Rill v. Adams, 2017 ONSC 5297

CITATION: Rill v. Adams, 2017 ONSC 5297

COURT FILE NO.: DC-17-129756

DATE: 20170911

ONTARIO

SUPERIOR COURT OF JUSTICE

BETWEEN:

Warren Rill

Appellant

– and –

Dr. John Adams, Dr. Mark Guttman and the Centre for Movement Disorders

Respondents

COUNSEL:

Warren Rill, In-Person

Lars Brusven, for the Respondents

HEARD: July 21, 2017

REASONS FOR DECISION

de sa j.:

[1] The Appellant appeals the decision of Deputy Judge Pikkov of the Small Claims Court dismissing his claim of medical negligence. For the reasons outlined below, the appeal is dismissed.

The Facts

Background

[2] Between 2006 and 2010, the Appellant (Mr. Rill) was in the care of the Defendant, Dr. Adams. When Mr. Rill was initially referred to Dr. Adams in October of 2006, he had been diagnosed with essential tremor and was treated accordingly. As time passed, the tremors worsened. By March of 2007, the tremor was fluctuating from day to day. He sometimes was requiring two hands to drink. He had also lost his balance and had fallen on three or four occasions.

[3] By June of 2007, Mr. Rill began exhibiting various different types of tremors suggesting the possibility of underlying tremor-dominant parkinsonism. In light of Mr. Rill’s developing symptoms, Dr. Adams prescribed levodopa therapy, a common treatment prescribed for Parkinson’s disease. For a number of months, the Appellant was responding favourably to the levodopa therapy which appeared to confirm the diagnosis. As time passed, however, the tremors again began to worsen.

[4] In 2010, the Appellant’s care was transferred from Dr. Adams to the Movement Disorder Clinic of Toronto Western Hospital, where he was treated by Dr. Connie Marras. In July of 2012, Dr. Robert Chen, a doctor assisting Dr. Marras in the course of Mr. Rill’s treatment, prepared a neurophysiology report indicating that the overall electrophysiological findings were suggestive of a functional etiology as cause of the Appellant’s tremors rather than Parkinson’s disease.

[5] Given this report, and other features of his tremor which were not consistent with Parkinson’s disease, Dr. Marras withdrew his Parkinson’s medication. After the withdrawal, the Appellant’s tremor improved and other signs of Parkinson’s disease which would normally appear after withdrawal of the medication did not emerge. On the basis of his reaction, together with the report provided by Dr. Chen, Dr. Marras began to question whether the Appellant had Parkinson’s disease. In a letter dated May 2, 2014, she explained:

I should add that on all of my examinations since withdrawal from Prolopa (medication for Parkinson’s disease) he has a rest tremor of his left hand which is parkinsonian in nature, in addition to his postural and action tremor that are consistent with essential tremor. He has no other signs of parkinsonism and the lack thereof and lack of worsening of his rest tremor over time makes me unwilling to make a diagnosis of Parkinson’s disease on the basis of the mild rest