Health Law

The appellant, found Not Criminally Responsible (NCR) for manslaughter, appealed the Ontario Review Board's detention order for failing to include a community living term.

The Court of Appeal found the Board's decision unreasonable because it did not adequately balance all factors under s. 672.54 of the Criminal Code, specifically the appellant's reintegration into society and mental condition, beyond public safety concerns.

The court emphasized the importance of including a community living term to address housing waitlists and facilitate long-term reintegration, even if not immediately exercisable, especially when there is no evidence of public safety risk.

The appeal was allowed, and the disposition order was amended to include a community living term with conditions.

The plaintiff, Cary Beazley, brought a motion to review a single motion judge's order of the Court of Appeal, which had dismissed his motion for an extension of time to appeal the dismissal of his medical malpractice action.

Beazley alleged negligence by physicians for failing to timely diagnose and treat Lyme disease.

The Court of Appeal panel reviewed the motion judge's decision, applying a deferential standard of review, and found no legal error or misapprehension of material evidence.

The panel upheld the motion judge's finding that the proposed appeal lacked arguable grounds, as the expert evidence did not support Beazley's claims regarding Lyme disease testing accuracy or the standard of care.

The review motion was dismissed without costs.

The appellants appealed a trial judge's decision to reduce prejudgment interest on non-pecuniary damages from the presumptive 5% to 1.3%.

The Court of Appeal found the trial judge erred by misinterpreting the statutory scheme under the Courts of Justice Act and Rules of Civil Procedure, failing to consider all mandatory factors under s. 130(2), and misinterpreting "changes in market interest rates." The Court clarified that the 5% rate is presumptive and can only be deviated from in unusual or special circumstances, with the onus on the party seeking deviation.

The appeal was allowed, and the 5% rate was reinstated.

The applicant sought a review of a motion judge’s decision to deny an extension of time for leave to appeal a Divisional Court decision.

The Divisional Court had dismissed the applicant's request to set aside or vary a previous decision as frivolous, vexatious, and an abuse of process.

The Court of Appeal found no basis to interfere, agreeing that the proposed leave application lacked merit and that an allegation of conflict of interest could not be grafted onto the original mandamus application.

The motion for an extension of time was dismissed.

This is an appeal from a medical malpractice judgment where the trial judge found the appellant physician negligent in treating a stroke victim, leading to permanent injuries.

The core issue on appeal was causation: whether the trial judge erred in finding that the physician's negligence caused the injuries, specifically by not requiring the plaintiff to establish precisely which treatment option would have prevented the unfavourable outcome.

The Court of Appeal dismissed the appeal, affirming the trial judge's robust and pragmatic application of the "but for" causation test, particularly in the context of an evidentiary gap created by the defendant's negligence.

The appellants, Wesley Moore and St. Jacobs Carpenter House Inc., appealed an order requiring them to cease operating an unlicensed retirement home.

The core issues were whether their facility met the statutory definition of a "retirement home" under the Retirement Homes Act, 2010, specifically regarding the provision of "care services" (meals and drug administration), and whether the application judge erred in finding an abuse of process or in ordering the cessation of operations.

The Court of Appeal upheld the application judge's findings, confirming that the facility provided at least two care services, including a broad interpretation of "administration of a drug" to encompass assistance.

The court also rejected the abuse of process argument and affirmed the judge's power to issue a cease and vacate order under the Act.

The appeal was dismissed with costs.

The plaintiffs in two medical negligence actions appealed a decision dismissing their motions to compel production of documents and answers to discovery questions related to hospital quality of care reviews.

The Associate Justice had found the information irrelevant and protected by common law quality assurance privilege.

On appeal, the court found the documents and questions to be relevant but upheld the Associate Justice's conclusion that a common law evidentiary privilege (Wigmore test) applied to the quality assurance communications, and that the Quality of Care Information Protection Act, 2016 (QCIPA) did not abrogate this common law privilege.

The appeals were dismissed.

The defendant moved for summary judgment to dismiss a medical negligence claim, arguing it was brought outside the two-year limitation period.

The plaintiff contended that the claim was not discovered until an expert medical opinion was obtained.

The court found that the plaintiff had actual knowledge of the material facts supporting a plausible inference of liability as early as mid-February 2013, and no later than October 2013, well before the claim was issued in August 2017.

The expert opinion merely addressed the merits, not the discoverability.

The motion was granted, and the claims were dismissed.

Mr. Ojaghi appealed a detention order issued by the Ontario Review Board, arguing it was unreasonable and seeking a conditional discharge.

He also challenged the Board's removal of a travel provision from his previous disposition.

The Court of Appeal upheld the detention order, finding it reasonable and necessary for public safety given the applicant's non-compliance with medication.

However, the court found that the Board breached its duty of procedural fairness by removing the travel provision without notice or inviting submissions, and therefore reinstated that provision.

The appellant challenged the validity of a Community Treatment Order (CTO) issued under the Mental Health Act on the grounds that not all participants in the Community Treatment Plan (CTP) signed it within 72 hours of the medical examination.

The Consent and Capacity Board found the CTO valid, holding that only the examining physician was required to sign within the 72-hour period.

The Superior Court appeal judge reversed, finding that all participants must sign within 72 hours.

The Court of Appeal allowed the appeal, holding that the 72-hour requirement applies only to the examining physician's entry into the CTP, not to other service providers who indicate their agreement to the plan.

The appellant appealed a disposition order from the Ontario Review Board dated January 5, 2017, which ordered his detention at Waypoint Centre for Mental Health Care – Provincial Forensic Division.

The appellant did not challenge the Board's finding that he posed a significant threat to public safety but argued that his transfer from CAMH to Waypoint was not necessary and appropriate for managing that risk.

He contended that the Board failed to consider the context of his behaviour and that the announcement of his transfer triggered his deterioration.

He also argued the Board did not give sufficient weight to the disruption of his therapeutic and familial relationships.

The Court of Appeal dismissed the appeal, finding the Board's decision was reasonable and amply supported by evidence.

An appeal from a December 14, 2016 Ontario Review Board disposition ordering the detention of a not criminally responsible accused at the General Forensic Unit of the Centre for Addiction and Mental Health.

The appellant, diagnosed with bipolar disorder and substance-use disorder, had committed index offences in 2004 involving robbery and theft.

The Board found the appellant posed a significant threat to public safety due to continued substance abuse and manic symptoms.

The Court of Appeal admitted fresh evidence of post-decision disruptive conduct and upheld the detention order, finding the Board reasonably applied the "significant threat" standard and selected the least restrictive disposition appropriate in the circumstances.

The appellant appealed two dispositions of the Ontario Review Board following his finding of not criminally responsible on account of mental disorder for offences committed in January 2016.

The Board found the appellant suffered from delusional disorder and posed a significant threat to public safety, ordering his detention on a secure forensic unit.

The appellant sought an absolute discharge or conditional discharge to return to the community.

Amicus curiae argued the hearings were procedurally unfair and the disposition was unreasonable.

The Court of Appeal dismissed the appeal from the Initial Disposition as moot and upheld the Current Disposition, finding the Board conducted a fair inquisitorial hearing and the detention decision was reasonable and supported by evidence.

The applicant regulatory body brought a motion seeking a finding of contempt against the respondent for breaching a prior court order prohibiting him from representing himself as a chiropractor or performing controlled acts associated with chiropractic practice.

The respondent had previously admitted breaches of the same order in earlier contempt proceedings and agreed to comply with settlement terms requiring immediate cessation of practice and removal of promotional materials.

Evidence including patient files, appointment records, and affidavits from patients established beyond a reasonable doubt that the respondent continued operating a chiropractic practice and using the title “doctor” or “D.C.” in connection with providing health services.

The court found the respondent knowingly and wilfully breached the 2006 order and continued to hold himself out as a chiropractor.

A finding of contempt was entered, with a further hearing to determine penalty and costs.

The appellant appealed a decision of the Consent and Capacity Board finding him incapable of consenting to treatment with antipsychotic medication under the Health Care Consent Act, 1996.

The court considered whether the Board lacked jurisdiction due to panel composition, the proper legal test for capacity under s. 4(1) of the Act, the applicable standard of review, and whether the Board’s application of the test was reasonable.

The court held that tribunal expertise justified deference regardless of the individual qualifications of panel members and that the standard of review for the Board’s application of law to facts was reasonableness.

The Board reasonably concluded that although the appellant could understand relevant information, symptoms described as perseveration and grandiosity prevented him from appreciating the reasonably foreseeable consequences of refusing treatment.

The Board’s decision fell within a range of defensible outcomes and was upheld.

An NCR accused detained at a psychiatric hospital challenged the constitutionality of s. 672.56 of the Criminal Code, arguing that it violated s. 7 of the Charter by allowing the hospital’s person in charge to determine whether increased restrictions on liberty should trigger mandatory Review Board oversight.

The applicant argued this created a conflict of interest and reasonable apprehension of bias.

The court held that when s. 672.56 is considered within the broader statutory framework of Part XX.1, including discretionary review powers and the availability of judicial review, the scheme provides a fair process.

The notification requirement imposes a statutory duty rather than discretionary review authority.

Accordingly, the provision does not violate principles of fundamental justice.

A pharmacist challenged the constitutionality of mandatory licence revocation provisions under the Health Professions Procedural Code after pleading guilty to sexual abuse of a patient based on a consensual sexual relationship.

The applicant argued the provisions were ultra vires the province because, in pith and substance, they regulated sexual morality and therefore fell within Parliament’s criminal law power.

The Superior Court held that the dominant purpose of the provisions was the protection of the public through the regulation of professional standards governing health care practitioners.

The provisions were therefore within the province’s jurisdiction over property and civil rights under s. 92(13) of the Constitution Act, 1867.

The court also held the Attorney General was estopped from challenging the court’s jurisdiction because the issue had already been determined in earlier proceedings.

The plaintiff brought a motion to adjourn a scheduled jury trial in a medical malpractice action after learning that a key expert witness would be unavailable on the trial date.

The defendants opposed the adjournment, arguing the unavailability resulted from the plaintiff’s counsel failing to notify the expert of the agreed trial date in a timely manner.

The court considered the discretionary test for adjournments and the need to balance the interests of the parties and the administration of justice.

Although the court criticized the plaintiff’s counsel’s conduct as inexcusable, it concluded the plaintiff would suffer prejudice if forced to proceed without the expert’s live testimony and there was no evidence of non‑compensable prejudice to the defendants.

The trial was adjourned and directed to be rescheduled peremptory on the plaintiff.

Two related class actions arising from a tuberculosis exposure incident at a hospital sought court approval of a negotiated settlement and class counsel fees under the Class Proceedings Act, 1992.

The litigation followed exposure notices issued to thousands of individuals after two patients were diagnosed with tuberculosis, leading to claims of negligent failure to diagnose and prevent transmission.

After extensive discovery, expert evidence, and partial summary judgment dismissing claims of uninfected class members, the remaining infected class claims were scheduled for a common issues trial.

The parties reached a $1.7 million settlement establishing a compensation scheme based on varying likelihoods of causation.

The court held the settlement fell within a reasonable range and was in the best interests of the class, and it also approved a 30% contingency fee and honorariums for the representative plaintiffs.

The defendants brought summary judgment motions seeking dismissal of a personal injury claim arising from a teeth whitening procedure performed by a dental hygienist.

The court held that allegations concerning negligent performance of the procedure required expert evidence regarding the applicable standard of care.

Because the plaintiff failed to provide admissible expert evidence meeting the requirements of Rule 53.03, the claims for negligent performance and breach of contract were dismissed.

However, the court found a genuine issue requiring a trial on whether the plaintiff gave informed consent, as the parties presented conflicting evidence regarding disclosure of the risk of burns.

The court also held that expert evidence was not required to determine whether the material risk of burns had been disclosed, and that the issue of potential vicarious liability of the dentists for any breach of disclosure duty remained for trial.