Michael E. Royce

The plaintiffs brought a medical negligence action alleging that a hospitalist physician negligently prescribed excessive doses of hydromorphone (Dilaudid) to a patient who had previously received morphine and was allegedly opioid‑naive.

The patient died several hours after receiving multiple doses of Dilaudid, and the coroner’s report listed the cause of death as acute mixed hydromorphone and morphine intoxication.

The court heard competing expert evidence regarding opioid equivalency ratios, titration practices, and whether the physician’s 5 mg dosing fell below the standard of care for a hospitalist managing severe uncontrolled pain.

The court preferred the defence experts’ evidence that the dosing decision was a reasonable clinical judgment given the patient’s persistent severe pain and lack of response to morphine, and that reliance on experienced nurses for monitoring was appropriate.

The court also found the clinical course inconsistent with opioid toxicity and concluded the plaintiffs had not proven causation on a balance of probabilities.

The negligence claim was dismissed.

The plaintiff underwent an ambulatory phlebectomy for a varicose vein near her ankle, during which the defendant physician inadvertently removed a 20.5 cm segment of her sural nerve, causing permanent damage.

The plaintiff sued for medical malpractice, alleging negligence in both the recommendation of the procedure and its execution.

The court found that while recommending the procedure met the standard of care, the execution of the procedure was negligent based on circumstantial evidence, including the amount of force required to avulse the nerve and the physician's failure to recognize he had hooked the nerve.

The plaintiff was awarded agreed-upon damages of $128,975.00.

The plaintiffs brought a medical malpractice action alleging that two obstetrician-gynecologists breached the standard of care during a laparoscopic assisted vaginal hysterectomy, resulting in the transection of the plaintiff’s ureter.

The court considered expert medical evidence regarding the standard of care, the surgical technique required to protect the ureter, and whether circumstantial evidence could support an inference of negligence.

The court held that ureteric injury can occur even when surgeons exercise appropriate care and that the evidence did not establish that the surgeons deviated from accepted surgical practice.

The court accepted the defence explanation that the injury resulted from aberrant anatomy and that the procedure was performed with appropriate supervision and technique.

The plaintiffs failed to prove negligence on a balance of probabilities.