Health Law - ONCA

An appeal under Part XX.1 of the Criminal Code from a disposition of the Ontario Review Board dated March 6, 2019.

The appellant, declared not criminally responsible on account of mental disorder for dangerous operation of a motor vehicle, appealed a conditional discharge disposition that prohibited him from driving and required abstinence from alcohol.

The appellant argued the Board's conclusion that he posed a significant threat to public safety was unreasonable and unsupported by evidence, particularly given his suspended driver's licence.

The Court of Appeal dismissed the appeal, finding the Board's disposition reasonable and supported by evidence, but expressed concern about the lack of information available regarding the licence suspension and directed that detailed information be obtained for the next review.

An appeal from an Ontario Review Board disposition finding that an NCR accused with schizophrenia and substance use disorders constituted a significant threat to public safety and ordering continued detention.

The appellant challenged the Board's application of the legal test for "significant threat" under the Criminal Code.

The Court of Appeal found the Board failed to properly apply the Winko standard by relying on speculative harm ("could" result) rather than assessing the real likelihood and seriousness of harm together.

The court allowed the appeal and returned the matter to the Board for a new hearing with proper legal analysis.

An appeal from an Ontario Review Board disposition under Part XX.1 of the Criminal Code.

The appellant, detained at the Centre for Addiction and Mental Health under a warrant of committal, challenged the Board's May 8, 2018 disposition imposing a detention order on a general secure unit and refusing community living privileges.

The appellant did not contest the Board's finding that she posed a significant threat to public safety but argued the conditions were not the least onerous and restrictive.

The Court of Appeal upheld the Board's decision, finding it reasonable based on the evidence regarding the appellant's mental illness, risk of reoffending, and the evidentiary basis for the alcohol prohibition condition.

An appeal under Part XX.1 of the Criminal Code from a disposition of the Ontario Review Board dated April 10, 2018.

The appellant, found not criminally responsible on account of mental disorder for possession of weapons dangerous, sought a conditional discharge or alternatively a new hearing.

The Board maintained a detention order in the general forensic unit at the Centre for Addiction and Mental Health with relaxed reporting requirements.

The Court of Appeal found the Board's decision unreasonable due to inadequate reasons regarding whether the appellant's risk to the public could be managed under a conditional discharge.

The court directed the Board to reconsider the disposition at its next hearing with proper consideration of relevant factors, including mechanisms for securing attendance at hospital and the timing of any intervention.

The appellant was found not criminally responsible on account of mental disorder and ordered detained at Waypoint Centre, a maximum security facility.

On appeal, the appellant sought to have the detention order set aside and a new hearing directed to consider placement at Ontario Shores, a medium security facility.

The Court of Appeal upheld the Ontario Review Board's decision, finding that while the appellant's recent conduct was positive, the Board was required to consider the entire picture, including the serious nature of the mental illness, the long history of mental disorder accompanied by serious criminal activity, past non-compliance with medication, and demonstrated history of quick decompensation and violence when medication was discontinued.

The court found the Board's conclusion that a transfer to medium security was premature was not unreasonable.

An appellant who was found not criminally responsible on a charge of assault in 2007 appealed a Superior Court decision dismissing her application for a declaration that section 672.56 of the Criminal Code violated her Charter rights under section 7.

The appellant argued that the section did not afford a not criminally responsible accused the ability to compel the Ontario Review Board to hold a hearing to review a decision by a hospital to significantly increase restrictions on liberty.

The Court of Appeal dismissed the appeal, finding that Part XX.1 of the Criminal Code provides adequate procedural safeguards and liberty protections for such accused persons.

The appellant appealed a disposition of the Ontario Review Board that maintained a detention order rather than granting a conditional discharge.

The appellant argued that the Board made a palpable and overriding factual error regarding his propensity to decompensate and that the Board failed to adequately consider alternative mechanisms for readmission to hospital.

The Court of Appeal rejected both arguments, finding that the Board's findings were supported by evidence and that the detention order was the least onerous and least restrictive disposition available given the appellant's risk to public safety.

An appeal from the Ontario Review Board's disposition continuing a conditional discharge for an individual found not criminally responsible on account of mental disorder.

The appellant argued that the Board's conclusion that he remained a significant threat to public safety was unreasonable, particularly given his 17-year history without violent behaviour while subject to Board jurisdiction.

The Court of Appeal upheld the Board's decision, finding it fell within the range of reasonable outcomes based on evidence including the appellant's serious index offences, lack of insight into his mental illness, resistance to treatment, high risk assessment scores, and the unanimous opinion of his treatment team that he remained a significant risk.

The appellants sought to add three health care providers as defendants to a medical malpractice action more than two years after the original injury.

The motion judge dismissed the motion on the basis that the limitation period had expired.

The Court of Appeal allowed the appeal, finding that the motion judge applied the wrong test under the Limitations Act, 2002.

The court held that the motion judge failed to make proper findings of fact regarding when the appellants knew or ought reasonably to have known of their claims against the proposed defendants.

The court also found that the motion judge erred in treating lack of due diligence as a standalone ground for finding claims statute-barred.

The key distinction was that the claims against the proposed defendants differed from the claim against the original defendant, as they involved allegations that the health care providers failed to take immediate action once cauda equina syndrome was suspected, information that was only revealed during examinations for discovery in 2015.

An appeal of a Criminal Code section 672.54(c) detention order made by the Ontario Review Board.

The appellant argued that the Board erred in concluding that he poses a significant risk to the public and that the Board committed a Carrick error by failing to make this determination independently of his admission.

The Court of Appeal dismissed the appeal, holding that while a Board must make its own determination of dangerousness, it is entitled to rely on counsel's credible acknowledgement that the significant threat standard has been met, provided the Board does not abdicate its responsibility to assess the evidence.

The appellant appealed from orders made over ten years prior determining equalization, child support, and spousal support in a family law proceeding.

The appellant had failed to appear at trial in 2007 and at a subsequent motion to set aside the trial order in 2008.

The Court of Appeal admitted fresh evidence demonstrating the appellant's serious mental health issues, including PTSD and major depressive disorder, which rendered her incapable of attending the proceedings.

The court found that the appellant's absence was excused and that procedural fairness required setting aside the trial and motion orders.

The court ordered a new trial to determine the issues of equalization and support, set aside a garnishment order, and required the respondent to return garnished funds with interest.

The appellant, a general surgeon, appealed a trial judgment finding him liable for medical negligence in the treatment of an 11-year-old patient who presented with abdominal pain.

The surgeon discharged the patient without ordering imaging or hospital admission, providing discharge instructions that the patient should only return if her condition worsened.

The patient's appendix subsequently ruptured, causing significant bowel damage.

The trial judge found the surgeon breached the standard of care in both his assessment and discharge instructions, and that causation was established.

The Court of Appeal dismissed the appeal, finding no palpable and overriding error in the trial judge's findings on standard of care or causation.

The court also addressed the inordinate delay in releasing reasons but concluded it did not impede fair adjudication.

Appeal from a trial judgment awarding damages for birth injuries caused by hospital negligence.

The trial judge found that hospital nurses negligently ruptured the membranes during delivery, causing the plaintiff to suffer hypotonic cerebral palsy with serious and permanent impairments.

The appellants admitted falling below the standard of care but contested causation and damages.

The trial judge awarded $5,568,393 in total damages, including $1,881,846 for future loss of income, and costs of $2,201,259.

The appellants appealed the damages award and costs decision.

The Court of Appeal upheld the trial judge's findings and dismissed the appeal.

An appellant appealed the Ontario Review Board's disposition continuing his conditional discharge on terms.

The appellant had been found not criminally responsible on account of mental disorder in 2006 for assault causing bodily harm and mischief.

The Board found the appellant remained a significant threat to public safety based on his lack of insight into his mental illness, his unwillingness to take medication absent a Board order, his continued residual symptoms despite medication, his history of marijuana use leading to clinical worsening, and threatening statements made in 2015.

The Court of Appeal upheld the Board's decision, finding the conclusion that a foreseeable and substantial risk existed was reasonable on the evidence.

The appellant, found not criminally responsible on account of mental disorder for uttering threats to cause death or bodily harm, appealed the Ontario Review Board's disposition continuing his detention at a forensic mental health facility.

The appellant sought an absolute discharge, arguing there was no evidence he posed a significant threat to public safety, the Board's reasons were insufficient, and his lack of incident while off medication for over a year demonstrated reduced risk.

The Court of Appeal dismissed the appeal, finding the Board's reliance on psychiatric evidence of continued mental illness symptoms and escalating risk assessment was reasonable and supported by evidence.

This appeal concerns damages claimed by Apotex for lost sales of its generic drug Apo-lansoprazole due to proceedings initiated by Abbott and Takeda under section 6 of the Patented Medicines (Notice of Compliance) Regulations.

The motion judge dismissed the defendants' motion for summary judgment, finding that Apotex would have received regulatory approval on April 17, 2007, but for the section 6 proceedings.

The appellants argued that Apotex's submission was deficient because it lacked a high-fat meal bioequivalence study.

The Court of Appeal upheld the motion judge's decision, finding no legal requirement for such a study and ample evidence supporting approval on the original submission.

The appellant appealed a disposition of the Ontario Review Board ordering his detention on a General Forensic Unit at the Centre for Addiction and Mental Health with the ability to live in community accommodation approved by the person in charge of CAMH.

The Court of Appeal upheld the Board's decision, finding that an absolute discharge was not appropriate given clear evidence that the appellant would stop taking medication, decompensate quickly, and engage in threatening and aggressive behaviour.

The court also rejected the argument that a conditional discharge was the least restrictive appropriate order, finding that the detention order with community living possibilities was reasonable given the appellant's homelessness and ongoing risk of harm.

The appellant appealed a finding of incapacity to consent to anti-psychotic medication made by a physician and confirmed by the Consent and Capacity Board.

The appellant had been found not criminally responsible (NCR) on criminal charges and was detained at a psychiatric facility.

Subsequently, her appeal of the NCR verdict was allowed and a new trial was ordered, but she remained detained under the Mental Health Act.

The Court of Appeal dismissed the appeal, finding that the incapacity finding was not moot despite the successful appeal of the NCR verdict, as the appellant remained lawfully detained at the time the incapacity determination was made.

The Court upheld the Board's finding that although the appellant could understand relevant information about treatment, she could not apply it to her own circumstances due to her delusional disorder.

An appeal under Part XX.1 of the Criminal Code against the disposition of the Ontario Review Board dated July 5, 2016.

The appellant challenged the Board's order regarding his detention and conditions.

The Court of Appeal found the appellant's conduct troubling but close to the threshold for satisfying the "significant threat to the safety of the public" requirement.

The Court upheld the Board's order but directed that on the next review, all possibilities including conditional discharge be fully addressed, noting the appellant's prior successful functioning on conditions for approximately four years.

An appeal of an Ontario Review Board disposition ordering that a person found not criminally responsible on account of mental disorder remain on the secure forensic unit of a hospital.

The appellant sought an absolute or conditional discharge.

The Board found the appellant posed a significant risk to public safety based on his lack of insight into his mental illness, likelihood of non-compliance with medication, and psychological testing indicating high risk of psychotic relapse and violent behaviour.

The Court of Appeal upheld the Board's disposition as reasonable and dismissed the appeal.