Court File and Parties

COURT FILE NO.: CV-20-2197 DATE: 20230731 ONTARIO SUPERIOR COURT OF JUSTICE

BETWEEN:

SHARON SHYN ANG Plaintiff – and – DR. SIMON LIN Defendant

Counsel: Sharon Shyn Ang, In Person Eric S. Baum, for the Defendant

HEARD: June 14, 2023

Reasons for Decision

CHARNEY J.:

[1] The Defendant, Dr. Simon Lin, brings this motion for summary judgment in a dental malpractice action commenced by the Plaintiff, Sharon Syn Ang, on August 13, 2020 and amended on September 26, 2022. The Plaintiff alleges that the Defendant was negligent with respect to dental treatment provided to her on August 13 and 21, 2018, and as a result she has suffered damages.

[2] The Plaintiff’s Amended Statement of Claim alleges that the Defendant breached the standard of care by administering too much local anesthetic. The Plaintiff alleges that the Defendant injected “about 30 mg” of the anesthetic Lidocaine, and some of the anesthetic leaked from the needle, causing her to swallow a large amount of anesthetic, which resulted in the Plaintiff developing a number of long-term medical problems, including memory loss, chest pain, numbness and weakness of extremities, proteinuria and a variety of ophthalmologic symptoms such as severe intermittent eye pain in both eyes, blurred vision and orange coloured eye discharge.

[3] The Plaintiff also alleges that the Defendant damaged her gums and various teeth “by cutting, drilling and shaving them”, and has caused the Plaintiff to develop a bony sequestrum at the site of tooth 21. She alleges that the Defendant drilled a “huge hole” in the back of her tooth and “shaved and cut” the tooth to “make it weak”.

[4] In his Statement of Defence, the Defendant has denied all allegations of liability and damages.

Motions for Summary Judgment

[5] Rule 20.04(2)(a) of the Rules of Civil Procedure, R.R.O. 1990, Reg. 194 provides: “The court shall grant summary judgment if the court is satisfied that there is no genuine issue requiring a trial with respect to a claim or defence.”

[6] Rule 20.04(2.1) sets out the court’s powers on a motion for summary judgment:

In determining under clause (2)(a) whether there is a genuine issue requiring a trial, the court shall consider the evidence submitted by the parties and, if the determination is being made by a judge, the judge may exercise any of the following powers for the purpose, unless it is in the interest of justice for such powers to be exercised only at a trial:

1. Weighing the evidence.
2. Evaluating the credibility of a deponent.
3. Drawing any reasonable inference from the evidence.

[7] These powers were extensively reviewed by the Supreme Court of Canada in Hryniak v. Mauldin, 2014 SCC 7, where it laid out a two-part roadmap for summary judgment motions at para. 66:

On a motion for summary judgment under Rule 20.04, the judge should first determine if there is a genuine issue requiring trial based only on the evidence before her, without using the new fact-finding powers. There will be no genuine issue requiring a trial if the summary judgment process provides her with the evidence required to fairly and justly adjudicate the dispute and is a timely, affordable and proportionate procedure, under Rule 20.04(2)(a). If there appears to be a genuine issue requiring a trial, she should then determine if the need for a trial can be avoided by using the new powers under Rules 20.04(2.1) and (2.2). She may, at her discretion, use those powers, provided that their use is not against the interest of justice. Their use will not be against the interest of justice if they will lead to a fair and just result and will serve the goals of timeliness, affordability and proportionality in light of the litigation as a whole.

[8] Even with these extended powers, a motion for summary judgment is appropriate only if the material provided on the motion “gives the judge confidence that she can find the necessary facts and apply the relevant legal principles so as to resolve the dispute” (Hryniak, at para. 50).

[9] In Hryniak, the Supreme Court held (at para. 49) that there will be no genuine issue for trial when the summary judgment process “(1) allows the judge to make the necessary findings of fact, (2) allows the judge to apply the law to the facts, and (3) is a proportionate, more expeditious and less expensive means to achieve a just result.”

[10] To defeat a motion for summary judgment, the responding party must put forward some evidence to show that there is a genuine issue requiring a trial. A responding party may not rest on mere allegations or denials of the party’s pleadings, but must set out—in affidavit material or other evidence—specific facts establishing a genuine issue requiring a trial.

[11] The motion judge is entitled to assume that the record contains all of the evidence that would be introduced by both parties at trial. A summary judgment motion cannot be defeated by vague references as to what may be adduced if the matter is allowed to proceed to trial: Tropper v. RBC Life Insurance Company, 2013 ONSC 2135, at para. 13.

[12] It is now well settled that “both parties on a summary judgment motion have an obligation to put their best foot forward” (see Mazza v. Ornge Corporate Services Inc., 2016 ONCA 753, at para. 9). Given the onus placed on the moving party to provide supporting affidavit or other evidence under Rule 20.01, “it is not just the responding party who has an obligation to ‘lead trump or risk losing’” (see Ipex Inc. v. Lubrizol Advanced Materials Canada, 2015 ONSC 6580, at para. 28).

[13] If the moving party meets the evidentiary burden of producing evidence on which the court could conclude that there is no genuine issue of material fact requiring a trial, the responding party must either refute or counter the moving party’s evidence or risk a summary judgment.

[14] A plaintiff or defendant bringing a motion for summary judgment has the initial onus of proving that there is no genuine issue for trial and must file some affidavit evidence to support that position. See for example, Sanzone v. Schechter, 2016 ONCA 566, at paras. 30-32, confirming the initial evidentiary obligation borne by the moving party (in that case the defendant) on a summary judgment motion:

First, the evidentiary burden on a moving party defendant on a motion for summary judgment is that set out in rule 20.01(3) – “a defendant may… move with supporting affidavit material or other evidence.” As explained in Connerty, at para. 9, only after the moving party defendant has discharged its evidentiary burden of proving there is no genuine issue requiring a trial for its resolution does the burden shift to the responding party to prove that its claim has a real chance of success.

[15] While Rule 20.04 provides the court hearing a summary judgment motion with “enhanced forensic tools” to deal with conflicting evidence on factual matters, the court should employ these tools and decide a motion for summary judgment only where it leads to “a fair process and just adjudication”: Mason v. Perras Mongenais, 2018 ONCA 978, at para. 44; Eastwood Square Kitchener Inc. v. Value Village Stores, Inc., 2017 ONSC 832, at paras. 3-6 (and cases cited therein).

[16] I am satisfied that, given the motion records filed by the parties, I am in as good a position as a trial judge to “find the necessary facts and apply the relevant legal principles so as to resolve the dispute” and that this is “a proportionate, more expeditious and less expensive means to achieve a just result.”

Legal Principles Applicable to Dental Malpractice Actions

[17] It is well established that to establish a breach of the standard of care to support a claim for medical/dental negligence, a plaintiff is required to lead expert evidence of a physician or dentist practising in the same field as the defendant attesting to the defendant’s negligence: Kurdina v. Dief, 2010 ONCA 288, at para. 2. The expert must be qualified to practice in Ontario or qualified to provide evidence on the applicable standard of care in Ontario: Kurdina at para. 4.

[18] Similarly, in the absence of evidence of causation, a claim must also fail: Markowa v. Adamson Cosmetic Facial Surgery Inc., 2012 ONSC 1012, at para. 177.

[19] On a motion for summary judgment (or at a trial for that matter), expert reports or medical literature must be tendered through direct evidence of an expert who may be cross-examined. Medical literature cannot be relied on without an expert attesting to its relevance and reliability. On a motion for summary judgment, the expert must either place the substance of his or her opinion in an affidavit, or the expert’s report must be appended to the expert’s affidavit, Markowa at para. 79:

Furthermore, it is well-established that, on a motion for summary judgment, expert reports or opinion evidence (including opinions found in medical literature) must be tendered through direct evidence and in a manner that permits cross-examination of the expert. The expert must either place the substance of his or her opinion in an affidavit or swear an affidavit to which the report is annexed and in which the truth of the report is attested to.

[20] See also: Sheldon v. Beaulieu, 2020 ONSC 4908, at para. 10:

The responding party relies on the expert report of Thomas Smahel. There are issues with respect to the admissibility of this report. It was not appended to an affidavit sworn by the expert. On this basis, the moving party says the evidence is not admissible. I accept that it is not appropriate to put forth the evidence of an expert merely as an exhibit to an affidavit of some other person. For that reason alone, it would be inadmissible.

Procedural History

[21] The motion for summary judgment was originally scheduled for December 5, 2022.

[22] On September 26, 2022, the Plaintiff served an Amended Statement of Claim.

[23] A Case Conference was held before R.S.J. Edwards, at the request of the Plaintiff, to amend the previous timetable orders. The Plaintiff was given until January 31, 2023 to serve an expert report and a further case conference was scheduled for February 22, 2023. The Plaintiff served her expert report on February 21, 2023.

[24] On February 22, 2023, the motion for summary judgment was scheduled for March 15, 2023. At the Plaintiff’s request, and to accommodate her medical appointments, the motion was rescheduled for June 14, 2023.

[25] On May 17, 2023, the Defendant served the Second Supplementary Report by Dr. Katchky to respond to the Plaintiff’s expert report. Defendant’s counsel advised the Plaintiff of Dr. Katchky’s availability for cross-examination, and asked the Plaintiff to advise if she intended to cross-examine Dr. Katchky. The Defendant also indicated his intention to cross-examine the Plaintiff’s expert once he received the expert’s curriculum vitae and an affidavit confirming the expert’s adoption of the report. This request was reiterated on May 19, 2023.

[26] On May 21, 2023, the Plaintiff responded:

I am still busy trying to find health care professionals who have the knowledge regarding the harmful effects of anesthetic/ lidocaine on the human body. Therefore, even though I intend to cross-examine Dr. Lin and Dr. Katchky it is impossible for me to schedule examinations for discovery right now.

[27] Counsel for the Defendant responded the same day, offering dates when Dr. Katchky was available for cross-examination that week.

Defendant’s Evidence

[28] The Defendant’s motion for summary judgment is supported by a number of affidavits. Three of the affidavits are by the Defendant, and three are by the Defendant’s expert witness, Dr. Allan Katchky.

[29] In his affidavits, the Defendant denied that any treatment in his office fractured Ms. Ang’s tooth 21, and stated that the Plaintiff told him that she fractured this tooth while eating.

[30] The Defendant stated that he administered one cartridge of anesthetic, and, following a period of treatment, administered a second cartridge to ensure continued anesthetic effect. The procedure was routine and uneventful. Each cartridge contained 1.8 cc of the anesthetic, which is “well below the maximum recommended dose for adult patients”. The Defendant stated that he does not believe that the Plaintiff swallowed any of the anesthetic, or that any of her alleged injuries are in any way related to the administration of the local anesthetic.

[31] Finally, the Defendant stated that he never provided any treatment to the Plaintiff’s teeth 11 or 22, nor did he cause damage to those teeth or the gum tissue as alleged.

[32] The Defendant attached his clinical notes and records with respect to the Plaintiff.

[33] Dr. Katchky is a general dentist with approximately 40 years’ experience practicing dentistry in Ontario. He graduated from the University of Toronto Faculty of Dentistry in 1982 and received his Certificate in Hospital Dentistry from the University of Pennsylvania in 1983. In addition to carrying on a full-time practice, Dr. Katchky is a part-time clinical instructor in the Department of Oral Medicine at the University of Toronto’s Faculty of Dentistry.

[34] After reviewing the clinical notes and records of Dr. Lin, Dr. Katchky concluded that the Defendant met or exceeded the standard of care expected of a general dentist practicing in Ontario, and that there were no errors or omissions on the part of the Defendant that caused the Plaintiff’s alleged injuries.

[35] Dr. Katchky confirmed that the instruments used by the Defendant and his dental hygienist are not capable of causing a fracture or breakage of an intact tooth. There is no evidence in the clinical notes and records of Dr. Lin or any other dentist or specialist who subsequently examined the Plaintiff to suggest that the Defendant injured the teeth or gums in the vicinity of the Plaintiff’s tooth 21. Dr. Katchky concludes that the fracture of the tooth was unrelated to the patient’s treatment at the Defendant’s office.

[36] Dr. Katchky states that AstraZeneca, the manufacturer of the anesthetic used by the Defendant, states that the maximum recommended dose for an adult patient is 30 mg, equivalent to 8.33 cartridges, so that the amount of anesthetic administered by the Defendant fell well below the maximum recommended dose. The usual duration of the anesthetic is 60 – 90 minutes. The Defendant administered the second cartridge of anesthetic one hour and ten minutes after the first due to the length of the procedure.

[37] Dr. Katchky acknowledged that it is possible for a small amount of anesthetic to leak from the cartridge during an injection if there is a crack in the cartridge. If a patient ingested a small amount of anesthetic, the only adverse reaction would be a bitter taste in the mouth of the patient, which the patient would likely immediately report to the dentist. The bitter taste could be alleviated by rinsing the mouth with water.

[38] Reported cases of toxicity to local anesthetics are exceedingly rare and relate to inadvertent intravascular injection or administration to very young children. The symptoms described by the Plaintiff (dizziness, short term memory loss, blurred vision and orange discharge from the eye) do not correlate with the symptoms of local anesthetic toxicity. In Dr. Katchky’s view, the symptoms reported by the Plaintiff are unconnected to, and incapable of being caused by, the local anesthetic administered to the Plaintiff by the Defendant.

[39] Dr. Katchky also notes that neither of the medical practitioners seen by the Plaintiff subsequent to the treatment provided by the Defendant (Drs. Tam and Gilbert), ever correlated the Plaintiff’s alleged symptoms to the administration of local anesthetic.

Plaintiff’s Evidence

[40] In response to the motion for summary judgment, the Plaintiff served a report from a dentist in Taiwan, Dr. David Chen. Following numerous requests, the Plaintiff provided a copy of Dr. Chen’s curriculum vitae on the eve of the summary judgment motion. The C.V. indicates that Dr. Chen graduated from the Faculty of Dentistry at Taipei Medical University in Taiwan and has practiced general dentistry since 1992. He is a member of the Taiwan Dental Association.

[41] Dr. Chen did not provide an affidavit, but provided a signed expert report dated February 12, 2023.

[42] Dr. Chen reviewed the Defendant’s clinical notes as well as the clinical notes of Drs. Tam and Gilbert. He also reviewed the clinical notes of various emergency room doctors at Mackenzie Health Hospital, the Cortellucci Vaughan Hospital, and the clinical notes of Drs. Wong, Yeung, Xu, Santhiramohan, Ibude and Yin.

[43] Dr. Chen states that, in his opinion, the dental treatment provided by the Defendant breached the standard of care expected of a competent and prudent dentist, and that the breach of the standard of care “directly caused the Plaintiff’s eyes, central nervous system, heart, eyelids, gum and teeth injuries”, and that her injuries are “linked to the symptoms of local anesthetic toxicity.”

[44] Dr. Chen stated:

I learned from the Plaintiff that the Defendant admitted to her and her husband two weeks after the Defendant injected her with more than the maximum recommended dose of anesthetic that he administered an excessive amount of his dental local anesthetic to the Plaintiff and caused her to ingest a large amount of his anesthetic.

[45] Dr. Chen states that “exposure to large amounts of Lidocaine [the anesthetic used in this case] can cause adverse effects on the central nervous system (CNS) as well as the ocular and cardiovascular systems”. He does not explain what he means by “large amounts”. He states:

According to the FDA, the Journal of Anesthesia and Pain Medicine and other current scientific literature on the subject of local anesthetic toxicity, symptoms of lidocaine toxicity are numerous and include but are not limited to blurred or double vision, loss of vision, eye pain, eye muscle damage (i.e. strabismus), methemoglobinemia, dizziness, difficulties breathing, arrhythmia, drowsiness, lightheadedness, chest pain, tightness in the chest, muscle weakness, confusion, eyelid muscle damage, numbness and twitching.

Even though the Defendant believed anesthesia, even in excessive amounts, is harmless the fact is an excessive amount of anesthesia is very harmful to the ocular and central nervous system.

[46] Dr. Chen lists the reported side effects of local anesthetics, including drooping eyelids and disturbance of eye muscles, but does not indicate the dosage associated with these side effects or the duration of the side effects.

[47] Dr. Chen relies on an article published on November 26, 2021, “Adverse effects following dental local anesthesia: a literature review” in the Journal of Dental Anesthesia and Pain Medicine, in which “doctors reported multiple visual disturbances after the administration of dental local anesthesia. Blurred vision, complete or partial loss of vision, eye pain, strabismus, diplopia, uniocular blindness, permanent vision loss have been reported”.

[48] With regard to the standard of care, Dr. Chen concludes:

The Defendant should have stopped the dental treatment immediately when he learned his needle was leaking anesthetic. After the Defendant knew the Plaintiff ingested a large quantity of his anesthetic solution, the Defendant made another mistake by injecting the Plaintiff with a second large dental local anesthetic injection.

Dr. Katchky’s Reply Report

[49] Following the receipt of Dr. Chen’s Report, Dr. Katchky provided a third report to respond to Dr. Chen.

[50] In his third report, Dr. Katchky reviewed the additional medical and dental records produced by the Plaintiff and referenced by Dr. Chen. These records related to the Plaintiff’s visits to various health care professionals, including three ophthalmologists, a neurologist, an allergy and immunology specialist, a family physician and two dentists, between the years 2019 to 2022. Dr. Katchky concludes that these records do not demonstrate any correlation between the symptoms reported by the Plaintiff and any physical findings.

[51] Significantly, none of these other health care professionals seen by the Plaintiff have provided an affidavit to support the Plaintiff’s allegations against the Defendant.

[52] Dr. Katchky also reviewed the four medical articles relied on by the Plaintiff, and concluded that none of the articles supported the Plaintiff’s position or changed the opinions, findings and conclusions rendered in his earlier reports. Dr. Katchky’s report provided a detailed analysis of the following articles:

1. “Adverse effects following dental local anesthesia: a literature review”. J Dent Aneth Pain Med 2021;21(6):507-525
2. “Lidocaine-induced Systemic Toxicity: A Case Report and Review if Literature” Cureus Journal of Medical Science (9)(5), May 25, 2017
3. “Diplopia with local anesthesia”. Natl J Maxillofac Surg 2011;2:82-5
4. Darby Dental Supply Product Monograph for Lidocaine (online)

[53] In particular, Dr. Katchky’s review of the first two articles stated:

“Adverse effects following dental local anesthesia: a literature review”

In this article, whereas certain ocular adverse effects were described following administration of local anesthetic, all of such effects were temporary in nature (usually lasting 15 minutes to 24 hours). In other words, this extensive search of 1,572 articles in the PubMed and Embase databases failed to find a single documented case of long-term ocular effects from local anesthetic administration. This is significant because, Ms. Ang alleges that the local anesthetic administered by Dr. Lin almost five years ago has resulted in ongoing ocular symptoms which, according to the literature, appears to be entirely unprecedented. My opinion therefore remains that it is exceptionally unlikely that Dr. Lin’s administration of dental local anesthetic caused the injuries caused by the Plaintiff.

“Lidocaine-induced Systemic Toxicity: A Case Report and Review of Literature”

This article is a case report involving a 33 year old female patient undergoing elective nasal surgery to repair a deviated nasal septum. The patient discussed in the article was administered 60 millilitres (ml) of 2% Lidocaine with 1% epinephrine subcutaneously. By comparison, as indicated in Dr. Lin’s clinical notes and records, Ms. Ang was only administered a total of 3.6 millilitres of Lidocaine, as each cartridge of dental anesthetic contains 1.8 millilitres of anesthetic and the Plaintiff received two cartridges of anesthetic during the procedure in question. In other words, the article referred to describes the administration of a dose of Lidocaine almost twenty times greater in quantity than that administered by Dr. Lin. Therefore, this article has no contextual relationship with the treatment rendered by Dr. Lin since, as I have stated in my earlier reports, Dr. Lin administered a quantity of local anesthetic that was far below the maximum recommended dose, and therefore the chance of systemic toxicity was exceedingly remote at best.

Analysis

[53] The Defendant argues that his expert evidence demonstrates that there is no genuine issue requiring a trial, and that the Plaintiff’s responding evidence is inadmissible, and even if admissible, fails to demonstrate that there is a genuine issue requiring a trial.

[54] The Defendant has provided affidavit evidence from Dr. Katchky, a qualified Ontario expert. Dr. Katchky’s evidence is that Dr. Lin met or exceeded the standard of care expected of a general dentist practicing in Ontario, and that there were no errors or omissions on the part of Dr. Lin that caused the Plaintiff’s alleged injuries.

[55] The Plaintiff did not cross-examine Dr. Katchky, although she was offered the opportunity.

[56] It is also significant that none of the medical practitioners seen by the Plaintiff subsequent to the treatment provided by Dr. Lin ever correlated the Plaintiff’s alleged symptoms to the administration of local anesthetic. None of these treating medical practitioners has provided an affidavit on this motion.

[57] Dr. Chen’s report is not appended to an affidavit, and is technically inadmissible. While the Plaintiff is self-represented, Defendant’s counsel advised her on at least five occasions that that Dr. Chen’s report had to be in the form of, or appended to, an affidavit.

[58] Furthermore, there is no evidence that Dr. Chen is qualified to opine on the standard of care in Ontario. He does not practice in Ontario, and there is nothing in his C.V. to suggest that he is qualified to give evidence about the standard of practice in the Province of Ontario.

[59] The relevance and admissibility of a foreign expert report was reviewed by the Alberta Court of Appeal in Grivicic v. Alberta Health Services (Tom Baker Cancer Centre), 2017 ABCA 246, at paras. 36 - 37:

It may well be that the standard of care for a particular medical specialty or medical procedure is the same in Canada and the United States... However, the party hoping to use a foreign expert should produce evidence to the effect that the standards of care are the same or similar to those in Canada. This follows the basic evidentiary requirement of relevance; the expert must be able to speak to the issues in the case at bar... Mrs. Grivicic did not provide any evidence of the equivalency of care in Canada and the United States.

While Mrs. Grivicic may be correct that there is no general principle barring the use of American experts, this does not exempt her from the requirement to prove that the reports of the American experts she refers to are relevant to the specific issues in this case. Where a foreign expert does not opine on the standard of care in Alberta, the court may give little weight to his or her opinion. [Citations omitted.]

[60] See also: Hirchberg v. Branson Drug Store, 2016 ONSC 4853, aff’d 2017 ONCA 62, leave to appeal refused, , where Matheson J. stated, at para. 45:

There are a number of difficulties with the evidence of Dr. Levin. Upon a review of Dr. Levin’s curriculum vitae and related enclosures, I am not satisfied that he is qualified to give expert evidence on the standard of practice in the province of Ontario with respect to any of the physician defendants. It is well accepted that the standard of care requires that a physician conduct their practice accordance with the conduct of a prudent and diligent physician in the same circumstances. In the case of a specialist, a physician’s conduct must be assessed in light of the conduct of other ordinary specialists who possess a reasonable level of knowledge, competence and skill expected of professionals in Canada in that field: ter Neuzen v. Korn, 1995 SCC 72, [1995] 3 S.C.R. 674, at para. 46; Branco v. Sunnybrook, [2003] O.J. No. 3287, 133 A.C.W.S. (3d) 421 (S.C.J.), at para. 8. Dr. Levin’s material is insufficient to establish his expertise regarding Canadian standards of practice, let alone those applicable to the physician defendants’ circumstances.

[61] Even if Dr. Chen’s report was presented in an affidavit, and even if he was properly qualified to give evidence on the standard of care in Ontario, I find his evidence to be unpersuasive, both with respect to the issue of causation and standard of care.

[62] Dr. Chen’s report is based on the premise that Dr. Lin injected the Plaintiff with more than the maximum recommended dose of anesthetic and caused her to ingest a large quantity of the anesthetic. There is no medical evidence – including Dr. Lin’s clinical notes – to corroborate this premise. Dr. Chen just takes the Plaintiff’s word for this. Without some medical evidence to corroborate this claim, Dr. Chen’s opinion is of little value.

[63] In this regard, I prefer Dr. Lin and Dr. Katchky’s evidence that Dr. Lin administered two cartridges of the anesthetic, one hour apart, and that each cartridge contained 1.8 cc of the anesthetic, well below the 30 mg maximum (equivalent to 8.33 cartridges) recommended dose for an adult patient. This evidence is consistent with Dr. Lin’s clinical notes.

[64] Nor is there any dispute regarding the number or timing of the injections. Paragraph 17 of the Plaintiff’s Amended Statement of Claim states that she “received a total of two anesthetic injections within one hour and ten minutes”, which is consistent with Dr. Lin’s clinical notes. There is no evidence to contradict Dr. Lin and Dr. Katchky’s evidence that each cartridge contains only 1.8 cc of anesthetic.

[65] Dr. Chen does not explain what quantity of anesthetic would have been required to cause the adverse side effects he lists in his report, or how many injections would have to be given to cause those side effects. He does not take issue with Dr. Katchky’s statement that each cartridge contains only 1.8 cc of anesthetic.

[66] Nor does Dr. Chen’s summary of the medical reports he relies on address any of the limitations set out in Dr. Katchky’s reply report: the reported side effects were temporary in nature, usually lasting 15 minutes to 24 hours, and do not support the long term side effects alleged by the Plaintiff, the reported side effects relate to a dose of Lidocaine almost twenty times greater than the quantity of local anesthetic administered by Dr. Lin.

[67] While Dr. Chen reviewed the same clinical records as Dr. Katchky, Dr. Chen does not provide any explanation as to how these clinical records support any of the Plaintiff’s allegation that her physical symptoms were caused by the Defendant’s treatment of her.

Conclusion

[68] Based on the record before me, I am satisfied that the Defendant has demonstrated that there is no genuine issue for trial, and that a trial is not required for me to justly decide this case.

[69] The motion for summary judgment is granted, and this action is dismissed.

[70] If the parties are not able to agree on costs, the Defendant may file costs submissions of no more than 3 pages, plus costs outline and any offer to settle, within 20 days of the release of this decision, and the Plaintiff may file responding costs submissions on the same terms, within a further 15 days.

Justice R.E. Charney Released: July 31, 2023