WARNING
The court hearing this matter directs that the following notice be attached to the file:
A non-publication and non-broadcast order in this proceeding has been issued under subsection 486.4(1) of the Criminal Code. This subsection and subsection 486.6(1) of the Criminal Code, which is concerned with the consequence of failure to comply with an order made under subsection 486.4(1), read as follows:
486.4 Order restricting publication — sexual offences. — (1) Subject to subsection (2), the presiding judge or justice may make an order directing that any information that could identify the victim or a witness shall not be published in any document or broadcast or transmitted in any way, in proceedings in respect of
(a) any of the following offences:
(i) an offence under section 151, 152, 153, 153.1, 155, 160, 162, 162.1, 163.1, 170, 171, 171.1,172, 172.1, 172.2, 173, 213, 271, 272, 273, 279.01, 279.011, 279.02, 279.03, 280, 281, 286.1, 286.2, 286.3, 346 or 347, or
(ii) any offence under this Act, as it read from time to time before the day on which this subparagraph comes into force, if the conduct alleged would be an offence referred to in subparagraph (i) if it occurred on or after that day; or
(b) two or more offences being dealt with in the same proceeding, at least one of which is an offence referred to in paragraph (a).
(2) MANDATORY ORDER ON APPLICATION — In proceedings in respect of the offences referred to in paragraph (1)(a) or (b), the presiding judge or justice shall
(a) at the first reasonable opportunity, inform any witness under the age of eighteen years and the victim of the right to make an application for the order; and
(b) on application made by the victim, the prosecutor or any such witness, make the order.
486.6 OFFENCE — (1) Every person who fails to comply with an order made under any of subsections 486.4(1) to (3) or subsection 486.5(1) or (2) is guilty of an offence punishable on summary conviction.
ONTARIO COURT OF JUSTICE
BETWEEN:
HIS MAJESTY THE KING
— AND —
PAUL ADAM
Before Justice Seth Weinstein
Heard on April 14-16, 20-22, 30 and May 7, 2026
Reasons for Judgment released on June 9, 2026
Matthew Shumka and Katherine Beaudoin counsel for the Crown
Daniel Brown and Chloe Boubalos counsel for Paul Adam
WEINSTEIN J.:
1Paul Adam is a dermatologist who operated two clinics in Toronto. He is charged with sexual assault in relation to five patients who attended his clinics between 1999 and 2023.
2The Crown alleges that Dr. Adam intentionally touched each complainant in a sexual way for no valid medical purpose. The Crown submits that the evidence of each complainant was both credible and reliable. Where there are lapses in memory, these are understandable because of the passage of time between the events and the reporting to the police. The Crown also brings a cross-count similar act application relying on the fact that all the complainants describe the same or similar encounters with Dr. Adam.
3The defence submits that the complainants misinterpreted accidental contact that occurred during otherwise appropriate medical examinations. Dr. Adam testified that he may have touched the complainants as alleged, but that any such contact was incidental and unintended. The defence submits that Dr. Adam’s evidence is credible and reliable. It is further submitted that the complainants’ evidence is inherently unreliable, in some respects incredible, and that the inconsistencies and improbabilities in their accounts render any dependence on their evidence unsafe.
4There is no real issue that each of the complainants were touched in the way they describe. The ultimate issue for me to determine is one of intentionality. In other words, whether the Crown has proven beyond a reasonable doubt that Dr. Adam deliberately touched the complainants in circumstances of a sexual nature without their consent.
Summary of the Relevant Facts
5I will provide a summary of each witness’s testimony and refer to the salient features of their evidence as it relates to this issue.
(a) Evidence of M.O.
6The chronology begins with allegations made by M.O. On November 10, 2023, Ms. O attended Dr. Adam’s clinic on Neilson Road about a lesion above her kneecap toward the inside of her thigh. She testified that the lesion had changed over time and that she was concerned that it might be cancerous.
7After arriving at the clinic, Ms. O checked in at the front desk, she was directed to a secondary waiting room and was then escorted by Dr. Adam into an examination room. She said that she sat on the examination bed with her legs hanging off the side, facing into the room. Ms. O then rolled up her pant leg to show Dr. Adam the lesion.
8Ms. O testified that while examining the lesion with a magnifying instrument, Dr. Adam placed his left hand on the examination table beside her right thigh. She stated that as he leaned forward in a hunched position, which she described as resembling a “cooked shrimp,” Dr. Adam’s groin made firm contact with her right knee and pressed against it. He made no sexual comments and said nothing about the physical contact. She estimated the contact lasted about 30 seconds.
9Ms. O acknowledged that to examine the lesion, Dr. Adam would have needed to be close to her with a magnifying glass near her skin. When confronted with the suggestion that the examination and the touching she described could not have occurred together, Ms. O stated, for the first time, that Dr. Adam did not, in fact, examine her knee.
10Dr. Adam told Ms. O that the lesion was likely caused by a bug bite and was not of concern. She testified that after receiving this information, she asked whether Dr. Adam would look at her acne or whether she would need another referral. She testified that Dr. Adam said he could examine the acne and approached her again. Ms. O was still seated in the same position on the examination bed, wearing a mask, which she lowered so that he could examine her face.
11Ms. O testified that while examining her face, Dr. Adam stood more upright and again pressed his groin firmly against her right knee. At one point while examining her face, Dr. Adam allegedly said he would make her beautiful, which she found unusual and inappropriate. Ms. O said that the contact with her knee on this occasion was between one and three minutes. However, in a statement provided to investigators from the College of Physicians and Surgeons of Ontario (CPSO), Ms. O said it lasted “about a minute”.
12Ms. O also testified that Dr. Adam had written her a prescription and told her to book a follow-up appointment in two months. However, in her statement to the CPSO, she said that Dr. Adam did not ask her to return and that no follow-up was required. She also said that she did not fill the prescription. However, in her statement to the CPSO she stated that she had in fact had the prescription filled.
13Ms. O stated that she left the examination room, told the front desk that she did not want to book another appointment and exited the clinic. Her husband was waiting for her outside. When she got into the car, she told him that something didn’t feel right and described that what had happened was uncomfortable and weird. She testified that her husband was upset and that she searched for information about Dr. Adam online. In doing so, she saw reference to an incident in 2001 where it was alleged that Dr. Adam had touched a patient with his groin. She agreed that this information influenced her perception of the incident and reinforced her belief that the conduct was intentional.
14After finding out about the prior complaint, Ms. O contacted the CPSO. She later learned that the CPSO resolved the matter by allowing Dr. Adam to surrender his licence in exchange for dismissal of her complaint. She was not happy with this outcome and was concerned that Dr. Adam would continue to see patients before the surrender took effect. After communicating those concerns to the College, Ms. O was advised that she could file a police report. She said that she then reported the matter to police because she wanted accountability and believed this was necessary to protect other patients.
15Dr. Adam was charged with sexual assault in relation to Ms. O on January 31, 2025.
16Ms. O has also launched a civil action against Dr. Adam seeking $250,000 in damages and costs.
Press Release
17After laying the charge, the police issued a press release notifying the public that Dr. Adam had been charged with a sexual assault that occurred during a medical examination at a clinic in the Tapscott Road and Neilson Road area. No other details of the alleged sexual assault were included in the press release.
(b) Evidence of K.L.
18Ms. L attended an appointment with Dr. Adam on November 26, 1999. She was referred by her family physician because she had a family history of skin cancer and there were concerns about moles on the backs of her hands.
19Ms. L testified that she sat on the edge of the examination table with her right leg crossed over her left while Dr. Adam stood in front of her to examine her hands. She said he then turned off the lights and used a light to examine her hairline for possible pigment loss. As he did so, he placed his fingers in her hair, which Ms. L said made her feel uncomfortable and nervous.
20Initially, Ms. L claimed there was no medical reason for Dr. Adam to examine her face or hairline and no need for him to be near her face. However, when confronted with the referral note setting out concerns about pigment loss, Ms. L ultimately agreed that there was a medical reason for the examination. She acknowledged that Dr. Adam was assessing hypopigmentation and her suitability for laser treatment.
21Ms. L testified that she felt Dr. Adam’s penis press against her knee during the examination. However, she provided inconsistent accounts as to when the alleged contact occurred. In a statement to the CPSO, Ms. L could not recall whether the contact occurred before or after the lights were turned off. In her statement to police, she said that the contact occurred while the lights were off. She later emailed the police stating that she believed both the hair touching and the genital contact occurred while the lights were off.
22Ms. L described Dr. Adam as standing directly in front of her, with his groin positioned at the level of her knee. She testified that she felt a sensation of pressure, which she described as “squishing.” Ms. L gave inconsistent accounts of the duration of the alleged genital contact. In her statement to the CPSO in 2000, she described it lasting two to three seconds. However, she suggested in her evidence that the contact was longer.
23According to Ms. L, the hair touching made her feel sick and was almost worse than the alleged genital contact. However, in her initial statement to police in 2025, she made no mention of the hair touching. She only reported it after reviewing a prior statement and being surprised to see it described there. Ms. L conceded that her emotional characterization of the hair touching has intensified over time and that this aspect of the incident became more salient after reviewing the materials.
24Dr. Adam recommended laser therapy and they discussed making another appointment. Ms. L testified that she felt distressed on her way home and considered reporting the incident but was reluctant to do so. She stated that she informed her husband, a friend, a physician friend familiar with Dr. Adam, and her referring physician of the incident shortly thereafter.
25Shortly after the appointment, Ms. L made a complaint to the CPSO, which resulted in a hearing at which she testified. The complaint was dismissed. She did not pursue a police complaint at that time, believing that a single incident would be difficult to prove criminally. Ms. L acknowledged that she was upset by the CPSO decision, describing it as inadequate and flawed. She testified that she felt the panel was reluctant to ruin a doctor’s life. She said that she felt vindicated and happy when she later learned that Dr. Adam had been arrested.
(c) Evidence of S.R.
26Ms. R. was referred to Dr. Adam for a rash that began as a small patch on her right buttock that later spread across her back and torso. She was unable to recall the exact date of her first appointment but stated that she believed it occurred sometime between March and May 2013. She knew that the appointment was prior to her June wedding because she recalled being concerned that the rash would be visible in photographs.
27According to her account, Ms. R. saw Dr. Adam on three separate occasions. The first she attended alone. Ms. R. testified that upon entering the examination room, Dr. Adam commented about her intelligence and said that she was attractive. She said that these remarks were unexpected and made her feel uncomfortable.
28At the first appointment Ms. R. lifted her shirt so that Dr. Adam could examine her back. She also exposed the area of her buttocks where the initial patch had appeared. She testified that Dr. Adam stood behind her and examined the rash using what she described as a “Sherlock Holmes–style” magnifying glass. Ms. R. said that during the examination, she felt Dr. Adam’s groin contact her buttocks. She described the contact as brief, that there was no grinding or thrusting motion, and that she did not feel an erection. Ms. R. did not react to the touching and neither she nor Dr. Adam said anything about it during the appointment.
29Ms. R. testified that she left the appointment uncertain about what had occurred and initially doubted whether the contact was intentional. She stated that she felt uncomfortable and told her fiancé, G.D., what had happened and asked him to accompany her to the next appointment.
30Ms. R. testified that she and Mr. D returned to see Dr. Adam for a biopsy. She stated that Dr. Adam appeared surprised when he entered the examination room and saw her fiancé. Dr. Adam allegedly raised his hands and said “not touching,” which Ms. R. interpreted as an acknowledgment of the earlier contact. She testified that no inappropriate physical contact occurred during this appointment but described Dr. Adam as being impatient and curt.
31Ms. R. testified that she returned alone for a third appointment to receive the biopsy results. She stated that this appointment occurred in an office rather than an examination room and that Dr. Adam again referred to her as attractive and intelligent. Ms. R. was unable to recall the biopsy results but testified that she was prescribed a cream which ultimately resolved the rash.
32Ms. R. did not report Dr. Adam’s conduct to her family physician, the CPSO, or to police at the time. She first contacted police in February 2025 after seeing news coverage that Dr. Adam had been arrested for sexual assault and that police were looking for additional complainants. She stated that the media coverage caused her to re‑evaluate her experience and it confirmed her belief that the contact during her first appointment was deliberate.
(d) Evidence of C.C.
33Ms. C attended Dr. Adam’s clinic on January 3, 2019. She had a family history of skin cancer and was referred by her family physician because of a small mole near her collarbone.
34Dr. Adam examined the mole and measured it. Ms. C said that after examining the mole, Dr. Adam’s hands came down and grazed her breast. She said that the contact with her breast was brief and was not overtly sexual but nonetheless unexpected and uncomfortable. She could not recall which hand touched her breast or what part of his hand made contact, but she testified there was no apparent medical reason for the contact. Ms. C acknowledged that she was uncertain at the time if the touching was deliberate.
35Dr. Adam recommended a biopsy to rule out malignancy. Ms. C testified that while performing the biopsy, Dr. Adam pressed his penis against her knee as she sat on the examination table. She said that the contact lasted for the duration of the excision, which she agreed was brief. Dr. Adam did not say anything during the contact, and she did not observe any deliberate repositioning by Dr. Adam to cause it to happen.
36After the biopsy, Dr. Adam returned to Ms. C and, using a scooping motion, with his hand on her thigh, demonstrated how he had removed the mole. She found this contact uncomfortable and unnecessary but conceded that it was limited to Dr. Adam explaining the medical procedure that he had just performed.
37Ms. C initially wondered whether the touch of her breast and knee was accidental. She confirmed that Dr. Adam made no sexual comments and that all the contact occurred during a medical examination or demonstration. She conceded that if each alleged contact had occurred in isolation, she might not have perceived it as problematic, but that the cumulative effect of the contact made her feel violated.
38Ms. C attended a follow-up appointment to get the biopsy results and for Dr. Adam to examine the healing site. There was no inappropriate touching at this appointment but she did not return to see him again. Ms. C said that when her family doctor later suggested returning to Dr. Adam, she refused but did not disclose details of the alleged incident.
39Ms. C reported the incident to the police after her mother saw a report concerning the arrest of a dermatologist accused of sexual assault and calling for additional complainants to come forward. She testified that this news validated her experience and led her to conclude that the conduct she experienced had been deliberate.
(e) Evidence of R.G.
40Ms. G was referred to Dr. Adam by her family doctor for lesions on the inside of her left leg, near her knee. She attended the Neilson Road clinic on April 29, 2022.
41After entering the examination room, Ms. G sat in the middle of the examination table with her legs hanging over the edge and rolled up her pant leg to reveal the affected area. She testified that Dr. Adam took a brief look while standing in front of her, asked a few questions, and then moved closer to examine the lesions. She said that as he did so, Dr. Adam pressed his genitals against her for approximately three to four seconds. Ms. G testified that the contact was intentional and immediately made her uncomfortable. She said that she tensed up or moved backward slightly, after which Dr. Adam stepped away.
42Ms. G maintained that she only attended the appointment for the leg lesions and that they did not discuss any other skin conditions. However, Dr. Adam’s contemporaneous medical records and the referral documentation revealed that Ms. G was also examined for actinic keratosis on her forearms, chest, and face, an infected cyst on her right scapula, and dystrophic toenails. Ms. G did not recall examination of those areas or that a biopsy had been performed.
43Ms. G testified that Dr. Adam diagnosed her condition as psoriasis and provided her with a prescription. She recalled leaving the appointment quickly because she wanted to get out of the office. Ms. G testified that she did not book a follow‑up appointment and never returned to see Dr. Adam. Instead, she said that she was referred to another dermatologist after she told her family doctor that she felt uncomfortable with Dr. Adam. The medical records revealed, however, that she attended a follow‑up appointment on May 26, 2022, at which time biopsy results were reviewed and a treatment plan was confirmed.
44Ms. G first reported her allegation to police in February 2025 after seeing a CP24 news report stating that Dr. Adam had been arrested for sexually assaulting a patient. When she initially spoke to police Ms. G described the incident as “iffy,” explaining that it was not an overt or immediate sexual assault and was subject to interpretation. She also told police that she recalled Dr. Adam having a moustache.
(f) Evidence of Dr. Adam
45Dr. Adam was 78 years old at the time of trial. He completed medical school at the University of Toronto in 1972, a residency in internal medicine in 1977, and a fellowship in dermatology in 1979.
46Dr. Adam practiced medicine for approximately 46 years until his resignation in 2024. He worked at St. Michael’s Hospital beginning around 1980, serving as Chief of Dermatology and as an assistant professor with the University of Toronto. He was involved in teaching, resident selection, and training.
47Over the course of his career, Dr. Adam maintained a busy dermatology practice at clinics on Sherbourne Street and Neilson Road. He testified that his practice routinely involved seeing between 60 and 80 patients per day.
48Dr. Adam described dermatology as a visual specialty. He explained that making an accurate diagnosis often requires close inspection of the affected area, sometimes using instruments such as a loupe or a dermatoscope with an integrated light source. He explained that he had poor vision in his left eye and so when examining patients, he relied primarily on his right eye. This sometimes required him to lean forward to get a proper view of a lesion. He stated that he typically positioned himself close to the patient to visualize the area of concern, particularly when assessing pigmented lesions or potential skin cancers. This technique often required him to bend significantly at the waist.
49Dr. Adam testified that his usual practice when assessing patients was to begin with a history, including questions about family history of skin cancer, sun exposure, occupation, and prior treatments. He explained that these inquiries informed his assessment of cancer risk and treatment options. He stated that, when possible, he asked patients to expose the area of concern themselves rather than physically repositioning or disrobing them, as those interactions could be intrusive. He testified that he rarely engaged in tactile examinations and that when physical contact was necessary for a procedure, such as a biopsy, he would explain what he was doing beforehand and obtain consent.
50Dr. Adam had no independent recollection of the individual appointments involving the complainants. He explained that, given the volume of patients he saw over many years, individual visits were fleeting and not memorable. He stated that his testimony regarding those encounters was therefore based on his medical notes and his usual practice. He emphasized that his notes were made contemporaneously with the appointments and reflected what he considered clinically relevant at the time.
51Dr. Adam denied intentionally touching any patient in a sexual manner. He testified that he never deliberately pressed his groin or genitals against a patient and that he had no sexual interest in any of the complainants. He acknowledged that, given the layout of the examination rooms and the need to work near patients, it was possible that he may have inadvertently brushed against a patient during an examination. He stated that any such contact would have been entirely accidental and not something of which he was aware at the time.
52With respect to Ms. L, Dr. Adam testified that he recalled the CPSO complaint arising from her visit in 1999 and the subsequent disciplinary hearing. He stated that he had no recollection of any inappropriate contact during that appointment and believed that her complaint arose from a misinterpretation of incidental contact during a legitimate examination. He testified that when the College dismissed the claim, it confirmed for him that he had done nothing wrong. He acknowledged that the process was stressful and upsetting but stated that it did not lead him to change his examination practices, as he believed his conduct had been appropriate.
53The referral documentation for Ms. L indicated concerns about benign lesions, pigment loss, and prior scarring, which would have required examination of her hands, face, and hairline. Dr. Adam testified that such assessments may involve turning off the lights and using a special light source and could reasonably involve proximity to the patient’s head and hairline.
54For Ms. R., Dr. Adam had only one contemporaneous medical record which documented a single appointment on May 10, 2013. The record reveals a diagnosis for pityriasis rosea, a condition characterized by a herald patch followed by a widespread rash. Dr. Adam explained that the diagnosis would have been based on his visual assessment and distribution patterns. He denied making any sexualized comments and denied intentionally positioning his body against Ms. R. during examination. He stated that any contact would have been inadvertent. Dr. Adam testified that he would not perform a biopsy for pityriasis rosea and there is no reference to a biopsy, no pathology report, and no notation of follow‑up visits in Ms. R.’s records.
55For Ms. C, Dr. Adam testified that the referral concerned a pigmented lesion near her clavicle with a family history of skin cancer. He explained that he would have examined the lesion using magnification, performed a biopsy to rule out malignancy, and that he reviewed the pathology results at a follow-up appointment. Dr. Adam acknowledged that he may have demonstrated the scooping motion when explaining how he did the biopsy but denied any intentional sexual touching. He expressed regret that Ms. C felt distressed by the encounter, stating that any contact was unintended.
56For Ms. G, Dr. Adam testified that the referral documentation and his notes indicated multiple issues, including actinic keratosis, a cyst on her scapula, dystrophic toenails, and a lesion near the knee. He explained that his practice was to address all concerns raised during the visit, even those not specifically listed in the referral. He testified that his notes reflected examinations of the forearms, chest, face, cyst, toenails, and knee lesion, including a biopsy that was later confirmed to be psoriasis. He stated that these examinations required him to be close to the patient but he denied intentionally pressing his body against her.
57With respect to Ms. O, Dr. Adam testified that the referral concerned a small, pigmented lesion near her knee and that she also raised concerns about acne. He testified that both issues were medically appropriate to assess and that acne examination would have required close inspection of the face. Dr. Adam denied intentionally pressing his groin against her knee or that he made any inappropriate comments. He acknowledged that he possibly said something about how treatment would improve her appearance but denied saying “I will make you beautiful” in a sexualized manner.
58Dr. Adam maintained that he always conducted himself professionally, that any physical contact with patients was incidental to legitimate dermatological examination, and that he was unaware at the time of any patient perceiving his conduct as inappropriate.
Similar Fact Application
59The Crown has brought an application to admit the evidence of each complainant to support a finding of guilt on all counts. If the similar fact application is not allowed, the evidence of each complainant can only be heard to support a conviction on their own allegations. If the application is allowed, evidence of one complainant may be considered as evidence on a charge related to another complainant.
60The Crown submits that the cross-count similar fact evidence is relevant to (1) inform my assessment of whether the physical contact was sexual in nature; (2) to establish a pattern of behaviour; and (3) to rebut Dr. Adam’s evidence that any contact with the patient was inadvertent and unintentional.
Governing Principles
61Similar fact evidence is presumptively inadmissible. It may only be admitted where its probative value outweighs its prejudicial effect. The analysis is a contextual one, rooted in the fundamental concern that such evidence, while potentially highly probative, also carries a significant risk of moral and reasoning prejudice: R. v. Handy, 2002 SCC 56; R. v. Ateyah, 2026 ONCA 287.
62Moral prejudice relates to the danger that a trier of fact will conclude that the accused is the kind of person likely to have committed the offence charged. Reasoning prejudice arises where the evidence distracts from a proper assessment of each count or effectively reverses the burden of proof. In cross-count cases, reasoning prejudice is attenuated because the evidence is already before the trier of fact; the same is true of moral prejudice in a judge-alone trial: R. v. Tsigirlash, 2019 ONCA 650, at para. 38.
63The similar act evidence must be relevant to a material issue in the case and the inference that the evidence invites must be compelling enough to have some degree of influence in its determination. In short, the proposed evidence must have some bearing upon the live issues in the case: Handy, at para. 26, 73; Ateyah at para. 15.
64In cross-count cases, probative value depends largely on the degree of similarity among the alleged acts. The analysis is not mechanical and does not require a “signature” level of uniqueness. Rather, a trial judge must consider the nature of the conduct, the surrounding circumstances, and the relationship between the accused and each complainant to determine whether the similarities support an inference beyond mere propensity.
65Similar fact evidence may be admissible where it demonstrates a distinctive propensity manifested through specific acts that bear a direct connection to the issues in dispute. This includes “situation‑specific behaviour” or a recurring pattern of conduct occurring within a narrowly defined and circumscribed context. Such evidence derives its probative value from the close linkage between the pattern of circumstances and the offences charged, such that the possibility of coincidence, mistake, or mischaracterization of the conduct is sufficiently diminished: Handy, at paras. 90-92.
66Similar fact evidence must be “reasonably capable of belief.” In performing this gatekeeping function, the trial judge considers credibility and reliability, but in a limited way. In a judge-alone trial, care must be taken not to make definitive credibility findings at the admissibility stage. The inquiry is not one of ultimate credibility and reliability, but whether the proposed evidence meets the threshold of reasonable capability of belief: Handy, at para. 134; R. v. S.S., 2025 ONCA 865, at paras. 30–31; R. v. C.D., 2023 ONCA 790, at para. 16.
67As the similar fact evidence gains its probative value from the improbability of coincidence, any evidence such as collusion or tainting negates this improbability. Where there is an air of reality to collusion or inadvertent tainting, the Crown must establish on a balance of probabilities that the complainants’ accounts are independent. The Crown does not need to disprove the possibility of tainting. Rather, the Crown must establish that the similar act evidence is not the product of direct or indirect influence. This requires examining what each complainant was exposed to, the information obtained, its detail, and the reliability of their accounts: Handy, at paras. 106, 112; Ateyah, at paras. 23, 131–135.
Analysis
68A principal factor in assessing the probative value of similar act evidence is its “connectedness” to the issues. I must evaluate the degree of similarity between the alleged acts to determine whether coincidence is objectively improbable. The required degree of similarity depends on the issues at trial, the purpose for which the evidence is tendered, and the surrounding evidence. Relevant considerations include, but are not limited to:
(1) the proximity in time of the similar acts.
(2) the extent to which the similar acts are similar in detail to the charged counts.
(3) the number of similar acts.
(4) the circumstances surrounding or relating to similar acts.
(5) any distinctive features unifying the incidents; and
(6) any other factor tending to support or rebut the underlying unity of the similar acts: Handy, at paras. 81-84.
69The potential probative value of the proposed similar fact evidence in this case stems from the improbability that the complainants' respective accounts would share so many similarities unless Dr. Adam did the things each of them claims.
70The alleged incidents are separated by significant periods of time and occupy only an extremely small fraction of Dr. Adam’s lengthy career. The Crown relies on five incidents spanning approximately twenty-four years, during which Dr. Adam examined thousands of patients. On one view, the relative infrequency of the allegations may attenuate the inference that the conduct is part of a continuous pattern and may lend some support to the possibility of coincidence.
71What assumes greater significance in this case, however, is the specific similarity in the way the alleged misconduct is said to have occurred. The nature of the touching, the circumstances in which it occurred, and the way it is said to have been introduced bear a compelling degree of resemblance. These similarities include:
(a) The incidents all occurred while Dr. Adam was conducting a medical examination.
(b) The incidents all occurred while the patients were alone with Dr. Adam.
(c) The alleged sexual touching occurred while Dr. Adam was leaning in and closely examining the complainants.
(d) All the complainants say that it was during these examinations that Dr. Adam pressed a part of his body into them in a sexual manner.
(e) Four of the complainants allege that Dr. Adam’s groin contacted their knee or leg during the examination.
(f) The complainants all describe the touching as being very brief.
(g) All the touching involved women.
(h) Two of the complainants describe what they perceived to be inappropriate comments being made during the examinations.
72These common features point to a distinctive pattern of behaviour. The alleged acts share a constellation of characteristics that, when considered cumulatively, can reasonably negate the possibility of coincidence. Their probative force lies less in the number of incidents than in their qualitative coherence. The repetition of conduct in strikingly similar circumstances provides a unifying thread supporting the inference that the acts were not incidental. Accordingly, despite temporal gaps and the relatively small number of incidents over the course of Dr. Adam’s career, the marked similarities among the allegations enhance their probative value and supports admissibility.
73There is no doubt that each complainant’s account contains frailties bearing on their credibility and reliability, most notably in the case of Ms. G. The Crown fairly acknowledges that, standing alone, Ms. G’s evidence would not support a conviction. At this stage, however, my task is not to make a final determination on credibility or reliability. The threshold is lower. I must determine only whether each account is reasonably capable of belief: Arp, at para 67, Ateyah, at para. 57.
74With that lower threshold in mind, I am satisfied that despite their frailties, each complainant’s evidence is reasonably capable of belief. In Ms. G’s case, the alleged incident is corroborated by Dr. Adam’s clinical notes, which confirm the examination during which the assault is said to have occurred. This contemporaneous record provides an objective anchor for her account and supports its plausibility. Although I have significant concerns about her overall reliability, I am nonetheless satisfied that her evidence meets the threshold of admissibility.
75Viewed cumulatively, the evidence establishes a sufficient foundation for the inference that Dr. Adam engaged in the alleged situation-specific conduct. While there are some dissimilarities in the complainants’ accounts, they are few and relatively minor compared to the similarities. The similarities are sufficient to support an inference of a behavioural pattern, from which it may be inferred that Dr. Adam acted in accordance with that pattern in his interactions with each complainant.
76There is no evidence of direct collusion. However, the press release gives rise to an air of reality to the possibility of inadvertent tainting. The Crown must therefore establish that the complainants’ accounts are independent. I am satisfied that they have met their onus.
77The press release contained no particular details of the allegations. There is no evidence that any complainant was aware of the specifics of the others’ allegations. Although Ms. O knew of a prior complaint where it was alleged that Dr. Adam had touched a patient with his groin, there is no evidence she knew further details. Most significantly, she was unaware that Dr. Adam had allegedly rubbed his groin against the patient’s knee. I am satisfied that her limited awareness of this fact did not affect her evidence that Dr. Adam had touched her knee with his groin.
78Although several complainants were exposed to the press release before reporting, there is no evidence their accounts were the product of tainting. The similarities relied on by the Crown are not limited to generalized or publicly disclosed features. Rather, they concern the physical circumstances of the examinations, the proximity involved, and the nature of the alleged conduct. I am therefore satisfied on a balance of probabilities that the complainants acted independently.
79In assessing the evidence at this stage, I note that the defence acknowledges that the complainants were likely touched as described. The issue is not whether physical contact occurred, but whether the complainants’ interpretation of that contact was later influenced or reframed by exposure to the press release and related information. Any potential impact of the press release on the complainants’ interpretations of events is a matter for the final weighing of the evidence, not a basis to exclude the similar act evidence.
80The prejudicial effect of admitting the similar fact evidence is minimal. I am satisfied that given the degree of similarity in the evidence of each complainant, the proposed similar act evidence supports a clearly defined, situation-specific propensity on the part of Dr. Adam. Accordingly, the similar fact evidence is admissible across the counts on the information.
81In admitting this evidence, I instruct myself to consider the similar fact evidence solely for the purpose for which it is tendered and not for the purpose of engaging in any prejudicial reasoning based on a general disposition or propensity of Dr. Adam to engage in sexual misconduct.
82With the similar act being admissible, I now turn to the trial proper.
Fundamental Legal Principles
83Dr. Adam is presumed innocent. There is no obligation on him to do anything to establish his innocence. The presumption of innocence remains in place unless and until the Crown has proven each essential element of the offence beyond reasonable doubt.
84Reasonable doubt is based upon reason and common sense. It is logically connected to the evidence, or the lack of evidence. Reasonable doubt requires more than mere probability. Although it cannot be described with mathematical precision, reasonable doubt is a high standard consistent with its role as a safeguard against wrongful convictions. At the same time, reasonable doubt does not require proof beyond all doubt nor is it proved to an absolute certainty. Based on the totality of the evidence, I must be sure of guilt before I convict. Anything less must result in an acquittal.
Assessing Credibility and Reliability
85The Crown’s case stands or falls on my findings of credibility and reliability of the complainants and Dr. Adam.
86There is a distinction between credibility and reliability. Reliability relates to the accuracy of the witness’ testimony which engages a consideration of the witness’ ability to accurately observe, recall and recount an event: R. v. H.C., 2009 ONCA 56 at para. 41. At times, a witness may credibly recount an observation or occurrence. However, that evidence may lack reliability for several reasons, including the conditions under which the witness made the observation as well as the impact of information received by the witness after an event. An incredible witness’s evidence cannot be relied on. However, the converse is not automatically true as credibility is not a proxy for reliability. A credible witness may, nonetheless, give unreliable evidence: R. v. Morrissey (1995), 22 O.R. (3d) 514 (C.A.) at p. 526.
87In assessing the evidence, I may accept all, some, or none of a witnesses’ testimony. However, I must ensure that I do not apply different standards of scrutiny to the evidence of the Crown and the defence: R. v. Phan, 2013 ONCA 787, at paras. 29-34. I must also avoid a piecemeal approach to the evidence. The standard of proof beyond a reasonable doubt does not apply to individual items of evidence, but only to a final determination as to guilt based on the essential features of the offences charged.
88There is no magic formula that applies in determining whether a witness is telling the truth. Instead, the witness’ evidence is considered using a common-sense approach that is not tainted by myth or stereotype. There are many factors that may be relevant in determining credibility. Some of the key factors include: whether the witness’ evidence is internally consistent, whether it is externally consistent with evidence from other witnesses or exhibits, whether the witness has a bias or motive to give evidence that is more favourable to one side or the other, whether inconsistencies in the evidence are about important or minor matters and what explanations are given for any inconsistencies.
89The Supreme Court made clear in R. v. Kruk, 2024 SCC 7 that trial judges are expected to rely on common sense and experience in determining issues of credibility and reliability. In doing so, however, I should exercise caution about making ungrounded assumptions that are not based on the evidence.
90Our law mandates that a criminal trial is not a credibility contest and can never be resolved by a judge simply selecting whose version of events they prefer. A criminal trial is not a binary choice between the evidence proffered in favour of the prosecution and the evidence proffered in favour of the accused. Rather, I must be guided by the principles articulated in R. v. W.(D.).
91The W.(D.) methodology is an analytical framework that serves to emphasize the burden of proof and the presumption of innocence by ensuring that criminal cases are not reduced to credibility contests. In applying the W.(D.) methodology, I am mindful that the methodology applies not only to instances where the defence calls exculpatory evidence, but also to exculpatory evidence that is found within the Crown’s case: R. v. J.H.S., 2008 SCC 30 and R. v. C.L.Y., 2008 SCC 2; R. v. B.D., 2011 ONCA 51 at para. 105.
92In considering the first two steps of the W.(D.) analysis, the evidence of the accused must be considered in the context of the evidence as a whole. In other words, the assessment is not simply whether Dr. Adam’s evidence standing alone and without context is believed or leaves a reasonable doubt: R. v. Carriere (2001), 159 C.C.C. (3d) 51 (Ont.C.A.) at para. 51, R. v. Hull, and R. v. J.J.R.D. (2006), 215 C.C.C. (3d) 252 (Ont.C.A.).
93There is no direct evidence on the central issue of intent. It must be inferred and, as such, the principles set out in R. v. Villaroman, 2016 SCC 33, apply. Accordingly, even if I were to reject Dr. Adam’s evidence, I can only convict if guilt is the only reasonable inference available from the circumstantial evidence.
94When assessing the circumstantial evidence, I must consider other reasonable possibilities inconsistent with guilt. However, the Crown does not need to "negative every possible conjecture, no matter how irrational or fanciful, which might be consistent with the innocence of the accused": Villaroman, at para. 37. The basic question is whether the circumstantial evidence, viewed logically and in light of human experience, is reasonably capable of supporting an inference other than that the accused is guilty: Villaroman, at para. 38 and R. v. Megill, 2021 ONCA 253, at para. 42.
95It is an error of law for a trier of fact to fail to distinguish between a rational conclusion as to reasonable doubt based on evidence, and an unsupported conclusion based on conjecture. In determining whether the Crown has met that burden in a circumstantial evidence case, I must apply logic and common sense to the totality of the evidentiary picture, including gaps, and consider whether other reasonable possibilities not only exist, but preclude a finding that an inference of guilt is the only reasonable inference available: R. v. Ali, 2021 ONCA 362, at para. 97.
96One final principle to emphasize is that the defence has no onus to demonstrate a motive to fabricate and the absence of evidence of a motive to fabricate does not mean there wasn’t one, nor does the absence of a motive to fabricate establish that the complainant is telling the truth. Evidence of a motive to fabricate is one of the factors to consider in assessing the complainant’s credibility: R. v. Batte (2000), 49 O.R. (3d) 321 (C.A.), at paras. 120-121; R. v. Polemidiotis, 2024 ONCA 905, 174 O.R. (3d) 359, at paras. 60-62.
The Elements of the Offence
97To establish the offences charged, the Crown must prove that Dr. Adam intentionally touched each of the complainants in circumstances of a sexual nature without their consent and knowing that they did not consent to the touching. The touching element of the offence is determined objectively: R. v. Ewanchuk, [1999] 1 S.C.R. 330.
98Consent involves the complainant’s state of mind at the relevant time. It relates to their conscious agreement to take part in the sexual acts in the encounter. Their consent must have been freely given at the time the sexual acts occurred. An accused must know that the complainant was not consenting to the sexual act or was reckless or willfully blind to the absence of consent. In other words, the Crown must prove either that Dr. Adam knew that the complainants were not consenting to the touching; that he knew there was a risk that they were not consenting but went ahead anyway; or was wilfully blind to the absence of consent: R. v. J.A., 2011 SCC 28, at paras. 24, 34; R. v. Ewanchuk.
99In R. v. Litchfield, the Supreme Court of Canada emphasized the need to consider all the surrounding circumstances when assessing consent. This is especially important in the context of a doctor‑patient relationship, where a patient may consent to some physical contact but not to contact of a sexual nature. In such cases, the trial judge must carefully examine the full context of the interaction to determine whether the conduct exceeded the scope of the complainant’s consent.
100Medical examinations may properly involve physical contact with parts of the body that would otherwise be regarded as sexual. Such contact will often be routine and connected directly to the condition being assessed or treated. In determining whether the touching can properly be characterized as sexual in nature, it is relevant to consider whether the examination represented a reasonable medical response to the clinical issue presented. A careful assessment of the surrounding circumstances of the examination is therefore essential to the Court’s evaluation of the alleged conduct: R. v. R.K., 2018 ONSC 2590.
101While I do not propose creating an exhaustive list, I consider the following circumstances to be relevant to a determination of the sexual nature of any examinations performed in this case:
(1) the content of any discussion between Dr. Adam and the patient
(2) the way the patient was positioned
(3) whether intimate body parts were exposed
(4) whether the examinations were medically appropriate
(5) the patient’s perception of the examination at the time it was occurring and
(6) the manner of the touching.
Analysis
102I found each of the complainants to be credible witnesses. The issue, however, is the reliability of their accounts, particularly when assessed in light of Dr. Adam’s evidence and the totality of the circumstances. This includes the nature of the medical appointments, the mechanics of the examinations, and the internal coherence and consistency of each witness’s account.
103Dr. Adam also presented as a forthright witness. He was responsive to the questions posed to him in both examination‑in‑chief and cross‑examination, made reasonable concessions where appropriate, and did not attempt to overstate his recollection of events. His evidence was not seriously undermined in cross‑examination. He did not claim specific memories where none existed, but instead relied on his usual practice, which he described in a clear and consistent manner. That evidence aligns with what would be expected in the context of routine professional medical interactions, including the need for being in close physical proximity with a patient when conducting dermatological examinations and the possibility of incidental contact occurring in that context.
104That said, I do have some concern that, following Ms. L’s complaint in 1999 and the subsequent regulatory proceedings, Dr. Adam did not change his examination practices. Even accepting his position that he was exonerated, he was, at a minimum, aware that the way he conducted his examinations had caused a patient to feel uncomfortable. He ought to have taken additional steps to minimize the risk of inadvertent contact thereafter. However, Dr. Adam explained that his primary focus throughout his practice was on ensuring that his examinations were medically appropriate and thorough. While the absence of any modification to his practice is a factor that warrants consideration, Dr. Adam’s explanation is logical and consistent with the way he described his approach to patient care. It does not, in my view, support a wholesale rejection of his evidence.
105I will proceed with my analysis in two stages. First, I will assess Dr. Adam’s evidence in the context of each individual complainant and determine, based on the totality of the evidence relating to that complainant alone, whether I am satisfied beyond a reasonable doubt that he intentionally touched them in a sexual manner. This requires a careful, independent evaluation of each complainant’s account, the surrounding circumstances, and the plausibility of the competing explanations. Having made those individual assessments, I will then go on to consider the role, if any, of the similar act evidence in the broader analysis, including whether it alters the conclusions reached on the individual counts or otherwise assists in establishing the Crown’s case.
M.O.
106Ms. O and Dr. Adam provide similar accounts of the circumstances leading to her attendance at the clinic and the medical purpose of the visit. Both agree that she attended for an assessment of a lesion near her knee and that Dr. Adam conducted an examination of that area using magnification while she was positioned on the examination table. Both also acknowledge that, following the knee assessment, Ms. O raised an additional concern regarding her acne, which Dr. Adam also examined at close range. In all material respects, apart from the allegation of sexualized contact, their evidence aligns as to the sequence of events, the areas of the body examined, and the general mechanics of how those examinations were carried out, including the need for Dr. Adam to position himself in close physical proximity to properly visualize the skin conditions he was assessing.
107It was submitted that it would have been physically impossible for Dr. Adam to maintain the degree of close visual inspection required to properly examine a lesion on or near the knee while simultaneously pressing his groin into the patient’s leg. While I am not prepared to conclude that such contact would necessarily be impossible, the mechanics described by Ms. O make her account implausible. Her evidence requires that Dr. Adam position his eye and magnification tool in close proximity to the lesion such that he is bent forward and focused downward while at the same time maintaining firm and continuous forward pressure with his groin against her knee. It is difficult to see how this positioning could be maintained. The more closely Dr. Adam would have positioned his upper body and focused on the lesion, the more his midsection would naturally move away from her. This inherent tension in the positioning significantly undermines the likelihood that the contact occurred in the manner Ms. O alleges.
108I also have concerns arising from a material inconsistency in Ms. O’s evidence regarding the mechanics of the examination. In her prior statements Ms. O consistently maintained that Dr. Adam maintained contact with her groin while positioning himself very close to her knee, with his eye and loupe near the lesion. When confronted with the unlikelihood of this occurring, Ms. O stated for the first time that Dr. Adam was not, in fact, close enough to properly examine the lesion. This shift is significant. It arose only after the defence highlighted the physical implausibility of maintaining close visual inspection while pressing his groin into her knee. The timing and nature of this change raises concerns that she changed her evidence in an attempt to address the inherent improbability in her earlier description.
109In addition to the concerns arising from the physical mechanics of the examination, several other issues emerged in Ms. O’s evidence. For example, Ms. O’s evidence regarding the duration of the alleged contact has materially shifted over time. In her initial account, she described the contact as lasting approximately 30 seconds. By the time she spoke with police, that estimate had expanded to roughly one to two minutes. At trial, her evidence evolved further, where she said the touching could have lasted as long as three minutes. The duration of the contact is not a peripheral detail. It is central to the assessment of whether the contact was incidental or deliberate. A brief contact may readily be explained by inadvertence during a close physical examination, whereas prolonged, sustained contact is more suggestive of intention. In that context, the expanding nature of her estimates significantly undermines the reliability of her evidence on this critical issue.
110I also cannot dismiss the possibility that Ms. O’s interpretation that the contact was deliberate was influenced by information obtained after the appointment. Ms. O acknowledged that, prior to going to the CPSO, she became aware of other allegations involving similar conduct by Dr. Adam. She accepted that this information altered her perception of what had occurred, transforming her initial reaction that the encounter was “weird” or “uncomfortable” into a belief that it was intentional.
111Moreover, her conduct after the alleged contact is difficult to reconcile with her account of prolonged and clearly deliberate contact. Despite alleging that Dr. Adam maintained firm groin contact for an extended period during the initial examination of her knee, she nevertheless asked him to examine her acne immediately thereafter. She remained in the room, engaged in further discussion, and permitted a second close‑proximity examination. To be clear, I do not rely on this conduct to invoke any assumption or stereotype about how a person who has been sexually assaulted ought to react. Rather, this evidence is relevant because it speaks to Ms. O’s contemporaneous perception of what occurred. In the circumstances, her actions are more consistent with an interpretation of the initial contact as ambiguous or possibly accidental at the time, rather than as clearly intentional or sexual in nature.
112Finally, I consider that Ms. O has a financial interest arising from a civil claim against Dr. Adam and acknowledged that a police report would assist her in that litigation. While that interest does not, in itself, render her evidence unreliable, it is a relevant contextual factor when considered alongside the other concerns identified.
113Having regard to all these concerns, I am not satisfied that Ms. O’s evidence is sufficiently reliable to support the finding that Dr. Adam intentionally put his groin into her knee. Her evidence, when considered alongside the plausible and consistent account given by Dr. Adam, leaves open a reasonable possibility that the contact was inadvertent.
K.L.
114I accept that Dr. Adam saw Ms. L for a dermatological consultation concerning lesions on her hands as well as scarring and pigment loss. His evidence that he conducted an examination of her hands, face, and hairline is consistent with the nature of the referral and is largely confirmed by Ms. L. Although he was first examining her hand, I find that the examination described by Dr. Adam nonetheless required him to work in close physical proximity to Ms. L, including positioning himself near her face and head to assess any pigment loss.
115With respect to the alleged groin contact, Ms. L ultimately described it lasting only a few seconds while Dr. Adam was conducting his examination. There was no evidence of movement, pressure, or accompanying conduct suggestive of a sexual purpose. Importantly, Ms. L also acknowledged that other parts of Dr. Adam’s body, including his hip, contacted her during the examination. This evidence supports the inference that incidental contact could have occurred as a result of his positioning during the examination. In these circumstances, Dr. Adam’s evidence that any such contact was inadvertent is plausible and consistent with the surrounding circumstances of the examination.
116In addition to the plausibility of Dr. Adam’s account, I have significant concerns about the reliability of Ms. L’s evidence. These concerns are borne primarily from the inconsistencies of her account of events over time. For example, she told police that the touch of the groin was lengthy only to then read the CPSO ruling to find out that she had previously said it lasted only a few seconds. She also introduced new elements that were not present in her original complaint, including an assertion that the assault occurred in the dark, despite previously stating that “nothing happened in the dark.” Her description of the examination was also inconsistent. In her police statement, she made no mention of Dr. Adam examining her face or hairline. She further asserted that there would be no reason for him to examine her hair, as her only complaint concerned her hands. This was contradicted by the referral note, which indicated that Dr. Adam had been asked to assess her hypo‑pigmentation and vitiligo.
117These inconsistencies are neither incidental nor peripheral. They bear directly on the purpose of the visit, the duration and nature of the alleged contact, and the context in which it occurred. I am mindful that Ms. L is recounting events from some twenty‑five years ago, and that some variation in recollection over time is to be expected. I also recognize that certain details not included in her police statement had been mentioned on other occasions. Nonetheless, I must be satisfied that her evidence provides a sufficiently reliable account of the events in question. In light of these significant frailties, I am not.
118Finally, I have considered Ms. L’s lingering dissatisfaction with the outcome of the earlier CPSO proceedings. It is a factor that must be considered in assessing whether her present recollection may have been influenced over time.
119Having regard to all these concerns, I am not satisfied that Ms. L’s evidence is sufficiently reliable to support the finding that any contact was deliberate. Her evidence, when considered alongside the plausible and consistent account given by Dr. Adam and the acknowledged circumstances of the examination, leaves open a reasonable possibility that any contact was inadvertent.
S.R.
120I turn next to Dr. Adam’s account of his interaction with Ms. R. I accept his evidence that he saw her in relation to a rash on her back which he immediately recognized as a classic presentation of pityriasis rosea. His description of the rash, including its distribution and progression, and his evidence that he was able to make a diagnosis through visual inspection and patient history, are supported by the contemporaneous “Dear Doctor” letter documenting both the diagnosis and the prescribed treatment. I also accept his evidence that this condition did not require a biopsy or multiple follow‑up visits, and that he would not have used a large magnifying device of the type described by Ms. R.
121Unlike some of the other complainants, Dr. Adam was able to assess Ms. R.’s condition through visual inspection, which did not require him to be in such close proximity to Ms. R. However, he explained that he still could have brushed up against Ms. R. as he was constantly moving around the small examination room moving around to get a better view of the affected areas of her back and the initial herald patch. In that context, any brief physical contact could reasonably occur as he positioned himself for inspection.
122With respect to the alleged touching, Ms. R. described a brief sensation of contact while she was facing away from Dr. Adam. She did not see what contacted her and could not definitively describe what part of Dr. Adam was touching her. She described no movement, pressure, or other conduct suggestive of a sexual purpose. She acknowledged that it was a fleeting touch. In these circumstances, Dr. Adam’s evidence that any contact, if it occurred at all, was inadvertent, is consistent with the mechanics of the examination and remains a plausible explanation.
123I also have significant concerns about the reliability of Ms. R.’s evidence. Ms. R.’s account of the treatment she received is inconsistent with the objective evidence. She testified that she attended three appointments, underwent a biopsy, and only received a diagnosis and treatment after multiple visits. This account is contradicted by the contemporaneous documentation and by the nature of the condition described, which was capable of immediate diagnosis and treatment. Her evidence that she received a prescription cream is also inconsistent with Dr. Adam’s evidence that he prescribed oral medication, and his evidence that the medication in question was not available in cream form. I agree with the Crown that Ms. R.’s medical records do not definitively establish that she only saw Dr. Adam on one occasion. However, the documentation certainly makes this a reasonable possibility.
124There are also significant inconsistencies between Ms. R.’s evidence and that of her husband. Ms. R. testified that she disclosed specific details of the alleged incident to Mr. D immediately after the first appointment and that they discussed Dr. Adam’s conduct in detail following the second visit. Her husband’s evidence contradicts that account. He testified that he was not aware of the details of any alleged misconduct at the time and only learned of them years later. He also described Dr. Adam’s reaction to seeing him at the appointment in a neutral, unsurprised manner, which is inconsistent with Ms. R.’s evidence that this reaction demonstrated an admission of wrongdoing.
125In addition, Ms. R.’s allegations arose approximately 12 years after the event and only after she became aware through media reporting that Dr. Adam had been charged. She testified that this information “unlocked” her memory. This sequence raises a concern that her recollection of events may have been influenced by knowledge that others had alleged rather than reflecting an accurate memory of the encounter itself. Indeed, Ms. R. acknowledged that she was filling in gaps in her memory and relying on her own reconstruction of events to provide a coherent narrative. This admission is significant, as it allows for the possibility that aspects of her evidence are not grounded on actual memory but rather on conjecture.
126In light of these issues. I am not satisfied that Ms. R.’s evidence is sufficiently reliable to ground a finding that any contact was deliberate. When considered together with Dr. Adam’s plausible account and the context of the examination, the evidence leaves open a reasonable possibility that any contact was inadvertent.
C.C.
127I accept that Dr. Adam saw Ms. C to assess and remove a lesion on her shoulder. His evidence that he measured the lesion, examined it at close range using a loupe, and then performed a biopsy is consistent with his notes and with Ms. C’s own description of the appointment. I further accept that these procedures required him to be in close physical proximity to Ms. C’s body. Dr. Adam acknowledged that, in performing this examination, there is a risk of brief incidental contact but he denied any intention to touch her in a sexual manner. His evidence that he may also have demonstrated the procedure on her leg while explaining what he had done is consistent with Ms. C’s acknowledgment that he provided an explanation while making a scooping motion on her thigh.
128With respect to the alleged breast contact, Ms. C described it as a brief “graze” or contact occurring as Dr. Adam moved his hand away from the area he had been examining. She could not identify precisely what part of his hand made contact and agreed it occurred quickly and without any accompanying gesture such as grabbing, groping, or caressing. Similarly, the alleged groin contact occurred while he was performing the biopsy in circumstances where she was seated on the examination table with her knee protruding. The contact occurred very quickly and without any other indicia of sexualized conduct. In these circumstances, Dr. Adam’s evidence that any such contact was inadvertent is consistent with the mechanics of the examination and remains a reasonable possibility.
129Dr. Adam’s demonstration on Ms. C’s thigh does not, without more, make his conduct unlawful. A physician is not required to explain every component of an examination, and a patient’s failure to appreciate the medical purpose of a particular step does not negate consent. Nor must every aspect of an examination be strictly medically necessary. It is sufficient that it be performed for a legitimate purpose and be clinically reasonable. Here, I accept Dr. Adam’s evidence that the demonstration was to explain the procedure that he had just performed.
130Turning to Ms. C’s evidence, I note at the outset that she presented as a sincere and credible witness. There was no suggestion that she was deliberately misleading the Court, and I accept much of her evidence. However, credibility alone does not resolve the issue. The central question is whether her evidence is sufficiently reliable to establish that the contact was intentional.
131There are several frailties in her evidence that bear on that assessment. First, at the time of the events, she herself was uncertain about the nature of the contact. She testified that at the time she did not know whether it was intentional or accidental. She did not react outwardly, and there was nothing in Dr. Adam’s conduct that indicated to her that it was deliberate.
132Moreover, Ms. C’s interpretation of the contact has evolved over time. She acknowledged that she had difficulty believing the contact was deliberate and that her assessment changed only after she became aware of other allegations. She accepted that this information influenced her thinking, causing her to reassess what had been, at the time, an uncertain experience. As with the other complainants, this raises a concern that her certainty now might have been influenced by her knowledge that others were alleging that they had been intentionally touched.
133Although multiple incidents of inadvertent contact within a single appointment is less likely than a single accidental touch, it remains a reasonable possibility, particularly in a setting where the physician is required to work in close proximity and interact with different parts of the patient’s body in quick succession. When the frailties in Ms. C’s evidence are considered alongside Dr. Adam’s consistent and plausible account of how the examination was conducted, I am unable to dismiss the reasonable possibility that the contact she describes was inadvertent. In all circumstances, Ms. C’s evidence does not satisfy me beyond a reasonable doubt that any of the touching was intentional.
R.G.
134I accept Dr. Adam’s evidence that he saw Ms. G for several reasons, including sun damage, a cyst, toenail issues, and a lesion on her knee. His account is supported by contemporaneous documentation, including his notes and correspondence with her referring physician, and reflects his consistent practice of addressing all patient concerns in a single visit. I further accept his evidence that he closely examined the lesion on her knee and that he ultimately performed a biopsy to confirm a diagnosis. His evidence that he did not prescribe medication until receiving the biopsy result, and that Ms. G returned for a follow‑up visit, is consistent with his usual practice and supported by the documentary record.
135With respect to the alleged contact, Ms. G described a brief interaction, lasting only a few seconds, without any accompanying movement, pressure, or sexualized conduct. In the context of a knee examination conducted while the patient is seated and the physician is positioned closely to visualize the lesion, incidental contact is a realistic possibility. Dr. Adam’s evidence that he did not intentionally touch her is consistent with the mechanics of the examination and the broader context of the visit.
136In addition to the plausibility of Dr. Adam’s account, Ms. G’s evidence is marked by pervasive reliability concerns. Ms. G’s evidence reveals a fundamental inability to accurately recall even the most basic aspects of her appointment with Dr. Adam. She initially denied that Dr. Adam treated multiple conditions that are clearly documented in the contemporaneous records. Even when confronted with those records, she maintained that these matters were not discussed or addressed, only later conceding that her memory is “confused.”
137Ms. G’s evidence also demonstrates a significant risk of misidentification or conflation. She acknowledged that she was seeing multiple physicians around the same time and, at points in her testimony, described the doctor she associated with certain examinations as someone other than Dr. Adam. Notably, she described the physician who allegedly engaged in wrongdoing as having a moustache. Dr. Adam’s unchallenged evidence is that he never had a moustache. She also expressed uncertainty as to whether Dr. Adam was the person who examined her toenails, stating that she “did not link it with him” and that she had seen “a lot of doctors at that time.”
138Further, Ms. G’s account of the treatment itself is demonstrably incorrect. She testified that she received a diagnosis and prescription on the day of her initial appointment and that no biopsy was performed. The documentary evidence establishes the opposite. A biopsy was done and no prescription was given until the results were reviewed at a subsequent visit. Ms. G also maintained that she did not return to see Dr. Adam, a claim that is contradicted by the records.
139I also note that Ms. G’s characterization of the alleged contact has evolved over time. She acknowledged that she initially viewed her complaint as “iffy”. It was only after learning of other allegations involving Dr. Adam that she came forward and came to describe the contact as clearly deliberate. She accepted that she was motivated, at least in part, by a desire to support other complainants. As with the other evidence in this case, this raises a concern that her current interpretation of events has been shaped by external information rather than by her contemporaneous perception.
140Taken together, I have no confidence in Ms. G’s evidence. Her evidence reflects a fundamental inability to accurately recall the events in question. Even if I were to accept that some form of contact occurred during the examination, I am left with no confidence in her ability to accurately describe its nature or to reliably distinguish between deliberate and inadvertent contact. When her evidence is considered alongside Dr. Adam’s consistent and plausible account, the reasonable possibility of inadvertent contact cannot be dismissed.
Impact of Similar Act Evidence
141One of the fundamental difficulties with the similar act analysis in this case is the unreliability of the evidence of each of the complainants. Using one unreliable witness to bootstrap the testimony of another unreliable witness is always fraught with danger.
142Moreover, the similar act evidence does not materially assist in establishing that any of the alleged touching was intentional. The common features across the complainants are that the contact was brief, fleeting, and occurring during otherwise appropriate medical examinations where close physical proximity was both necessary and expected. There is no reliable evidence of sexualized comments, no suggestion that Dr. Adam was sexually aroused and no other conduct that would objectively render the interactions as being sexual in nature. Rather than demonstrating a pattern of deliberate misconduct, the evidence reflects situations in which incidental contact could occur. Viewed in this light, the similar act evidence does not negate the possibility of accident.
143Given the frailties in the complainants’ recollections and the absence of independent indicia of intentional misconduct, the possibility that any such contact was inadvertent remains both plausible and reasonable.
Conclusion
144I accept that Dr. Adam touched the complainants in a manner that left them feeling uncomfortable. However, considering the evidence on each count in the context of the evidence as a whole, a reasonable possibility exists that the touching was unintentional.
145Accordingly, Dr. Adam is not guilty.
Released: June 9, 2026
Signed: Justice Seth Weinstein