Health Law - ONCA

The appellants appealed the dismissal of their medical malpractice action following the death of a 22-year-old man in hospital.

The deceased had been switched from morphine to Dilaudid by the respondent physician, and the appellants alleged the dosage was excessive and caused his death by opioid overdose.

The trial judge accepted the respondent's expert evidence that the dosage met the standard of care and that the cause of death was not an opioid overdose.

The Court of Appeal dismissed the appeal, finding no error in the trial judge's approach to liability, standard of care, or causation.

The appellant appealed a disposition of the Ontario Review Board, which found he posed a significant threat to public safety and denied him an absolute discharge.

The hospital and treatment team supported an absolute discharge, noting that while the appellant suffered from schizophrenia, he was not violent and could be managed under the civil mental health system.

The Court of Appeal found the Board's decision unreasonable, as it relied on speculative correlations between drug use, mental illness symptoms, and risk to the public, while ignoring the unique circumstances of the index offence and the appellant's lack of violent history.

The appeal was allowed and an absolute discharge was substituted.

The appellant appealed a Disposition Order of the Ontario Review Board that granted him a conditional discharge, arguing he should have received an absolute discharge.

The appellant contended the Board erred in finding he represented a significant threat to public safety.

The Court of Appeal dismissed the appeal, finding no basis to interfere with the Board's unanimous decision, which relied on evidence that the appellant would pose a significant risk without the control of a conditional discharge.

The appellant appealed a disposition of the Ontario Review Board under Part XX.1 of the Criminal Code.

The Court of Appeal dismissed the appeal, finding that the Board's decision was reasonably supported by the evidence.

The appellant, who was found not criminally responsible for aggravated assault, appealed a disposition of the Ontario Review Board ordering his detention on a secure forensic unit.

He argued the Board erred by rejecting a hybrid disposition that would have allowed discretion to transfer him to a general forensic unit.

The Court of Appeal dismissed the appeal, finding the Board's conclusion that a hybrid disposition was premature to be reasonable given the early stages of the appellant's treatment.

Although the Board improperly relied on the appellant's request for an absolute discharge to buttress its findings, the error was of no consequence.

The appellants appealed a judgment of the Superior Court of Justice.

The Court of Appeal ordered the continuation of the appeal of the minor appellant and subsequently dismissed the appeal without costs on the consent of all parties.

The appellant appealed a disposition of the Ontario Review Board, arguing the conditions imposed were not the least onerous and restrictive and seeking supervised accommodation.

The Court of Appeal dismissed the appeal, finding the Board properly applied the criterion and its decision was not unreasonable given the medical evidence, noting the conditions were less restrictive than the previous disposition.

The appellant appealed the dismissal of an application for interim relief regarding end-of-life decisions for a patient.

The appellant sought to suspend a no-CPR order, arguing that consent was required to withdraw treatment.

The Court of Appeal dismissed the appeal, finding that the existing treatment plan gave the physician discretion regarding CPR components, and the contested order was not a withdrawal of treatment but a refusal to impose treatment that offered no medical benefit and would only inflict harm.

The appellant appealed a disposition of the Ontario Review Board ordering his detention at a mental health facility.

He argued his risk could be managed on a conditional discharge and that his detention amounted to cruel and unusual punishment.

The Court of Appeal dismissed the appeal, finding the Board's conclusion reasonable given the appellant's lack of community support, history of elopements, and substance abuse issues.

The Court also rejected the Charter argument, noting the detention was not a probable period of indefinite incarceration as the facility offered necessary programming for potential future reintegration.

The appellants requested a suspension of the court's judgment released on June 10, 2013.

On consent of the respondent, the Court of Appeal for Ontario ordered that the judgment be suspended until June 25, 2013, to allow for an orderly winding-down of the operations of RX Processing Services Inc.

The appellants operated an online pharmacy selling prescription drugs to Americans, with a call center located in Ontario.

The Ontario College of Pharmacists sought an injunction to stop the appellants from selling drugs without accreditation and using restricted terms.

The application judge granted the injunction, finding the sales occurred in Ontario and the College had jurisdiction.

The Court of Appeal dismissed the appeal, holding that a purposive approach to the legislation confirmed the sales took place in Ontario and that there was a sufficient connection to ground the College's jurisdiction to protect the public interest.

The appellant appealed a decision of the Ontario Review Board under Part XX.1 of the Criminal Code, alleging that the hospital report contained falsehoods.

The Court of Appeal dismissed the appeal, finding that the disposition was well-founded on the evidence and that the Board's decision was reasonable.

The appellants, three physicians, appealed a trial judgment finding them liable in negligence for the delayed diagnosis and death of a patient from infective endocarditis.

The trial judge found the emergency room resident breached the standard of care by failing to review a SARS form containing critical clinical history, and held the supervising physician vicariously liable.

The Court of Appeal allowed the appeal regarding the supervising physician, as vicarious liability was neither pleaded nor argued at trial.

However, the Court dismissed the appeal regarding the resident's breach of the standard of care and the trial judge's causation findings, concluding that the evidence supported the determination that a timely diagnosis would have prevented the patient's death.

The appellant appealed a disposition of the Ontario Review Board denying her an absolute discharge.

The appellant argued there was no evidence she would stop taking her medication if discharged.

The Court of Appeal dismissed the appeal, finding the Board's conclusion was reasonable and supported by evidence of the appellant's missed psychiatric appointments, lack of insight, and past omissions to take medication.

The appellants, a nurse and a hospital, appealed a jury verdict finding them liable for a brain injury suffered by an infant during birth.

The jury found the nurse 75% liable and the hospital 25% liable, while dismissing claims against the delivering physician.

The appellants argued the verdict was unreasonable due to insufficient evidence of causation and lack of expert evidence on the hospital's standard of care, and that the trial judge erred in the jury charge.

The Court of Appeal dismissed the appeal, holding that the jury was entitled to determine the hospital's standard of care without expert evidence, that there was sufficient evidence to support the jury's finding of causation based on a robust and pragmatic application of the 'but for' test, and that the jury charge contained no reversible errors.

The appellants, a nurse and her employer, appealed a trial judge's finding that they were 50 per cent liable in negligence on a crossclaim by a hospital.

The trial judge found that the nurse's delay in diagnosing and treating a patient's vasospasm exacerbated his brain injuries.

The appellants conceded the nurse fell below the standard of care but argued the trial judge's finding on causation was unreasonable.

The Court of Appeal dismissed the appeal, holding that the evidence, viewed as a whole, supported the trial judge's conclusion that the continuing negligence exacerbated the harm.

The appellant, who was previously found not criminally responsible for criminal harassment and failing to comply with a recognizance, appealed a disposition of the Ontario Review Board continuing his conditional discharge.

He argued the Board erred in finding he posed a significant threat to public safety and in failing to order a Community Treatment Order (CTO) instead.

The Court of Appeal dismissed the appeal, finding the Board reasonably relied on psychiatric evidence that the appellant would stop his medication and become a threat if absolutely discharged.

The Court also noted the Board lacked jurisdiction to order a CTO, as only a physician can issue one under the Mental Health Act.

The Person in Charge for Ontario Shores Centre for Mental Health Sciences appealed a disposition of the Ontario Review Board.

The Court of Appeal admitted fresh evidence, finding it trustworthy and relevant to the issue of risk to public safety.

Concluding that the fresh evidence could reasonably have affected the Board's decision, the Court allowed the appeal and ordered a new hearing before the Board.

The appellant, who was previously found not criminally responsible for threatening to kill his sister, appealed a disposition of the Ontario Review Board ordering his continued detention in a forensic unit with limited community privileges.

He sought a conditional discharge or discretion for community living.

The Court of Appeal dismissed the appeal, finding that the Board's conclusion that the appellant remained a significant threat to public safety was supported by the evidence, and the disposition was appropriate.

The appellant, who was found not criminally responsible on account of mental disorder, appealed a disposition of the Ontario Review Board ordering her transfer to the Brockville Mental Health Centre.

She argued the order was unreasonable due to delays in the transfer and that it was not the least onerous disposition.

The Court of Appeal admitted fresh evidence showing the transfer had recently occurred, rendering the delay arguments moot.

The Court found the Board's conclusion that the transfer was the least onerous and least restrictive disposition was reasonable and supported by psychiatric evidence.

The appeal was dismissed.