Health Law - ONCA

The appellant, M.R., appealed from a Superior Court order upholding the Consent and Capacity Board’s finding that he lacked capacity to consent to treatment.

The respondent, Dr. Achal Mishra, moved to adduce fresh evidence showing that M.R. was found capable of consenting to treatment in July 2024 and has maintained capacity since.

The Court of Appeal found the appeal to be moot, as there was no longer a live issue, and dismissed the appeal, admitting the fresh evidence and making no order as to costs.

The appellant, Amy Smith Cox, appealed a detention order of the Ontario Review Board that found she continued to pose a significant threat of serious harm to the public and imposed a no-contact provision with her father.

The Court of Appeal dismissed the appeal regarding the significant threat finding but allowed the appeal in part regarding the no-contact provision, varying it to permit contact with her father at the discretion of the treatment team.

The appellant, Shafaq Joya, appealed the Ontario Review Board’s decision to continue his conditional discharge and deny his Charter application for an absolute discharge.

The Court of Appeal for Ontario dismissed the appeal, finding that the Board’s assessment of risk and refusal to grant an absolute discharge were reasonable and supported by the evidence.

The court also found no Charter breach, as the Board’s decision was based on public safety, not resource limitations.

The appellant, J.A., appealed a decision of the Superior Court of Justice upholding a finding by the Consent and Capacity Board that he was incapable of consenting to treatment with antipsychotic medication.

The Court of Appeal found no reversible error in the lower court’s decision, upholding the dismissal of the appellant’s adjournment request and the application of the relevant legal principles regarding capacity and consent.

The appeal was dismissed.

The appellant, Donald Snoek, appealed the disposition of the Ontario Review Board, which found him a significant risk to public safety.

The Court of Appeal dismissed the appeal, finding no basis for a conditional discharge at this time and holding that arguments about alternative conditions should be made at a future hearing before the Board.

The Court of Appeal for Ontario dismissed the appeal of Padraig Teggart from a decision designating him as a "high risk accused" (HRA) under the Criminal Code following a finding of not criminally responsible for attempted murder.

The court found that the application judge applied the correct legal standard and properly considered the evidence, including expert opinions and statutory factors, in concluding that there was a substantial likelihood that Mr. Teggart would use violence endangering the life or safety of others.

The decision affirms the exceptional and sparing use of the HRA designation and the heightened risk threshold required.

The Court of Appeal for Ontario dismissed the appeal from the denial of certification of a class action alleging systemic negligence in the use of seclusion and restraint at a forensic psychiatric hospital.

The court found that the motion judge did not err in concluding that the claims lacked commonality, as the alleged wrongdoing could only be determined on an individual basis.

The court also upheld the dismissal of claims against individual hospital administrators and affirmed the costs award, finding no reversible error in the motion judge’s analysis.

The appellant, Sami Kazi, appealed the October 24, 2024 disposition of the Ontario Review Board, which found him Not Criminally Responsible and ordered his detention with conditions.

After a subsequent Board hearing in January 2025 resulted in a new disposition, the Court of Appeal held that the appeal was moot, as the original disposition was no longer operative.

The court found no live controversy remained and declined to exercise discretion to hear the appeal, noting the issues were fact-specific and overtaken by events.

The Court of Appeal for Ontario allowed Ernest Clayton’s appeal from a Review Board disposition finding him unfit and “permanently unfit” to stand trial.

The court held that the Board failed to apply the fitness test contextually, as required by law, and did not consider relevant evidence about the simplicity of the charges and Clayton’s ability to understand and respond to them.

The Board’s finding of permanent unfitness was also unsupported by sufficient reasons.

The matter was remitted to a differently constituted Board for a new determination of fitness.

The Court of Appeal for Ontario considered when a gender affirming surgery, specifically a vaginoplasty without penectomy, qualifies as an insured service under the Ontario Health Insurance Plan (OHIP).

The court held that vaginoplasty is a specifically listed insured service in the Schedule of Benefits, regardless of whether it is accompanied by a penectomy, and that the exclusion for experimental procedures does not apply to specifically listed services.

The appeal by the General Manager of OHIP was dismissed.

This decision concerns an appeal by Iesha Mitchell from a detention order imposed by the Ontario Review Board.

The Board had found that, although Mitchell could live in the community with certain privileges, her housing required approval by the person in charge of the Centre for Addiction and Mental Health (CAMH), and that the Mental Health Act alone would not be sufficient to manage her risk to public safety.

The Court of Appeal found no error in the Board’s reasoning, holding that the evidence supported the need for approved housing and a detention order, given the subtlety of Mitchell’s decompensation and the need for prompt intervention.

The appeal was dismissed.

The Court of Appeal for Ontario dismissed the appeal of Pierre Dartiguenave from a disposition of the Ontario Review Board.

The Crown requested dismissal on the basis that Mr. Dartiguenave was no longer under the jurisdiction of the Board, and the appellant could not be located.

The appeal was dismissed.

The Empowerment Council sought leave to intervene as a friend of the court in an appeal from the refusal to certify a proposed class action concerning psychiatric inpatients at Waypoint Centre for Mental Health Care.

The Court of Appeal dismissed the motion, finding that the proposed intervener’s submissions were largely duplicative of the appellants’ and would not usefully contribute to the resolution of the appeal without prejudicing the parties.

The appellant, Douglas Naus, appealed an order confirming a Consent and Capacity Board decision that he was incapable of consenting to treatment and subject to a community treatment order (CTO) requiring antipsychotic medication.

The Court of Appeal found the appeal from the incapacity finding was moot, but exercised its discretion to decide the CTO issue, holding that the Board and appeal judge erred in interpreting the statutory preconditions for a CTO.

The Court held that the Mental Health Act requires successful treatment to have occurred during a prior hospitalization, not the current one, before a CTO can be issued.

The CTO was quashed.

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

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

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

The Court of Appeal for Ontario dismissed Apotex Inc.'s appeal regarding its claim for damages under section 8 of the Patented Medicines (Notice of Compliance) Regulations.

Apotex sought damages for delayed market entry of its generic drug due to Eli Lilly's prohibition application.

The trial judge found that Apotex was not entitled to damages, as the prohibition application was dismissed as moot, not on the merits, and that Apotex would not have entered the market earlier in a hypothetical world without the prohibition application due to risk aversion and potential patent infringement liability.

The Court of Appeal upheld these findings, concluding that Apotex failed to demonstrate any actual entitlement to damages.

The applicant, Songfu Liu, sought an extension of time to appeal the dismissal of his medical malpractice action against Dr. Jonathan Chan.

The original action alleged fraud and misrepresentation regarding a prostate cancer diagnosis and subsequent surgery.

The motion judge had dismissed the applicant's claims, finding no evidence of fraud and that the applicant's own expert supported the respondent's medical care.

The Court of Appeal dismissed the motion for an extension of time, finding that while the delay was short and excusable (due to a common self-represented litigant's mistake about appeal period commencement), the proposed appeal was entirely devoid of merit, seeking to re-argue factual findings without identifying legal errors.

The court emphasized that the "justice of the case" required an end to the unfounded allegations.

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

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

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

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

This motion concerned a request for a stay pending appeal of a lower court's dismissal of an application for leave to intervene.

The underlying matter involved the College of Physicians and Surgeons of Ontario seeking an order to compel Dr. Kilian to provide patient files related to COVID-19 vaccine exemptions.

The moving parties, anonymous patients of Dr. Kilian, argued their s. 8 Charter privacy rights would be violated without their intervention.

The Court of Appeal dismissed the motion for a stay, finding no serious issue to be tried.

The court held that the expectation of privacy in medical records is lower in a regulatory context, as the primary purpose of such investigations is public protection, and existing confidentiality protections within the regulatory scheme are sufficient.

Nathaniel White, found not criminally responsible, appealed a disposition of the Ontario Review Board (ORB) that removed his community living and 30-day pass privileges.

The ORB had accepted his request for a lateral transfer to another facility but removed the privileges based on clinical opinion that community living was not realistic due to his recent decompensation and need for a slower, more supported approach to treatment.

The Court of Appeal dismissed the appeal, finding the ORB's decision was not unreasonable or based on an error of law, distinguishing it from a case where there was a misapprehension of information.