Dr. George Vilos

The plaintiff underwent a laparoscopic hysterectomy performed by the defendant gynaecologist, during which her colon was perforated, requiring subsequent reconstructive surgery.

The plaintiff brought a medical malpractice action alleging the defendant failed to obtain informed consent, failed to review prior operative reports, lacked the skill to perform the surgery given her anatomy, and negligently caused the perforation.

The court dismissed the action, finding the defendant met the standard of care in his pre-operative advice and surgical technique, and that the bowel injury was a known complication likely caused by abnormal anatomy rather than negligence.

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.