Jan Marin

This is a motion for court approval of a settlement in a complex medical malpractice case involving a person under disability, Nathaniel Hughes.

The plaintiffs sought approval of a $4.5 million settlement, including a structured annuity, for injuries sustained by Nathaniel as an infant at Peterborough Regional Health Centre.

The court reviewed the settlement under Rule 7.08 of the Rules of Civil Procedure, considering the risks of litigation and the best interests of the person under disability.

The court found the settlement, including legal fees and disbursements, to be fair and reasonable given the complexities and risks, and approved it.

The appellants appealed the dismissal of their medical malpractice action.

The trial judge found that the respondent breached the standard of care by discharging the appellant without reviewing an MRA, but concluded that this negligence did not cause the appellant's second, severe stroke.

The Court of Appeal upheld the trial judge's decision, finding no error in the admission of expert evidence and agreeing that the appellants failed to establish a prima facie case on causation, as the evidence did not show that treatment with Heparin would have been more effective than Aspirin in preventing the second stroke.

The plaintiff suffered a life-altering stroke and sued the defendant physician for medical malpractice.

The defendant admitted to breaching the standard of care by failing to review a critical imaging report before discharging the plaintiff, which delayed the diagnosis of a vertebral artery dissection.

The sole issue at trial was causation: whether the delayed administration of anticoagulant therapy (Heparin) caused the plaintiff's second stroke.

After weighing competing expert medical evidence, the court found that while the defendant's negligence delayed the administration of Heparin, the plaintiffs failed to prove on a balance of probabilities that earlier treatment would have prevented the second stroke.

The action was dismissed.

The appellant underwent a laparoscopic colectomy performed by the respondent surgeon, during which her left ureter was injured, ultimately necessitating removal of her left kidney.

The trial judge found that the surgeon breached the standard of care and that the breach caused the injury requiring the kidney's removal.

The Court of Appeal majority set aside the trial decision, holding the trial judge erred in law in identifying and applying the standard of care.

The dissenting judge found no basis to interfere with the trial judge's approach and conclusions.

The Supreme Court unanimously restored the trial judgment, adopting the reasons of the dissenting judge.

The appellant, Dr. Colin Ward, appealed a trial judgment finding him liable for negligence in performing a laparoscopic colectomy on the respondent, Karen Armstrong, in February 2010.

The trial judge found that Dr. Ward breached the standard of care by bringing a LigaSure device within one to two millimetres of the respondent's left ureter, causing a thermal injury that resulted in stricturing of the ureter and eventual removal of the kidney.

The majority of the Court of Appeal (Paciocco and Juriansz JJ.A.) allowed the appeal, finding that the trial judge erred in law by defining the standard of care as a goal or result (avoiding injury) rather than as the means a prudent surgeon would employ.

The majority held that since the trial judge found Dr. Ward took the steps a prudent surgeon would take, he should have been exonerated.

Van Rensburg J.A. dissented, finding the trial judge's findings on standard of care were fully supported by the evidence and that staying at least two millimetres away from the ureter was a necessary step, not merely a goal.