Daniela M. Pacheco

The plaintiffs brought a medical malpractice action against three obstetricians and a hospital regarding the birth of the infant plaintiff.

The mother alleged that she did not consent to the use of a vacuum or forceps during delivery, claiming medical battery and lack of informed consent.

She also alleged that the doctors breached the standard of care in their antenatal record keeping, failure to recommend a Caesarean section earlier, and the decision to attempt a vacuum and forceps-assisted delivery.

The court dismissed the action, finding that the mother had provided informed consent to the use of the instruments in the face of an urgent obstetrical situation involving fetal distress.

The court also found that the doctors met the standard of care in all respects and that the plaintiffs failed to prove that the neonatal injuries caused the infant plaintiff's subsequent neurodevelopmental limitations.

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 respondents brought a medical malpractice action after the plaintiff suffered a severe brain injury from a cardiac arrest during a caesarean section.

The trial judge found the primary obstetrician (Dr. Padmore), the anesthesiologist (Dr. Jamensky), and the hospital liable for negligence.

On appeal, the Court of Appeal allowed the appeals of Dr. Padmore and the hospital, finding the trial judge erred in his legal causation analysis regarding their respective pre-delivery acts and omissions.

The Court dismissed Dr. Jamensky's appeal, upholding the trial judge's findings that he breached the standard of care by prematurely converting the patient to a general anesthetic and that this negligence caused the cardiac arrest.

Dr. Jamensky was held solely liable for the agreed $12 million in damages.

The plaintiff suffered a cardiac arrest and profound brain damage following a Caesarean section delivery.

She brought a medical malpractice action against the obstetrical and anaesthesiology teams.

The court found that the obstetrical team met the standard of care.

While the staff anaesthesiologist breached the standard of care in three respects, the court concluded that these breaches did not cause the plaintiff's injuries.

The court accepted expert evidence that the cardiac arrest was caused by an unpredictable and unpreventable amniotic fluid embolism, rather than hemorrhagic shock.

The court also ruled that the claim against the anaesthesiologists was not statute-barred due to the discoverability doctrine.

The action was dismissed.

The plaintiff brought a medical negligence action against her family physician, alleging he failed to obtain informed consent regarding the increased relative risks of blood clots associated with the birth control pill Yaz.

The plaintiff suffered a stroke shortly after taking sample packs of Yaz provided by the physician.

The court dismissed the action, finding that the physician met the standard of care for disclosure and that the plaintiff would have taken the medication even if fully informed of the statistical risks.

Furthermore, the court held that the plaintiff failed to prove factual causation, as medical evidence indicated her stroke was cryptogenic and not caused by the medication.

Following a 42-day medical negligence trial where damages were agreed at $12 million, the plaintiffs sought costs of over $4.5 million.

The court considered the complexity of the case, the high hourly rates of senior counsel, and the defendants' stout denial of liability.

The court awarded the plaintiffs $4,218,052.00 in partial indemnity costs and disbursements, payable two-thirds by the unsuccessful physicians and one-third by the hospital.

The court declined to make a Sanderson Order, instead ordering the plaintiffs to pay $250,000 in costs to the two successful defendant physicians.

The plaintiff attended the emergency department with symptoms of dizziness, nausea, and facial weakness, and a referral note from his family doctor requesting to rule out a stroke.

The defendant emergency physician diagnosed peripheral vertigo and Bell's Palsy, and discharged the plaintiff without conducting a gait assessment or consulting a neurologist.

The plaintiff returned the next day with a severe basilar artery occlusion, resulting in catastrophic long-term disabilities.

The court found the defendant breached the standard of care and that, but for this breach, the plaintiff would have received timely recanalization treatment with a successful outcome.

The defendant's request for a 25% discount on the agreed damages was dismissed.

This decision addresses a request by the respondent (defendant in the original action) to limit the scope of a new trial on liability and damages, which had been ordered by the Court of Appeal in a prior decision.

The court dismissed the request, emphasizing that the evidence and issues were complex, interrelated, and interdependent.

Limiting the trial to specific issues would risk artificial credibility assessments and unreliable fact-finding.

The appellants appealed the dismissal of their medical malpractice action against an obstetrician following a catastrophic birth injury.

The infant suffered acute near-total oxygen deprivation prior to birth, resulting in severe permanent brain damage.

At trial, the judge dismissed the action, finding no breach of the standard of care and no causation.

On appeal, the Court of Appeal found the trial judge's reasons were legally inadequate regarding causation and one of the standard of care issues (the failure to complete the delivery with Kielland forceps).

The reasons failed to explain critical findings, preventing meaningful appellate review.

The appeal was allowed and a new trial ordered on all issues of liability and damages.

The respondent doctor brought a motion for an extension of time to appeal an order granting the Ontario Trial Lawyers Association (OTLA) intervenor status in a judicial review application.

The underlying application concerned a regulatory decision regarding the doctor's access to a former patient's medical records.

The Divisional Court granted the extension of time, finding the short delay was reasonably explained by counsel's inadvertence.

On the merits, the court set aside the intervenor order, concluding that OTLA's proposed submissions would be duplicative of the applicant's and that the matter was primarily a private regulatory dispute.

The appellants, triplets born with serious disabilities, appealed the dismissal of their negligence claim against a physician who prescribed a fertility drug to their mother pre-conception.

They alleged the physician failed to provide informed consent and prescribed a contraindicated medication.

The Court of Appeal, in a majority decision, dismissed the appeal, affirming that a physician does not owe a duty of care to a future child for alleged negligence occurring pre-conception, citing policy concerns regarding conflicting duties and women's autonomy.

The dissenting judge argued that the allegation of a contraindicated drug could distinguish the case and warrant a full trial to determine if a novel duty of care exists.

The defendant physician brought a motion to strike portions of the plaintiffs' Fresh as Amended Statement of Claim in a medical malpractice action.

The impugned paragraphs alleged that the defendant had a history of past incompetence and a pattern of substandard practice, which the plaintiffs argued supported a claim for breach of fiduciary duty and punitive damages.

The court granted the motion, finding that the plaintiffs failed to plead sufficient material facts to support the allegations of similar fact evidence and breach of fiduciary duty, and struck the relevant paragraphs.

The plaintiffs brought a medical malpractice action against a urologist, alleging negligent performance of a trans-urethral resection of the prostate (TURP) that resulted in total and continuous urinary incontinence.

The court dismissed the action, finding that the plaintiffs failed to establish, on a balance of probabilities, that the urologist breached the standard of care or that the alleged breach caused the incontinence.

The court concluded that the incontinence was a known complication, likely attributable to pre-existing conditions of an overactive bladder and a weakened external sphincter, rather than surgical negligence.

The Plaintiffs' medical negligence action against the Defendants was dismissed after a jury found breaches of standard of care but no causation.

The Defendants, as successful parties, sought costs.

The court, exercising its discretion under the Courts of Justice Act and Rules of Civil Procedure, rejected the Plaintiffs' arguments for no costs based on "divided success" access to justice concerns, or the Canadian Medical Protective Association covering the physicians' costs.

The court awarded costs on a partial indemnity basis to the Defendant Physicians and the Defendant Hospital, fixing specific amounts.

While the main Plaintiff, Jordan Sacks, was held liable for the bulk of the costs, the Family Law Act claimants (Jordan's wife and parents) were held liable for apportioned, rather than joint and several, amounts to ensure fairness given the derivative nature and comparatively modest value of their claims.

In a jury trial for medical negligence arising from hospital treatment, the parties disputed the proper wording of causation questions to be put to the jury and whether the jury should provide particulars explaining any finding of causation.

The plaintiffs argued the jury should be asked whether the defendants' breach 'caused or contributed to' the injury, relying on principles recognizing multiple causes in negligence.

The defendants argued the jury must be instructed using the Supreme Court of Canada’s 'but for' causation test articulated in Clements.

The court held the jury questions should follow the 'but for' formulation, finding the 'cause or contribute' wording risked confusion.

The court also ruled that if causation were found, the jury should be required to provide particulars of its reasoning due to the complexity of the medical evidence and multiple defendants.

In a medical negligence action arising from alleged delayed diagnosis of a postoperative complication leading to catastrophic injuries, the defendant physicians brought a motion seeking permission for one defendant physician to testify at trial by videoconference.

The physician was on maternity leave in another province and argued that attending in person would cause expense and inconvenience.

The court considered Rule 1.08 of the Rules of Civil Procedure and the efficiency principles articulated in Hryniak v. Mauldin.

The court held that the request was inappropriate because the proposed witness was a party defendant whose credibility and conduct were in issue, and the plaintiff had a fundamental right to have the parties attend court for trial.

The inconvenience to the defendant did not constitute sufficient hardship to override due process considerations.

The appellant radiologist failed to detect a cancerous lesion on the respondent's liver following colon cancer surgery.

The respondent later died of metastatic colon cancer.

A jury found the appellant negligent and awarded substantial damages, concluding that the delayed diagnosis deprived the respondent of a greater than 50 percent chance of being cured.

The appellant appealed, arguing the jury's finding on causation was unreasonable, the trial judge erred in her charge regarding survival versus cure rates, and the jury failed to properly discount future income loss for adverse contingencies.

The Court of Appeal dismissed the appeal, finding the jury's verdict was supported by expert evidence, the jury charge was adequate, and the damages award was reasonable.