no privacy concerns.

The applicant dentist sought judicial review of a decision by the Health Professions Appeal and Review Board (HPARB), which affirmed a decision of the Inquiries, Complaints, and Reports Committee (ICRC) of the Royal College of Dental Surgeons of Ontario.

The ICRC had ordered the applicant to complete a specified continuing education or remediation program (SCERP) and receive a caution regarding unnecessary dental restorations and providing inaccurate information during the investigation.

The applicant argued the ICRC made impermissible credibility findings and that the HPARB failed to provide meaningful analysis.

The Divisional Court dismissed the application, finding that the ICRC's factual conclusions were reasonable, within its mandate, and supported by the documentary record, and that the HPARB's review was adequate and responsive.

The moving party, a physician recently acquitted of criminal sexual assault charges, sought an interim stay of a scheduled disciplinary hearing before the College of Physicians and Surgeons of Ontario pending his application for judicial review.

He argued the disciplinary proceedings were an abuse of process and res judicata given his acquittal.

The Divisional Court dismissed the motion, finding the application for judicial review premature as the Discipline Committee had not yet heard or decided the abuse of process arguments.

The court also found no evidence of irreparable harm and held that the balance of convenience favoured the public interest in allowing the self-regulating profession to proceed with its hearing.

The College of Physicians and Surgeons of Ontario brought a motion to quash an application for judicial review commenced by a physician whose licence was revoked.

The physician sought to challenge the Discipline Committee's revocation decisions and an earlier interim suspension by the Inquiries, Complaints and Reports Committee.

The Divisional Court granted the motion to quash, finding that the physician had an adequate alternative remedy through a statutory right of appeal for the revocation decisions.

The court also dismissed the challenge to the interim suspension due to excessive delay of over two years and because the issue was moot following the licence revocation.

The applicant pharmacy sought judicial review of a decision by the Executive Officer of the Ontario Drug Benefit Program to revoke its billing privileges.

The Executive Officer found the pharmacy had made over $87,000 in unsubstantiated billings and over $62,000 in improper billings.

The Divisional Court dismissed the application, finding the Executive Officer's decision was reasonable and that the applicant was not denied procedural fairness.

The appellant physician appealed a decision of the Discipline Committee revoking his certificate of registration for professional misconduct.

The misconduct included a guilty plea related to OHIP billing, clinical and record-keeping deficiencies, and misleading the College regarding a vaccine administration.

The Divisional Court dismissed the appeal, finding no error in principle in the Committee's conclusion that the appellant was irremediable given his extensive 18-year disciplinary history.

The court held that the penalty of revocation was proportionate and not clearly unfit.

The applicant, a designated manager of a pharmacy, sought judicial review of a decision by the Inquiries, Complaints and Reports Committee (ICRC) of the Ontario College of Pharmacists.

Following a dispensing error where a pediatric patient received the wrong medication, the ICRC ordered the applicant to receive an oral caution and complete a remedial course on root cause analysis.

The applicant argued he was denied procedural fairness and that the decision was unreasonable.

The Divisional Court dismissed the application, finding no breach of procedural fairness and concluding that the ICRC's decision was reasonable given the applicant's responsibility for pharmacy policies.

The appellant appealed a motion judge's decision refusing to certify a proposed class action against a medical clinic for infection control lapses during endoscopies.

The motion judge had denied certification on the basis that the appellant failed to establish an identifiable class of two or more people who suffered harm.

The Divisional Court allowed the appeal, finding the motion judge erred in law by requiring evidence of actual harm to multiple people at the certification stage, rather than just an objective basis to identify class members.

The matter was remitted to the motion judge to determine the remaining certification criteria.

The applicant physician sought judicial review of interim orders made by the Inquiries, Complaints and Reports Committee (ICRC) of the College of Physicians and Surgeons of Ontario, which restricted his medical practice due to concerns that his conduct exposed patients to harm.

The applicant argued the decisions were unreasonable and procedurally unfair.

The Divisional Court dismissed the application, finding that the ICRC reasonably relied on expert evidence to conclude patients were likely to be exposed to harm, and that the paper-based process followed by the ICRC met the required duty of procedural fairness for interim protective orders.

The applicants sought judicial review of an Ontario regulation that discontinued the reimbursement of out-of-country medical expenses under the provincial health insurance plan.

The Divisional Court found that the regulation clearly violated the portability criterion of the Canada Health Act, which would disqualify Ontario from receiving a full federal cash contribution.

Because the Health Insurance Act explicitly prohibits the Lieutenant Governor in Council from making regulations that would cause such disqualification, the impugned regulation was declared ultra vires.

The applicants' Charter challenges under sections 7 and 15 were dismissed.

The appellant appealed a decision of the Health Professions Appeal and Review Board (HPARB) denying him hospital privileges.

The Divisional Court found that HPARB reasonably addressed alleged procedural irregularities and correctly applied the statutory test under the Public Hospitals Act.

The court upheld HPARB's finding that the appellant's hostile conduct towards other health professionals, which continued on social media, made his continued involvement at the hospital untenable.

The appeal was dismissed with costs.

The appellant appealed a decision of the Health Services Appeal and Review Board denying OHIP funding for out-of-country residential psychiatric treatment at the Austen Riggs Centre.

The Board found that the appellant failed to establish that the required services were not available at an OHIP preferred provider facility.

The Divisional Court upheld the Board's decision as reasonable, noting that while the chosen facility may have been preferred by the appellant's expert, the evidence did not show that the preferred providers could not provide the necessary care.

The appeal was dismissed.

The applicant, a pharmacy manager, sought judicial review of a decision by the Health Professions Appeal and Review Board (HPARB) confirming an Inquiries, Complaints and Reports Committee (ICRC) decision to caution him and require an educational program following a serious dispensing error by a pharmacist at his pharmacy.

The applicant argued the decisions were unreasonable and procedurally unfair, claiming he was improperly held responsible for another's mistake and denied procedural fairness regarding his discipline history and communication issues.

The Divisional Court dismissed the application, finding the decisions reasonable and procedurally fair, noting the applicant's responsibility as designated manager for pharmacy policies and procedures.

The Registrar appealed a Licence Appeals Tribunal decision setting aside a proposal to revoke the respondent's crematorium operator licence.

The respondent used a low-temperature alkaline hydrolysis process, which the Registrar argued posed a public health risk due to potential failure to destroy prions.

The Divisional Court dismissed the appeal, finding the Tribunal reasonably concluded the Registrar failed to establish reasonable grounds to believe the process created a risk to public health and safety.

The Court also found the Tribunal did not err in its application of the precautionary principle or in declining to impose further licence conditions.

The appellant massage therapist appealed a decision of the Discipline Committee revoking his certificate of registration for professional misconduct, including sexual abuse of a patient.

The appellant argued the investigation was procedurally unfair, there was undue delay, and the Committee erred in its credibility assessments.

The Divisional Court dismissed the appeal, finding that any initial procedural unfairness was cured, there was no evidence of prejudice from delay, and the Committee's credibility findings were reasonable and entitled to deference.

The applicant physician sought judicial review of an interlocutory decision by the Health Professions Appeal and Review Board (HPARB) refusing to remove the respondent hospital's counsel for an alleged conflict of interest.

The hospital moved to quash the judicial review application as premature, while the applicant moved to convert the application into an appeal and stay the HPARB proceedings.

The Divisional Court quashed the judicial review application, finding no exceptional circumstances justified interfering with the ongoing administrative process.

The court also refused to convert the application to an appeal, as the HPARB decision was interlocutory, and dismissed the motion for a stay.

The appellant, a dental hygienist, appealed the revocation of his license by the Discipline Committee after he provided dental hygiene treatment to his wife.

The Committee found this constituted professional misconduct under the Health Professions Procedural Code, which mandates license revocation for sexual abuse of a patient, defined to include sexual relations.

The appellant argued the mandatory revocation and public registry notation violated his and his wife's rights under sections 7 and 12 of the Charter.

The Divisional Court dismissed the appeal, finding no section 7 violation as there is no constitutional right to practice a profession, and no section 12 violation as the mandatory revocation and registry notation did not constitute cruel and unusual treatment.

The court noted the harshness of the result but held it was bound by the legislation as the government had not yet passed a proposed spousal exemption regulation for dental hygienists.

The applicant coalition sought judicial review of a coroner's decision denying them standing at an inquest into the death of a psychiatric patient.

The Divisional Court dismissed the application, finding the coroner made no serious error in principle in applying the tests for direct interest and public interest standing.

The court also rejected the applicant's argument that they were denied procedural fairness by not receiving the coroner's full brief prior to the standing hearing.