Health Law - OCA

The appellant, Jerome Williams, appealed the Ontario Review Board’s decision ordering his continued detention in the High Secure Provincial Forensic Programs Division at Waypoint Centre for Mental Health Care.

Williams argued that he no longer posed a significant threat to public safety and sought an absolute discharge, or alternatively, a transfer to a medium secure facility.

The Court of Appeal for Ontario dismissed the appeal, finding that the Board’s assessment of risk and the necessity of continued detention at Waypoint were reasonable and supported by the evidence, particularly in light of ongoing concerns about medication compliance and substance use.

The appellant challenged the appeal judge’s dismissal of her appeal from a Consent and Capacity Board decision, which had confirmed her involuntary admission to the Centre for Addiction and Mental Health (CAMH).

The appeal judge dismissed the appeal as moot because the appellant had been discharged from CAMH.

The Court of Appeal upheld this decision, finding no live controversy and no special circumstances to warrant exercising its discretion to hear the moot appeal.

The court rejected arguments that the appeal right would become illusory or that appellate guidance was needed on the interpretation of Box B criteria under the Mental Health Act.

The appellants, Tyson Rogerson and his adoptive parents, appealed the dismissal of their medical malpractice action against two physicians, Dr. Elyse Savaria and Dr. Nkiruka Nwebube.

The appellants argued that the physicians breached their duty of care by failing to report a suspected risk of harm to Tyson to the Children's Aid Society (CAS) under s. 72 of the Child and Family Services Act, which they contended would have prevented Tyson's catastrophic brain injury.

The Court of Appeal upheld the trial judge's findings that the physicians did not breach the standard of care in failing to report, and even if there was a breach, the appellants failed to prove causation, as the CAS would not have intervened in a way that would have prevented the injury.

The appeal was dismissed.

Dr. Rochagné Kilian appealed a Superior Court order compelling her to comply with an investigation by the College of Physicians and Surgeons of Ontario regarding alleged false COVID-19 vaccine exemption certificates.

Dr. Kilian had refused to provide patient records, citing confidentiality and challenging the lawfulness and constitutionality of the College's demands and the statutory provisions.

The Court of Appeal dismissed the appeal, affirming the application judge's decision that the scope of a s. 87 application (to compel compliance) is limited to determining if there was a breach of statutory obligations and if the information requested was within investigatory powers.

The Court reiterated the principle of non-interference in ongoing administrative processes, holding that constitutional challenges and arguments regarding the lawfulness of the investigation's initiation must first be raised before the College's Discipline Committee before seeking judicial review.

The appellant, found Not Criminally Responsible (NCR), appealed a detention order, arguing for a conditional discharge as the least onerous and restrictive disposition.

The Court of Appeal upheld the Ontario Review Board's decision, finding that the Board reasonably rejected a conditional discharge.

The Board's decision was based on the appellant's history of non-compliance with hospital stays, her limited insight into her mental illness, and the unsuitability of the proposed housing with her husband, given their problematic relationship and her past unstable housing as a risk factor.

The court found no error in the Board's assessment that a detention order was necessary to manage the significant risk to public safety.

Matthew Gibson, found not criminally responsible (NCR) for criminal harassment and breach of recognizance, appealed the Ontario Review Board's disposition maintaining conditional discharge.

He argued the Board erred in finding he posed a significant threat to public safety, contending the risk assessment was unreasonable and unsupported by evidence, particularly given his compliance with medication and treatment, and stable family support.

The Court of Appeal dismissed the appeal, finding no error in the Board's application of the significant risk test under the Criminal Code.

The court affirmed the Board's holistic consideration of risk factors, including lack of insight into his illness and index offences, and continued cannabis use, which outweighed protective factors, concluding the conditional discharge was necessary to manage the ongoing significant risk to public safety.

The appellant, found not criminally responsible on account of mental disorder (NCRMD), appealed a disposition of the Ontario Review Board that maintained a detention order and denied an absolute discharge.

The appellant argued the Board erred in failing to grant an absolute discharge, giving weight to previous appellate findings, and considering the vigour of counsel's submissions.

The Court of Appeal dismissed the appeal, finding the Board's decision that the appellant remained a significant threat to public safety was reasonable, based on expert evidence of likely relapse and criminal conduct without supervision.

An appeal by an NCR (not criminally responsible) accused against the Ontario Review Board's disposition continuing his conditional discharge.

The appellant sought an absolute discharge, arguing the Board erred in finding he continued to pose a significant risk to public safety.

The appellant had been living unsupervised in the community for over a decade with stable mental health and medication compliance.

The Court of Appeal dismissed the appeal, finding the Board's decision was reasonable based on the appellant's lack of insight into his illness, his history of violence when unmedicated, and concerns that the civil mental health system could not adequately manage the risk of treatment non-compliance.

The appellant, found not criminally responsible on account of mental disorder for aggravated sexual assault in 2013, appealed a disposition order from the Ontario Review Board requiring his detention in the secure unit at the Centre for Addiction and Mental Health.

The appellant challenged the order as unreasonable and argued the Board should have intervened to break a treatment impasse.

The Court of Appeal upheld the disposition, finding that the appellant posed a significant threat to public safety based on his history of elopement, substance use, and limited understanding of sexual consent.

The court determined that detention in the secure unit was the least onerous and least restrictive disposition and that rehabilitative programming was available in that setting.

The respondents appealed an order from the Superior Court of Justice directing a new trial on the basis that the jury's answers on causation were fatally flawed.

The moving parties brought a motion to quash the appeal, arguing that the order was interlocutory and therefore only appealable to the Divisional Court with leave.

The Court of Appeal held that an order directing a new trial is interlocutory in nature, as it does not finally determine the substantive rights of the parties but rather requires another trial for that purpose.

The appeal was quashed and transferred to the Divisional Court.

The appellant appealed the motion judge's order striking her statement of claim without leave to amend on two grounds: that the action was commenced beyond the applicable limitation period and that it disclosed no reasonable cause of action for civil fraud.

The appellant sought damages for fraudulent billing submissions to OHIP and alleged inability to obtain travel insurance.

The Court of Appeal dismissed the appeal, finding that the appellant's own pleadings admitted discovery of the alleged fraud in 2009, which triggered the two-year limitation period under the Limitations Act, 2002.

The court also addressed procedural issues regarding the improper use of rule 21.01(1)(a) to advance a limitations defence and the inappropriate reliance on rule 21.01(1)(b) after the respondents had filed a statement of defence joining issue on the material facts.

An appeal from an Ontario Review Board disposition finding that an NCR accused continues to pose a significant threat to public safety and ordering a conditional discharge rather than an absolute discharge.

The appellant, found not criminally responsible in 2002 for serious violent offences including aggravated assault, kidnapping, and assault with a weapon, argued the Board's finding was unreasonable.

The Court of Appeal upheld the Board's decision, finding sufficient evidence to support the conclusion that the appellant poses a significant threat within the meaning of the Criminal Code, based on his serious index offences, ongoing psychiatric symptoms including paranoid delusions, lack of insight into his mental illness, substance abuse, and stated intention to discontinue medication if absolutely discharged.

The appellant appealed a disposition of the Ontario Review Board dated April 12, 2017, regarding his placement and security regime.

The appellant and Waypoint Centre for Mental Health Care argued that the Board's decision was unreasonable.

The Court of Appeal upheld the Board's decision, finding it reasonable.

The Board had concluded that public safety would be compromised if the appellant was transferred unless the maximum security regime at Waypoint could be effectively replicated at the receiving hospital, which would negate the purpose of transfer.

The court noted that further assessment by an independent assessor remained possible at the appellant's annual hearing scheduled for early April.

A lawyer brought an application for an interim injunction to restrain a hospital from withdrawing life support from her client without instructions to do so and without notice to the client's family.

The application was granted ex parte but subsequently set aside by the reviewing judge after the client was declared brain dead.

The lawyer then appealed both the substantive decision and the costs award against her personally.

The Court of Appeal dismissed both appeals, finding that the lawyer had no authority to bring the application, acted without instructions, and seriously interfered with the administration of justice by misusing the court process during an emotionally sensitive family decision regarding end-of-life care.

The appellant appealed a disposition of the Ontario Review Board dated February 6, 2017, challenging the Board's addition of a "24-hour-a-day" supervision requirement to a community accommodation condition.

The appellant contended this requirement was not part of the joint submission made at the hearing.

The Court of Appeal found no merit in the appeal, determining that the hearing transcript clearly showed counsel for the Centre for Addiction and Mental Health had proposed a housing clause specifically including 24-hour staff supervision, which the appellant's counsel had supported.

The Board's disposition therefore accepted the parties' joint submission rather than departing from it.

The appeal was dismissed.

An appeal under Part XX.1 of the Criminal Code against the Ontario Review Board's disposition dated October 16, 2016.

The appellant sought an absolute discharge from a conditional discharge, arguing the Board's decision was unreasonable.

The Board upheld the conditional discharge, finding the appellant remained a significant threat based on expert evidence that absolute discharge would lead to medication non-compliance and increased marijuana use, resulting in decompensation and threatening behavior.

The Court of Appeal dismissed the appeal, finding the Board's disposition reasonable and supported by evidentiary foundation.

An appeal from a Superior Court decision dismissing an appeal from a Consent and Capacity Board decision confirming the appellant's involuntary status under the Mental Health Act.

The appellant, a dangerous offender with a lengthy history of violent and sexual crimes, challenged his detention as an involuntary psychiatric patient, arguing that the Mental Health Act was being used to extend his prison sentence indefinitely (psychiatric gating) and that his Charter rights were violated.

The Court of Appeal upheld the Board's decision, finding that the appellant suffers from mental disorders (paraphilia, antisocial personality disorder with psychopathy) that pose a serious risk to others, that the initial Form 1 was properly completed, and that the appellant's Charter claims under sections 7, 9, 11(h), and 12 all failed.

An appellant appealed a disposition decision of the Ontario Review Board dated June 7, 2016, which declined to modify the conditions of his detention order to provide broader community access privileges.

The appellant had been found not criminally responsible by reason of mental disorder for second degree murder and was detained at a mental health facility.

The appellant raised two grounds of appeal: first, that the Board failed to consider readily available and relevant information from the original NCR hearing; and second, that the disposition was unreasonable.

The Court of Appeal dismissed the appeal, finding that the Board's decision was reasonable and that the NCR hearing information was not material to the narrow issue before the Board regarding whether the appellant's risk could be managed through modified detention terms.

An appeal under Part XX.1 of the Criminal Code against the Ontario Review Board's disposition dated April 29, 2016.

The appellant, found NCRMD for sexual assault, challenged the Board's decision to continue his detention in a Secure Forensic Unit rather than place him in a general forensic unit or impose a hybrid order allowing discretionary transfer.

The appellant conceded he remained a significant threat to public safety and that detention was appropriate, but argued the Board erred in: (1) failing to provide reasons for rejecting a hybrid order; (2) misapprehending evidence regarding his low risk for coercive sexual contact; and (3) failing to apply the least restrictive disposition test.

The Court of Appeal dismissed the appeal, finding no legal error in the Board's disposition.

An appeal under Part XX.1 of the Criminal Code against a disposition of the Ontario Review Board dated May 13, 2016.

The appellant raised three grounds of appeal: (1) the Board failed to apply the Winko test in concluding the appellant remains a significant threat to public safety and failed to order an absolute discharge; (2) the Board erred in failing to order a conditional discharge; and (3) conditions should be amended to allow community living in Brockville rather than North Bay due to North Bay's inability to receive the appellant.

The Court of Appeal dismissed the first two grounds but allowed the appeal on the third ground, permitting the appellant to live in approved community accommodation in Brockville.