Dr. Andrew Browning

The plaintiff sued her gynecologist for medical malpractice after suffering a ureteric injury during a laparoscopic hysterectomy.

The plaintiff alleged the defendant was negligent in failing to detect the injury during surgery and in failing to consider the possibility of a ureteric injury and consult a urologist when the plaintiff presented with post-operative complications.

The court found no breach of the standard of care during the surgery, as the injury was likely a thermal ischemic injury that was not visually observable.

While the court found the defendant breached the standard of care by failing to consider a ureteric injury and consult a urologist post-operatively, the action was dismissed because the plaintiff failed to prove causation.

The court concluded that earlier urological intervention would not have altered the plaintiff's medical outcome or prevented the need for subsequent repair surgery.

This appeal concerned a medical negligence action where the appellant gynecologist failed to perform an endometrial biopsy on the deceased, Armineh Hacopian-Armen, in 2009, leading to a delayed diagnosis of Stage IV uterine leiomyosarcoma (uLMS) and her subsequent death.

The trial judge found the gynecologist liable for breaching the standard of care and for factual and legal causation.

On appeal, the appellant challenged the findings on causation.

The Court of Appeal dismissed the appeal, affirming the trial judge's conclusions that the appellant's negligence caused the harm, emphasizing the deference owed to a trial judge's assessment of expert evidence and the foreseeability of the type of harm.

Medical negligence trial arising from an alleged delayed diagnosis of uterine leiomyosarcoma in a patient presenting with fibroids, prolonged heavy bleeding, and risk factors including age over 40 and nulliparity.

The court held that the gynecologist breached the standard of care by failing to perform an endometrial biopsy at the initial consultation and by maintaining inadequate clinical notes.

Applying the but for causation test, the court found that an earlier biopsy would likely have detected Stage I disease, leading to earlier hysterectomy and a substantially improved prognosis.

The court rejected the defence reliance on statistical literature as determinative and found both factual and legal causation established.

The appellants, a nurse and a hospital, appealed a jury verdict finding them liable for a brain injury suffered by an infant during birth.

The jury found the nurse 75% liable and the hospital 25% liable, while dismissing claims against the delivering physician.

The appellants argued the verdict was unreasonable due to insufficient evidence of causation and lack of expert evidence on the hospital's standard of care, and that the trial judge erred in the jury charge.

The Court of Appeal dismissed the appeal, holding that the jury was entitled to determine the hospital's standard of care without expert evidence, that there was sufficient evidence to support the jury's finding of causation based on a robust and pragmatic application of the 'but for' test, and that the jury charge contained no reversible errors.