Health Law - SCJ

The defendant Canada Life brought a motion for the plaintiff, who is self-represented and has a history of mental health issues, to undergo a capacity assessment.

The court, explaining its decision in simple language for the plaintiff, found that the plaintiff's capacity to manage the litigation was relevant and there was good reason to believe she might be incapable.

The motion was granted, ordering the plaintiff to attend a capacity assessment, with Canada Life bearing the costs.

The representative plaintiffs in a certified class action against Cook (Canada) Inc., Cook Incorporated, and William Cook Europe APS moved for court approval of a notice plan for a proposed settlement.

The class action concerned optionally retrievable inferior vena cava filters.

The court reviewed the proposed short-form and long-form notices and the dissemination plan, finding them compliant with the Class Proceedings Act, 1992.

The motion for approval of the notice plan was granted.

The plaintiff, Cary Beazley, sued 27 physicians and Queensway Carleton Hospital for medical malpractice, alleging delayed diagnosis and treatment of Lyme disease.

Three motions for summary judgment were heard: one by the defendant physicians, one by the Hospital, and a cross-motion by the plaintiff seeking a finding of liability in his favour.

The court dismissed the plaintiff's claims against all defendants, finding that the plaintiff failed to provide admissible expert evidence to support his claims in negligence, negligent misrepresentation, and breach of fiduciary duty.

The court also denied the plaintiff's request to file a second expert affidavit and to be qualified as an expert.

The Estate of Helen Martindale brought a medical malpractice action against two emergency room physicians, Dr. Lee and Dr. Chiu, alleging negligence in their diagnosis and treatment of Helen Martindale's perianal pain, which was later diagnosed as anal cancer requiring an ileostomy.

The plaintiff contended that the doctors breached the standard of care by failing to properly diagnose, investigate, and provide adequate follow-up.

The court found that both Dr. Lee and Dr. Chiu met the applicable standard of care, concluding that their assessments and treatment plans were reasonable given the patient's presentation and the circumstances at a community hospital.

The court also found the plaintiff's evidence unreliable regarding follow-up instructions and determined that no imaging was medically necessary at the time of the initial emergency room visits.

As no breach of the standard of care was found, the issue of causation was not determined, but the court noted that the plaintiff failed to prove that any alleged breach caused the need for an ileostomy.

The action was dismissed.

The appellant, N.H., appealed a decision of the Consent and Capacity Board which found him incapable of consenting to medical treatment for a mental disorder (antipsychotic medication and/or electroconvulsive therapy).

The Board's decision was based on N.H.'s inability to appreciate the reasonably foreseeable consequences of his treatment decisions due to his mental illness, despite understanding the relevant information.

The Superior Court of Justice reviewed the Board's decision on a standard of palpable and overriding error, finding that the Board's conclusion regarding N.H.'s lack of appreciation was amply supported by the evidence, including his inconsistent testimony about his mental illness.

The appeal was dismissed, affirming the Board's finding of incapacity.

The respondent brought a motion to admit fresh evidence and to dismiss the appellant's appeal from a Consent and Capacity Board decision for delay or as moot.

The court admitted the fresh evidence without requiring leave, finding it relevant to the motion.

The court found the appeal should be dismissed for delay due to the appellant's two-year inaction and relocation to the Congo, and also found the appeal moot as the appellant had been discharged from treatment and the capacity issue was no longer a live dispute.

The motion was granted, and the appeal was dismissed.

The appellant, S.B., appealed a decision by the Consent and Capacity Board (the Board) that upheld a physician's finding of his incapacity to manage property due to Huntington's disease.

The Board applied a two-part test under the Substitute Decisions Act, finding S.B. could understand financial information but could not appreciate the reasonably foreseeable consequences of his financial decisions.

The Superior Court of Justice reviewed the appeal on a standard of palpable and overriding error for mixed questions of fact and law.

The court dismissed the appeal, concluding that the Board correctly applied the capacity test by considering S.B.'s lack of insight into his condition's impact on his finances, coupled with his history of poor financial management and vulnerability to exploitation.

The court also rejected the argument that a pre-existing Power of Attorney nullified the capacity assessment, as this issue was not raised at the initial Board hearing.

This appeal concerned a decision by the Consent and Capacity Board (the "Board") confirming the appellant's incapacity to consent to treatment.

Subsequent to the Board's decision, the appellant regained capacity, leading both parties to seek to admit new evidence.

The court admitted the new evidence but ultimately dismissed the appeal, finding it moot as the live controversy regarding the appellant's capacity had disappeared.

In the alternative, the court found no palpable and overriding error in the Board's original decision, which had correctly applied the legal test for capacity under the Health Care Consent Act, 1996.

The accused, Justice Snache, was charged with second-degree murder.

The trial proceeded in two stages: first, to determine guilt based on an Agreed Statement of Facts, and second, to determine criminal responsibility due to mental disorder.

The court found that the Crown proved the elements of murder beyond a reasonable doubt, including the actus reus and mens rea, based on the agreed facts and the accused's admission.

However, the court then considered the Not Criminally Responsible on Account of Mental Disorder (NCRMD) defence under Section 16 of the Criminal Code.

Relying on expert psychiatric evidence, particularly from Dr. Naidoo, the court found that the accused was suffering from schizophrenia at the time of the offence, which rendered him incapable of appreciating the moral and legal wrongfulness of his actions.

Consequently, the accused was found not criminally responsible for the murder and remanded to the jurisdiction of the Ontario Review Board for disposition.

The defendant, Dr. Yair Karas, moved for summary judgment, asserting that the plaintiff's medical malpractice action was statute-barred under the Limitations Act.

The plaintiff, Denise Bosse, alleged claims of uninformed consent and breach of standard of care related to Radial Keratotomy (RK) surgeries performed by the defendant between 1994 and 2005.

The court found that the plaintiff had actual and constructive knowledge of her injury, its cause by the defendant's acts, and that a legal proceeding was an appropriate remedy by July 11, 2011, when she filed a complaint with the College of Physicians and Surgeons of Ontario.

Consequently, the two-year limitation period expired in July 2013, nine months before the Statement of Claim was issued in April 2014.

The court dismissed the plaintiff's argument that the standard of care claim was only discoverable upon receipt of an expert report in November 2013, emphasizing that knowledge of a breach of standard of care is not required for discoverability.

The defendant's motion for summary judgment was granted, and the action was dismissed.

The appellant, JS, appealed two decisions of the Consent and Capacity Board: one declining jurisdiction over his appeal regarding capacity to manage property, and another upholding a finding of incapacity to consent to antipsychotic medication.

The Superior Court of Justice allowed the appeal on property management capacity, finding the Board erred in declining jurisdiction due to an administrative glitch that denied JS his statutory right to prompt rights advice.

This issue was remitted back to the Board for a hearing on the merits.

The court dismissed the appeal on capacity to consent to treatment, finding the Board applied the correct test and had ample evidence to support its findings, without conflating mental illness with lack of capacity or failing to consider up-to-date evidence.

The appellant, Dr. Mistry, appealed an Associate Justice's order that granted a motion to add him and Dr. Karmali-Rawji as defendants in a medical malpractice action.

The core issue was whether the claim against Dr. Mistry for delayed diagnosis and failure to refer was statute-barred under the Limitations Act, 2002.

The Master had found the claim was discovered in May 2017 when the plaintiff's counsel reviewed medical records, thus the limitation period had not expired.

Dr. Mistry argued the claim was discoverable earlier, by February 2015.

The court dismissed the appeal, finding no palpable and overriding error in the Master's decision.

It affirmed that the plaintiff, an unsophisticated litigant, and his counsel could not have drawn a plausible inference of liability against Dr. Mistry without the new information from the full medical records, which revealed the spinal lesion was diagnosable earlier.

The College of Physicians and Surgeons of Ontario (CPSO) sought an order compelling Dr. Rochagne Kilian to provide patient files related to COVID vaccine exemptions.

Anonymous patients (Proposed Intervenors) brought a motion to intervene as parties, arguing their privacy and Charter rights under sections 7 and 8, and the applicability of the O'Connor process.

Dr. Kilian supported the intervention, raising constitutional challenges to the CPSO's investigation powers.

The court reserved its decision on the intervention motion, finding that the "subject matter and scope of this Application" needed to be determined first, as there was significant dispute between the parties on this fundamental issue.

This ruling addresses the continuation of an ongoing jury trial for second-degree murder amidst the rapid spread of the Omicron variant of COVID-19.

Despite a joint submission from the Crown and defence to continue the trial, the court exercised its discretion to adjourn the proceedings.

The judge balanced the accused's right to an expeditious and fair trial against the paramount health and safety concerns for all courtroom participants, including jurors, counsel, staff, and the accused's family.

The court took judicial notice of the Omicron variant's significantly increased transmissibility and its impact on vaccine effectiveness, noting the high likelihood of trial disruptions due to exposures or infections.

The trial was adjourned until February 7, 2022, with a reassessment meeting scheduled for January 31, 2022.

This decision concerns a new trial to determine if the accused, René Goudreau, was not criminally responsible (NCR) by reason of mental disorder for the first-degree murder of his mother.

The accused had previously been convicted by a jury, but the Ontario Court of Appeal ordered a new trial solely on the NCR issue.

The court considered expert psychiatric evidence, the accused's behaviour before and after the offence, and evidence of extensive planning related to life insurance policies on the victim.

Despite evidence of mental disorder, the court found that the accused failed to prove on a balance of probabilities that he was incapable of appreciating the nature and quality of his acts or knowing they were wrong.

The court concluded that the accused engaged in detailed planning for financial gain and acted rationally in many aspects, tipping the scales against an NCR finding.

This is an appeal from a decision of the Consent and Capacity Board (CCB) which found the appellant incapable of consenting to treatment with antipsychotic medications under the Health Care Consent Act.

The appellant, who did not appear for the virtual hearing, argued that the CCB failed to consider whether he could recognize the possibility of being affected by a mental condition and erred in its corroboration finding.

Applying the palpable and overriding error standard of review, the court found that the CCB had sufficient evidence to support its conclusion that the appellant could not appreciate the reasonably foreseeable consequences of refusing treatment due to his illness, and that the corroborative evidence from his family was sufficient.

The appeal was dismissed.

The plaintiffs, Daniele Marthe Hutterli and Charles Hutterli, brought a medical negligence action against Dr. Douglas Scott, alleging he failed to meet the standard of care in assessing Mrs. Hutterli's ankle injury.

Mrs. Hutterli sustained an ankle fracture but was misdiagnosed with a sprain, leading to delayed treatment.

The plaintiffs claimed increased cartilage damage and higher risk of osteoarthritis due to the delay.

The court found that Dr. Scott met the standard of care in applying the Ottawa Ankle Rules, despite the misdiagnosis, concluding it was an error in judgment, not negligence.

Furthermore, the court found the plaintiffs failed to prove causation or damages, as there was no evidence that the alleged harm (increased cartilage damage, osteoarthritis risk) was caused by the delay, rather than the original fracture, or that a better outcome would have resulted.

The action was dismissed.

The Attorney General of Ontario brought a motion to determine the appropriate sentence for Trinity Bible Chapel and six individuals (the "Contemnors") who were found in contempt of a January 22, 2021 court order.

The order restrained them from holding gatherings of more than 10 persons, contravening Ontario Regulation 82/20.

The Contemnors had intentionally and publicly breached the order, having previously expressed an intent to engage in civil disobedience rather than challenge the legislation constitutionally.

The court considered proportionality, mitigating and aggravating factors, deterrence, denunciation, and similar sentences.

The court imposed fines totaling $38,000 ($15,000 for Trinity Bible Chapel, and varying amounts for the individual Contemnors based on their involvement) and fixed costs of $45,000 on a substantial indemnity basis, payable jointly and severally by the respondents.

The applicants, comprising raw milk producers and consumers, challenged federal and provincial prohibitions on the sale and distribution of unpasteurized milk, alleging violations of their freedom of conscience, freedom of religion, and equality rights under the Canadian Charter of Rights and Freedoms.

The court dismissed all claims, finding that the applicants' belief in raw milk's health benefits did not constitute a profound moral dimension for freedom of conscience, the religious interference was trivial and insubstantial, and the equality claim lacked a sufficient evidentiary basis.

The court further held that even if Charter violations were established, they would be justified under section 1 due to the compelling public health objective of preventing milk-borne illnesses, which pasteurization effectively mitigates.

This class action concerned a health hazard at a dental practice due to improperly cleaned instruments, leading to potential exposure to Hepatitis B, C, and HIV for approximately 9,000 patients.

The court approved a proposed settlement of $1,550,000 in damages, plus costs and disbursements, resulting in a net settlement amount of $1,058,550.

The settlement fund was divided into an Infected Claims Fund (70%) and an Exposed (Uninfected) Claims Fund (30%), with provisions for the Ontario Ministry of Health's subrogated claim.

The court also approved class counsel fees of $465,000, plus HST and disbursements, based on a 30% contingency fee.

The approval was based on the settlement being fair, reasonable, and in the best interests of the class, considering litigation risks and the benefits of a streamlined claims process.