Dr. Derek Armstrong

The plaintiffs brought a medical negligence action against several physicians, nurses, and a hospital, alleging that their negligence during the plaintiff mother's labour and delivery caused the infant plaintiff to suffer a severe hypoxic-ischemic brain injury resulting in cerebral palsy.

The plaintiffs alleged that an artificial rupture of membranes was negligently performed when the fetal head was high, causing a cord prolapse.

The court found that the defendant physicians and nurses met the standard of care, with the exception of one resident physician's failure to document the events, which was not causative.

The court also concluded that the plaintiffs failed to prove factual causation, as the clinical evidence at birth was inconsistent with the infant being completely deprived of oxygen for the 18 minutes following the cord prolapse.

The action was dismissed.

In an obstetrical malpractice action, the defendant midwives and physicians brought motions for an order compelling the infant plaintiff and his biological parents to undergo blood tests for specific genetic testing.

The defendants argued that the infant's severe neurocognitive impairments may have a genetic etiology rather than being caused by perinatal hypoxia.

The plaintiffs opposed the motions, arguing that the court lacked jurisdiction to order genetic testing due to the federal Genetic Non-Discrimination Act, and that the defendants were liable for all injuries under the thin skull doctrine regardless of any genetic predisposition.

The court held that it has the authority to order genetic testing under section 105 of the Courts of Justice Act and Rule 33.

Finding that the possibility of a genetic cause was not frivolous and that the factors of fairness, necessity, and prejudice weighed in favour of the defendants, the court ordered the infant and his biological parents to provide blood samples for genetic testing.

Following an obstetrical malpractice trial where the jury found the defendant obstetrician 32% liable for the infant plaintiff's severe cerebral palsy, the defendant brought a motion under Rule 52.08 to dismiss the action or order a retrial.

The defendant argued the jury gave conflicting answers on causation and that there was no evidence to support their findings on the standard of care and delay in delivery.

The court dismissed the motion, finding the jury's use of the word 'contributed' did not conflict with the 'but for' causation test, and that there was ample expert evidence supporting the jury's conclusion that the defendant's failure to promptly prepare for an emergency c-section caused the infant's brain damage.

Judgment was ordered to be entered in accordance with the jury's verdict.

The appellants appealed the dismissal of their medical malpractice claim against a family physician for alleged negligence in prenatal care that resulted in the infant appellant being born with cerebral palsy.

The appellants argued the trial judge erred in rejecting their theories that the mother suffered from pre-eclampsia or elevated blood pressure, and that the physician was negligent in failing to induce labour or refer her to an obstetrician.

The Court of Appeal found no palpable and overriding error in the trial judge's findings that the physician met the standard of care and that the appellants failed to prove causation.

The appeal was dismissed.

The plaintiffs brought a medical malpractice action alleging that the defendant family physician's negligence during the mother's pregnancy and delivery caused the infant plaintiff to be born with cerebral palsy.

The plaintiffs argued the doctor failed to properly monitor the mother's hypertension, failed to refer her to an obstetrician, and negligently prescribed enalapril, an ACE inhibitor, shortly before birth.

The Superior Court of Justice dismissed the action, finding that the doctor met the standard of care of a family physician in the circumstances and that his clinical judgments were reasonable.

Furthermore, the court concluded that the plaintiffs failed to prove on a balance of probabilities that the enalapril or the mother's hypertension caused the infant's injuries, which were likely the result of an acute intrauterine event such as cord compression.

In a medical negligence trial arising from a compromised birth, the plaintiffs alleged that labour and delivery nurses failed to meet obstetrical monitoring standards before a severe bradycardic event.

The court found that active labour had begun by at least 18:00, requiring half-hourly auscultation, and held the nursing care fell below the standard by failing to monitor appropriately, verify concerning findings, and escalate monitoring.

On causation, the court preferred expert evidence that a prolonged partial hypoxic-ischemic process likely developed before 21:00 and would probably have been detected with proper surveillance.

The court concluded earlier intervention would likely have prevented or substantially reduced the neurological injury.

The hospital was found liable, with damages previously admitted subject to approval.