Mark Turnbull v. Registrar of Motor Vehicles, 2025 CanLII 10781

Licence Appeal Tribunal File Number: 16571/MED

Appeal under section 50(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the “HTA”), from a decision of the Registrar of Motor Vehicles to suspend a driver’s licence under subsection 47(1) of the HTA.

Between:

Mark Turnbull

Appellant

and

Registrar of Motor Vehicles

Respondent

DECISION AND ORDER

ADJUDICATOR: Dr. Peter Savage, Member

APPEARANCES:

For the Appellant: Mark Turnbull, Self-Represented

For the Respondent: Stephen Grootenboer

Heard by Teleconference: January 30, 2025

REASONS FOR DECISION AND ORDER

A. OVERVIEW:

1On October 20, 2024, the Registrar of Motor Vehicles (the “Registrar”) suspended the appellant’s class G licence under s. 47(1) of the Highway Traffic Act, R.S.O. 1990, c. H.8 (the “HTA”), after receiving a report from a physician that the appellant suffers from a seizure and loss of consciousness condition likely to significantly interfere with his ability to drive a motor vehicle of the applicable class safely. The appellant appeals the suspension and asks the Tribunal to reinstate his licence.

2At the hearing, the Registrar clarified the reason for the suspension. Medical examination had ruled out seizure and focused on a cardiovascular condition that had caused the syncope and transient hemiparesis. The Registrar advised that the suspension is based on a cardiovascular condition and seizure is not an issue in this hearing.

3Having considered all the evidence and for the reasons that follow, the Tribunal confirms the Registrar’s decision to suspend the appellant’s driver’s licence for medical reasons.

B. ISSUES

4The issue in this appeal is whether the appellant suffers from a cardiovascular condition that is likely to significantly interfere with his ability to drive a vehicle of the applicable class safely.

5To answer that issue, I will address the following questions:

a. Does the appellant suffer from a cardiovascular condition?

b. If the appellant suffers from a cardiovascular condition, is it likely to significantly interfere with his ability to drive a vehicle of the applicable class safely?

C. LAW:

6Under the HTA, the Registrar is responsible for ensuring that drivers are medically fit to drive vehicles on the highway. In this case, the Registrar acted pursuant to s. 47(1) of the HTA and s. 14(1)(a) of O. Reg. 340/94 under the HTA (the “Regulation”). Under s. 14(1)(a) of the Regulation, 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 drive a motor vehicle of the applicable class safely. Subsection 47(1) of the HTA permits the Registrar to suspend a driver’s licence for any sufficient reason.

7Under s.14(2)(b) of the Regulation, the Registrar may require a driver to provide satisfactory evidence that he or she is able to drive safely.

8A person whose licence is suspended under these provisions may appeal the suspension to the Tribunal under s. 50(1) of the HTA.

9On appeal, the Registrar has the burden of establishing, on a balance of probabilities, that the appellant has a medical condition that is likely to significantly interfere with their ability to drive a motor vehicle of the applicable class safely.

10Following a hearing, the Tribunal may, under s. 50(2) of the HTA, confirm, modify or set aside the decision or order of the Registrar.

D. EVIDENCE AND ANALYSIS:

a. Does the appellant suffer from a cardiovascular condition?

11The Registrar alleges that the appellant suffers from a medical condition namely a congenital heart defect. The Registrar’s position is based on medical reports that it received.

12The unsolicited medical condition report submitted by Dr. Paula Adler, dated October 12, 2024 suggested the appellant suffered from a seizure or syncopal condition. Subsequent questionnaires submitted by nurse practitioner Jillian Ulrichsen clarified the appellant suffered from a congenital heart defect. This defect (patent foramen ovale or, in layman’s terms, a hole in the wall of the heart) allowed a small blood clot to travel from the right or venous side of the heart to the left side or arterial side of the heart. This small clot went through the arterial system to the brain where it caused a period of loss of consciousness and transient paralysis in the appellant.

13Nurse practitioner Ulrichsen’s cardiovascular questionnaire of January 17, 2025 confirms that a diagnosis of patent foramen ovale has been made and that there are medical plans to have this condition repaired by an interventional cardiologist. The nurse practitioner notes there have been two bouts of syncope related to this condition in the last six months, one resulting in transient hemiparesis.

14The appellant testified and confirmed that he has a cardiovascular condition and further testifies he is awaiting treatment for this condition. He further testifies he is now booked to see the interventional cardiologist on February 11, 2025 and plans to have this condition treated.

15The medical evidence presented supports the conclusion that the appellant suffers from a cardiovascular condition. The appellant’s testimony confirms the appellant has the condition.

16On a balance of probabilities, I find the Registrar has established the appellant has a cardiovascular condition.

b. If the appellant suffers from a medical condition, is it likely to significantly interfere with his ability to drive a vehicle safely?

17The Registrar has the burden of establishing that the appellant’s medical condition is likely to significantly interfere with his ability to drive a motor vehicle safely. I find that the Registrar has met that burden.

18The Registrar points out the appellant testified he had an extensive hospital work up, including CT scans, MRIs, EEGs, and the specialists had told him his syncope was caused by the cardiovascular condition.

19The Registrar pointed out that this cardiovascular condition could cause sudden loss of consciousness syncope or stroke. The Registrar argued that while driving, an attack like the two that the appellant had previously suffered would cause severe safety risk both to the appellant and other users of the road.

20The Registrar argued that there had been two episodes of syncope in the last 6 months. The Registrar pointed out there was a medical plan to correct this cardiovascular condition; however, the required procedure has not yet been carried out. The Registrar argued the appellant’s driver’s licence should remain suspended until the condition was corrected and further argued their position was reasonable, prudent, and supported by law.

21The appellant maintains he is a safe driver, has a safe driving record and argues that it is not likely his cardiovascular condition will affect his driving safety.

22The appellant testifies that, while he has a cardiovascular condition, there were special circumstances on both occasions he lost consciousness. He has recognized the triggering factors and taken steps to prevent any reoccurrence and that there have been no further episodes since October of 2024.

23The appellant testified that:

1. He has a health care team and regularly sees his nurse practitioner and is following up with cardiovascular specialists.

2. He believes that the two episodes of loss of consciousness and hemiparesis were not directly caused by his cardiovascular condition. The appellant believes the syncope and transient hemiparesis is essentially heat exhaustion caused by other circumstances:

i. The days he had his two previous episodes were extremely hot with temperatures of at least 35 degrees Celsius.

ii. The days he had his two episodes he was working extremely hard and had refused to take a break.

iii. He had not eaten properly on the days in question and had not drunk adequate water.

3. He has made changes in his lifestyle including slowing down, resting more, adjusting his lifestyle and feels these changes have prevented any recurrence of the syncope.

4. He is now on medication to lower his cholesterol and aspirin as a blood thinner. It is his position that these medications will further prevent possible complications from his cardiac condition.

5. He has insight into his condition and would stop driving if he noted any recurrence of symptoms.

24I find the appellant testified in an open and clear manner and is taking steps to manage his cardiovascular condition. The appellant has presented a possible alternate explanation to his two episodes of loss of consciousness and further explained the steps he has taken to prevent further episodes.

25The Registrar argues there is no medical evidence to support the appellant’s theory and neither the doctor nor the nurse practitioner mention heat exhaustion or any other cause of syncope. I am compelled by the Registrar’s arguments noting the high safety risks of another episode while driving. I can understand the appellant’s belief that exhaustion and extreme heat were causative factors, but I am compelled by the Registrar’s argument that neither the doctor nor nurse practitioner included this possibility in their reports. I also take note that neither medical practitioner has made a recommendation to set aside the driving suspension.

26I believe that every case must be judged on its own merits and, in this case, I have to agree with the Registrar and find, on a balance of probabilities, that the appellant’s cardiovascular condition is likely to significantly interfere with his ability to drive a vehicle safely and recommend the licence remain under suspension until the condition is corrected and there has been a period of stability following the correction.

E. ORDER:

27For the reasons set out above, pursuant to subsection 50(2) of the HTA, I confirm the Registrar’s decision to suspend the appellant’s driver’s licence for medical reasons.