Maria Damiano

The appellant physician appealed a trial judgment finding her liable for the respondent's catastrophic brain injury following an acute asthmatic attack.

The trial judge found the appellant breached the standard of care by delaying intubation and failing to call for help sooner.

On appeal, the appellant argued the trial judge improperly relied on a critical care note containing double hearsay and opinion evidence regarding the respondent's hypoxemia, and erred in his causation analysis.

The Court of Appeal dismissed the appeal, holding the note was admissible under the business records exception and as a party admission, and that the trial judge's causation findings were supported by the expert evidence.

The plaintiff suffered a severe asthma attack and was admitted to the hospital.

The defendant internist assumed care but failed to promptly consult an intensive care specialist or arrange for timely intubation by an experienced clinician.

The plaintiff was eventually intubated by a respiratory therapist after multiple attempts and suffered a hypoxic brain injury, rendering her an incomplete quadriplegic.

The court found the defendant breached the standard of care by failing to consult a specialist sooner, delaying the decision to intubate, and failing to ensure the most experienced clinician performed the procedure.

The court also found that these breaches caused the plaintiff's brain injury.

Judgment was granted for the plaintiffs.

This decision addresses an evidentiary dispute during a trial regarding the admissibility of post-assessment medical reports through a defendant fact witness, Dr. McPherson.

The defendants sought to introduce reports created after Dr. McPherson's last assessment of the plaintiff, Jeremy Veran, to demonstrate improvement in symptoms.

The plaintiffs objected, arguing Dr. McPherson had not seen these documents and was not an expert witness.

The court ruled that documents not seen or received by Dr. McPherson, and not directly relevant to his care of the plaintiff, could not be introduced through him as a fact witness, even if they were part of the joint book of documents.

The defendants brought a motion to address two issues: the admissibility of opinions in two plaintiff expert reports (Miyanji and Levin) and the admissibility of evidence from five lay witnesses.

The court ruled that portions of the Miyanji and Levin reports that did not respond to specific "Defence Expert Reports" or introduced new standard of care issues were inadmissible due to late service and lack of reasonable explanation.

The motion to exclude the lay witnesses was dismissed as premature, with the court stating that the admissibility of their evidence, particularly any opinion evidence, should be assessed at the time it is tendered at trial.

The plaintiffs brought a motion seeking several orders before trial, including dismissal of claims against certain defendants, leave to amend their statement of claim, preliminary determination of jury questions, and exclusion of expert evidence.

The court granted the dismissal of claims against the "Released Defendants" without costs, as it was previously agreed upon.

Leave was granted to file a Fresh as Amended Statement of Claim, as the proposed amendments were extensive and did not remove admissions.

The court also determined the format for jury questions, largely adopting the plaintiffs' approach for damages and requiring explanations for answers, emphasizing standard of care and "but for" causation.

The issue of expert evidence was adjourned to a later date.

The plaintiffs brought a motion to preclude the defendants from introducing evidence from fifteen expert reports served late in a medical malpractice action.

The court considered the admissibility under Rule 53.08, assessing whether there was a reasonable explanation for the late service and if granting leave would cause irreparable prejudice or undue delay.

The court allowed some reports as supplementary or responding reports, finding a general reasonable explanation for delay due to discovery issues and prior party understanding.

However, it excluded a vocational report that introduced new scenarios without prior notice and a neuropsychological report, reiterating a previous ruling that no neuropsychological impairment issue was pleaded or supported by evidence, and its introduction would cause significant prejudice and necessitate trial adjournment.

The defendants (appellants) brought a motion for leave to appeal the order of W.D. Newton J. dated August 28, 2023.

The Divisional Court dismissed the motion for leave to appeal.

As the plaintiffs (respondents) did not file a Bill of Costs, the court made no order as to costs.

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 plaintiff suffered a fractured femur and a pulseless leg following a motorcycle accident.

He was treated in the emergency room by the defendant physician, who failed to urgently transfer him to a trauma centre or communicate the pulseless nature of the limb to the trauma team leader.

Due to the delay in transfer, the plaintiff's leg became unsalvageable and was amputated.

The court found the defendant physician breached the standard of care and that this breach caused the amputation.

The court awarded the agreed-upon damages without deduction for statutory accident benefits or OHIP subrogated claims.

This is an appeal in a class action concerning an infectious disease outbreak at a pain care centre.

The appellant, Dr. Stephen James, challenged the trial judge's findings of negligence, breach of fiduciary duty, and the application of the limitation period, as well as the award of punitive damages and costs.

The Court of Appeal upheld the trial judge's conclusions that Dr. James breached the standard of care by failing to consistently use aseptic technique and to report/investigate infections.

The court affirmed the use of statistical evidence to establish a rebuttable presumption of causation for the class, and found no error in the breach of fiduciary duty or the appropriateness of punitive damages.

The appeal on costs, including the order for Dr. James to pay the successful co-defendant nurses' costs, was also dismissed.

Following a five-week common issues trial in a medical malpractice class action, the plaintiff was entirely successful against the main defendant doctor.

The doctor had crossclaimed against several nurse defendants, but those claims were entirely unsuccessful.

The court ordered the doctor to pay the plaintiff's agreed-upon costs within 30 days, rejecting his argument to defer payment until individual trials were completed.

The court also made a Sanderson/Bullock order, requiring the doctor to pay the costs of the successful nurse defendants on a partial indemnity scale up to the date of their offers to settle, and on a substantial indemnity scale thereafter.

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.

The plaintiff brought a class action against an anesthesiologist, a pain clinic, and its nursing staff following an outbreak of bacterial meningitis and epidural abscesses among patients who received epidural injections.

The court found that the anesthesiologist breached the standard of care and his fiduciary duties by failing to use proper aseptic techniques, failing to report and investigate infections, and misinforming patients about the risks.

The court drew an inference of causation linking the anesthesiologist's substandard infection prevention and control practices to the patients' infections.

The claims against the nursing staff were dismissed as there was no evidence they breached the standard of care.

The court also found the anesthesiologist's conduct warranted punitive damages.

A trial management conference was held to provide directions for an upcoming 10-day virtual trial.

The action was proceeding against only one defendant, the others having been dismissed.

The court provided directions regarding the use of a shared document folder, the preparation of trial materials including an Agreed Statement of Facts and Joint Document Book, and the completion of a Report to Trial Judge.

The court also scheduled a practice run for the virtual platform and provided guidance on managing exhibits and video presence during the trial.

Following a jurisdiction motion where the defendant insurers successfully argued that the court lacked jurisdiction over the proposed class actions, the insurers sought costs of approximately $620,000.

The court found this request preposterous and excessive, fixing costs payable by the plaintiffs to the 13 non-settling insurers at $28,000 on a partial indemnity basis.

The costs payable by the government regulator to the plaintiffs were settled at $12,500.

The plaintiffs filed proposed class actions against 15 auto insurers and the provincial regulator, FSCO, alleging improper deduction of HST from statutory accident benefits.

The defendant insurers brought motions to dismiss the actions for lack of jurisdiction, arguing the Licence Appeal Tribunal (LAT) has exclusive jurisdiction over such disputes.

The court agreed, dismissing the actions against the insurers and refusing to approve two early settlements, as the claims fell squarely within the LAT's exclusive jurisdiction under s. 280 of the Insurance Act.

However, the court found it had jurisdiction to hear the claims against FSCO for regulatory negligence, as those allegations did not directly concern benefit entitlements or amounts.

In a class action alleging bacterial infections from epidural injections, the defendant physician, Dr. James, moved for documentary discovery and oral examinations of class members.

The court, considering the plaintiff's novel epidemiological causation theory, granted further documentary production for relevant, non-duplicative information.

However, it denied oral examinations for most class members, ordering written interrogatories for a selected sample instead, citing concerns about litigation delay, expense, and the passive role of class members.

The representative plaintiff could be re-examined orally.

The plaintiff brought a motion to amend the certification order in a class action concerning a bacterial infection outbreak among patients who received epidural steroid injections from the defendant physician.

The plaintiff sought to revise and expand the common issues to include negligence, causation based on epidemiological evidence, fiduciary duty, and limitation periods, and to add two subclasses.

The defendant physician brought a cross-motion to decertify the action, arguing that causation and standard of care required individualized assessments.

The court granted the plaintiff's motion to amend the certification order and dismissed the defendant's motion to decertify, finding that the plaintiff's novel methodology of using statistical correlation to prove causation met the 'some basis in fact' standard for certification and should be tested at a common issues trial.

A case conference was held to set a schedule for the plaintiff's upcoming motion to amend pleadings and common issues in a certified class action.

The court established a timetable for the exchange of motion materials, expert reports, cross-examinations, and factums, and scheduled the motion to be heard on July 11 and 12, 2019.

The plaintiff and defendants both brought unsuccessful motions for summary judgment in an action for solicitor negligence arising from a medical negligence claim.

The court determined the costs for both motions.

The defendants were awarded $18,196.23 in costs for the plaintiff's motion, with expert disbursements of $9,570 ordered as costs in the cause.

The plaintiff was awarded $12,161.56 in costs for the defendants' motion, with the court reducing the plaintiff's claimed fees to reflect the fair and reasonable expectations of the unsuccessful party.