Ashley Young v. Registrar of Motor Vehicles, 2024 CanLII 81207

Licence Appeal Tribunal File Number: 16048/MED

In the matter of an appeal under subsection 50(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the “Act”), from a decision of the Registrar of Motor Vehicles to suspend a licence pursuant to Section 47(1) of the Act.

Between:

Ashley Young

Appellant

and

Registrar of Motor Vehicles

Respondent

DECISION

ADJUDICATOR: Kailey Minnings

APPEARANCES:

For the Appellant: Ashley Young

For the Respondent: Ian Sookram, Representative

HEARD: August 1, 2024

OVERVIEW

1Ashley Young (the “appellant”) appeals from the decision of the Registrar of Motor Vehicles (“Registrar”) to suspend her Class G licence under s. 47(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the “Act”) after the Registrar received a report from a treating health care provider that the appellant suffers from a medical condition that may affect her safety to drive.

2The Registrar has the authority under s. 47(1)(g) of the Act to suspend or cancel a driver’s licence for any sufficient reason. Section 14(1)(a) of O. Reg. 340/94 under the Act (the “Regulation”) states that a holder of a driver’s licence must not suffer from any mental, emotional, nervous or physical condition or disability likely to significantly interfere with their ability to safely drive a motor vehicle of the applicable class safely. Under s. 14(2)(b) of the Regulation, the Minister of Transportation may require a driver to provide satisfactory evidence that they are able to drive safely.

3The Registrar takes the position that the appellant suffers from a medical condition, namely seizure due to drug withdrawal, that is likely to significantly interfere with her ability to drive safely and that this provides sufficient reason to suspend her licence under s. 47(1)(g) of the Act.

4The appellant appeals the suspension under s. 50(1) of the Act. She denies that she suffers from seizure due to drug withdrawal and denies that she suffers from a medical condition which interferes with her ability to drive safely.

5Pursuant to section 50(2) of the Act, after a hearing the Tribunal may confirm, modify, or set aside the decision or order of the Registrar.

PRELIMINARY ISSUES

6The grounds for suspending the appellant’s driver’s licence were clarified at the onset of the hearing. In the Registrar’s first letter to the appellant dated April 9, 2024, the reported conditions were drug induced seizure and/or substance use disorder, and in the subsequent letter dated July 26, 2024, the reported condition was changed to seizure due to drug withdrawal. The Registrar’s position is that the licence is under suspension based only on the condition of seizure due to drug withdrawal, which, they assert, is linked to substance use disorder in the Canadian Council of Motor Transport Administrators Medical Standards for Drivers [February 2021] (the “CCMTA Standards”). The appellant agreed to address seizure due to drug withdrawal as the alleged condition resulting in licence suspension.

ISSUES

7The issue in this appeal is whether the appellant suffers from a medical condition that is likely to significantly interfere with her ability to drive a motor vehicle safely. To resolve that issue, I will address the following questions:

i. Does the appellant suffer from seizure due to drug withdrawal?

ii. If so, is this likely to significantly interfere with her ability to drive a motor vehicle safely?

8The Registrar bears the burden of proving on a balance of probabilities that the answer to each of the above questions is “yes.”

RESULT

9Having considered all the evidence and submissions and for the reasons that follow, I find that the Registrar has not satisfied its burden to establish that the appellant suffers from the alleged medical condition, and I set aside the Registrar’s decision to suspend the appellant’s driver’s licence.

ANALYSIS

Does the appellant suffer from seizure due to drug withdrawal?

10The evidence presented at the hearing does not establish that the appellant suffers from a seizure due to drug withdrawal.

11The Registrar’s position is that the appellant suffers from a drug withdrawal seizure. They point to a medical condition report (MCR) from Dr. Benjamin Tam, a critical care physician, that is dated April 5, 2024. The MCR indicates that the appellant had a seizure due to cocaine, THC, and benzodiazepine. The form also indicates that there is a substance use disorder and specifies cocaine, THC, and benzodiazepine.

12The appellant acknowledges that on April 1, 2024, she had a seizure. In her view, the seizure was caused by a cocaine overdose. In her testimony, she admitted that she does not recall many of the events or the timeline of that day. She testified that approximately 4 weeks prior to April 1, 2024, she began to take fluoxetine, an antidepressant medication that was prescribed to her by a physician to treat anxiety. She stated that she began to have suicidal thoughts which she attributes to an adverse side effect of fluoxetine. She testified that she was “in a dark place” mentally and sought to attempt suicide by overdosing on cocaine. She states that she had never used cocaine previously but was able to obtain some and used an unknown amount.

13She agrees that she had a seizure and cardiac arrest as a result of the substances she had used on or before April 1, 2024. According to her testimony, she was admitted to the intensive care unit and placed on life support. She denies that the seizure was due to drug withdrawal and instead asserts that it was due to acute drug toxicity from a cocaine overdose.

14She acknowledges that three substances were identified on a toxicology screen while she was in hospital: cocaine, THC, and a benzodiazepine. She testified that around that same time, she had been taking lorazepam, a medication in the class of benzodiazepines which had been prescribed to her in a small quantity 2 days prior by a physician. She testified that she is unsure why THC, a component of cannabis, was found in her system because to her knowledge, she last used cannabis approximately two years ago.

15The appellant relies on the MCR completed by Dr. Tam, on which “seizure due to drug withdrawal” is not checked off. Further, she points to narrative letters from her specialist physicians to support her position:

i. A letter from cardiologist Dr. George Zimakas, dated July 17, 2024, which states, “I don’t see any reason for her driving to be restricted at this time from a cardiac perspective. She is medically cleared for driving.”

ii. A letter from neurologist Dr. Jose Martin Del Campo, dated July 22, 2024, which states “She had a single seizure in April 2024 associated with a cocaine “overdose”. Investigations in the form of EEGs (routine and sleep deprived) as well as brain imaging failed to reveal an ominous cause for her seizure. At this point, from the neurological perspective, I do not have any evidence to suggest that her driving privileges be restricted.”

16I note that on the MCR, Dr. Tam indicates “Seizure due to cocaine, THC, and benzo [benzodiazepine]” and not “Seizure due to alcohol/drug withdrawal”. Further, in his letter Dr. Del Campo states that the seizure was due to a cocaine overdose.

17As a physician duly licenced in the province of Ontario, I am aware that both cocaine and benzodiazepines are associated with a risk of seizures. Cocaine is more likely to cause seizures during the acute intoxication phase, not during withdrawal. Benzodiazepines carry a risk of seizure during the withdrawal period following prolonged and regular use. I take note of these facts pursuant to s.16(b) of the Statutory Powers Procedure Act.

18Given her testimony that the seizure was directly following cocaine use and that she had only taken a benzodiazepine at a low dose for approximately 2 days and taking into account Dr. Tam’s and Dr. Del Campo’s opinions, I find, on a balance of probabilities, that the seizure was due to an acute intoxication from cocaine and not due to drug withdrawal.

19I note that the Registrar alleges that substance use disorder is a condition that is linked to seizure due to drug withdrawal. However, substance use disorder is an independent condition from seizure due to drug withdrawal and is not included on the alleged medical conditions, as per the Registrar’s latest letter to the appellant dated July 26, 2024. As the Registrar did not clearly articulate that the allegations on which the licence suspension is based included substance use disorder in their communications to the appellant, I am not going to consider whether the appellant suffers from substance use disorder as a matter of procedural fairness. The appellant has the right to know the case in front of her.

20I find that the Registrar has not established on a balance of probabilities that the appellant suffered from a seizure due to drug withdrawal in April 2024. As the Registrar has failed to show that the appellant suffers from the alleged medical condition, I do not need to decide the second issue.

Conclusion

21I find that the Registrar has not discharged the onus of establishing on a balance of probabilities that the appellant suffers from a medical condition, namely seizure due to drug withdrawal, that is likely to significantly interfere with her ability to drive a motor vehicle safely.

ORDER

22For the reasons set out above, pursuant to subsection 50(2) of the Act, I set aside the Registrar’s decision to suspend the appellant’s driver’s licence.