Health Law - SCJ

The defendant dentist brought a motion for partial summary judgment in a dental malpractice action, arguing that claims relating to treatment before a specified date were statute‑barred under the Limitations Act, 2002.

The plaintiffs had originally commenced an action concerning later dental treatment but later amended the pleading to include earlier procedures and alleged failures to treat additional teeth.

The court held that the amendments asserted new causes of action rather than merely providing further particulars of the original claim.

Applying the discoverability principles under ss. 4 and 5 of the Limitations Act, the court found the plaintiffs knew or ought to have known of the potential negligence years earlier based on communications with subsequent dental specialists.

The claims relating to treatment before the specified date were therefore outside the limitation period.

In a medical malpractice action arising from the labour and delivery of an infant plaintiff, the defendant physician admitted breaching the standard of care and causing neurological impairment.

The dispute concerned the proper form of judgment following the admission of liability and the terms of a proposed advance payment.

The court determined the wording of the judgment to reflect the admission while limiting liability to damages causally linked to the physician’s negligence, with damages to be assessed at trial.

The court ordered an advance payment of $300,000 to be used for specified care and accommodation needs of the infant plaintiff and directed that the payment be credited against any eventual damages award.

No costs were awarded due to the good‑faith nature of the dispute between counsel.

The regulatory college applied for injunctive relief under the Health Professions Procedural Code alleging that the respondent unlawfully practised traditional Chinese medicine and held herself out as a practitioner after the profession became regulated.

Evidence showed that the respondent, who was not registered with the college, examined an individual, communicated a traditional Chinese medicine diagnosis, used restricted titles, and represented herself through business materials as qualified to practise acupuncture.

The court found that the respondent communicated a diagnosis and held herself out as a practitioner contrary to the Traditional Chinese Medicine Act, 2006 and the Regulated Health Professions Act, 1991.

The court concluded that providing health advice in these circumstances created a foreseeable risk of serious bodily harm and also breached statutory restrictions on the use of the title “Doctor.” The requested injunction was granted.

Two physicians sought judicial review and constitutional relief challenging registration requirements under the Medicine Act and requesting mandamus orders compelling the regulatory body to issue certificates of registration.

They also sought Charter-based relief preventing the regulator from investigating professional conduct.

The court held that the applications were premature because the applicants had alternative statutory remedies through the regulator’s processes, including review by the Health Professions Review Board and appeal to the Divisional Court.

The applicants had also failed to provide sworn evidence or comply with procedural requirements for judicial review.

The court further found the requested mandamus and constitutional relief lacked factual and legal foundation and dismissed the applications.

The appellant appealed a decision of the Consent and Capacity Board confirming that he lacked capacity to consent to treatment for a mental disorder under the Health Care Consent Act.

The Board found the appellant incapable of consenting to treatment due to delusional beliefs preventing appreciation of the reasonably foreseeable consequences of refusing medication.

The court held that the Board’s finding of incapacity with respect to anti‑psychotic medication and related side‑effect medication was reasonable and supported by the evidence.

However, the evidentiary record contained insufficient information regarding benzodiazepines and cholinergic medication.

The appeal was therefore allowed in part and the matter remitted to the Board for a rehearing on those medications before a differently constituted panel.

The defendants brought a motion for summary judgment seeking dismissal of a dental malpractice claim.

The plaintiff alleged negligent dental treatment involving implants and extractions but failed to provide proper expert evidence supporting breach of the standard of care or causation.

The court held that professional negligence claims require admissible expert opinion evidence from a qualified professional and that such evidence must comply with Rule 53.03 of the Rules of Civil Procedure.

The document relied upon by the plaintiff was not sworn, did not meet expert report requirements, and was therefore inadmissible.

Without admissible expert evidence, the plaintiff’s claim had no reasonable prospect of success.

In a medical negligence action arising from dental treatment, the defendants brought a summary judgment motion seeking dismissal of the claim and argued that an alleged condition described as “geographic tongue” was not caused by any negligence of the treating dentist.

After releasing earlier reasons dismissing the summary judgment motion, the court permitted additional written submissions on whether causation regarding that specific condition should nonetheless be resolved on the motion record.

The court declined to isolate and determine a discrete causation issue at the summary judgment stage.

It held that questions of damages and causation should be determined by the trial judge on a full evidentiary record, including expert evidence.

The action was therefore left to proceed to trial.

The appellant appealed a decision of the Consent and Capacity Board finding her incapable of consenting to psychiatric treatment under the Health Care Consent Act, 1996.

The Board had rescinded a certificate of involuntary admission but upheld the physician’s finding that the appellant lacked capacity to consent to treatment due to inability to appreciate the reasonably foreseeable consequences of refusing antipsychotic medication.

Applying the reasonableness standard of review and the test for capacity under s. 4 of the Act, the court found the Board reasonably concluded the appellant’s delusional beliefs and disorganized thinking prevented her from performing a risk–benefit analysis regarding treatment.

The court rejected arguments that the Board equated mental illness with incapacity or failed to ensure the appellant had been informed about treatment options.

The appeal was dismissed.

A physician brought a motion under Rule 21.01 of the Rules of Civil Procedure to strike the plaintiff’s claims alleging negligent medical treatment of the plaintiff’s child, conspiracy, defamation, abuse of public office, and Charter breaches.

The court held that the pleadings failed to disclose a reasonable cause of action, lacked necessary material facts, and improperly advanced speculative allegations against numerous defendants.

The court further found no duty of care owed by the physician to the plaintiff personally, as the treatment was provided to the child and no therapeutic relationship with the plaintiff was pleaded.

Several asserted causes of action were legally untenable or inadequately pleaded, and the claims were also barred by the two‑year limitation period under the Limitations Act, 2002.

The claims against the physician were struck without leave to amend.

The moving parties sought an interlocutory injunction preventing the responding parties from excluding them from jointly operating several addiction-treatment medical clinics and pharmacies following a breakdown in their business relationship.

The applicants also sought directions regarding patient communications, access to clinics, and division of software and other assets.

Applying the test for interlocutory injunctions from R.J.R.-MacDonald Inc. v. Canada (Attorney General), the court held that the applicants failed to demonstrate irreparable harm if access to the clinics was denied.

The court found that the applicants had already established alternative clinic locations and were intending to compete with the respondents.

Instead of granting the injunction, the court ordered a structured disengagement process, including patient choice protections and limited directions regarding software and patient database access.

The appellant appealed a decision of the Consent and Capacity Board under the Mental Health Act concerning ongoing involuntary detention at a maximum security psychiatric facility.

The appeal raised issues regarding the standard of review, the application of the statutory criteria for detention, and alleged breaches of Charter rights under ss. 7, 9, 11(h), and 12.

During the hearing, the Court of Appeal released its decision in P.S. v. Ontario, which addressed the constitutionality of long-term involuntary committals and the limited powers of the Consent and Capacity Board.

The court held that the appellate ruling fundamentally altered the legal landscape and rendered the issues raised in the appeal moot, as the appellant fell within the class of long-term involuntary patients affected by the constitutional findings in that decision.

The applicant regulatory body brought a motion seeking a finding of contempt against the respondent for breaching a prior court order prohibiting him from representing himself as a chiropractor or performing controlled acts associated with chiropractic practice.

The respondent had previously admitted breaches of the same order in earlier contempt proceedings and agreed to comply with settlement terms requiring immediate cessation of practice and removal of promotional materials.

Evidence including patient files, appointment records, and affidavits from patients established beyond a reasonable doubt that the respondent continued operating a chiropractic practice and using the title “doctor” or “D.C.” in connection with providing health services.

The court found the respondent knowingly and wilfully breached the 2006 order and continued to hold himself out as a chiropractor.

A finding of contempt was entered, with a further hearing to determine penalty and costs.

The appellant appealed a decision of the Consent and Capacity Board finding him incapable of consenting to treatment with antipsychotic medication under the Health Care Consent Act, 1996.

The court considered whether the Board lacked jurisdiction due to panel composition, the proper legal test for capacity under s. 4(1) of the Act, the applicable standard of review, and whether the Board’s application of the test was reasonable.

The court held that tribunal expertise justified deference regardless of the individual qualifications of panel members and that the standard of review for the Board’s application of law to facts was reasonableness.

The Board reasonably concluded that although the appellant could understand relevant information, symptoms described as perseveration and grandiosity prevented him from appreciating the reasonably foreseeable consequences of refusing treatment.

The Board’s decision fell within a range of defensible outcomes and was upheld.

An NCR accused detained at a psychiatric hospital challenged the constitutionality of s. 672.56 of the Criminal Code, arguing that it violated s. 7 of the Charter by allowing the hospital’s person in charge to determine whether increased restrictions on liberty should trigger mandatory Review Board oversight.

The applicant argued this created a conflict of interest and reasonable apprehension of bias.

The court held that when s. 672.56 is considered within the broader statutory framework of Part XX.1, including discretionary review powers and the availability of judicial review, the scheme provides a fair process.

The notification requirement imposes a statutory duty rather than discretionary review authority.

Accordingly, the provision does not violate principles of fundamental justice.

A pharmacist challenged the constitutionality of mandatory licence revocation provisions under the Health Professions Procedural Code after pleading guilty to sexual abuse of a patient based on a consensual sexual relationship.

The applicant argued the provisions were ultra vires the province because, in pith and substance, they regulated sexual morality and therefore fell within Parliament’s criminal law power.

The Superior Court held that the dominant purpose of the provisions was the protection of the public through the regulation of professional standards governing health care practitioners.

The provisions were therefore within the province’s jurisdiction over property and civil rights under s. 92(13) of the Constitution Act, 1867.

The court also held the Attorney General was estopped from challenging the court’s jurisdiction because the issue had already been determined in earlier proceedings.

The plaintiff brought a motion to adjourn a scheduled jury trial in a medical malpractice action after learning that a key expert witness would be unavailable on the trial date.

The defendants opposed the adjournment, arguing the unavailability resulted from the plaintiff’s counsel failing to notify the expert of the agreed trial date in a timely manner.

The court considered the discretionary test for adjournments and the need to balance the interests of the parties and the administration of justice.

Although the court criticized the plaintiff’s counsel’s conduct as inexcusable, it concluded the plaintiff would suffer prejudice if forced to proceed without the expert’s live testimony and there was no evidence of non‑compensable prejudice to the defendants.

The trial was adjourned and directed to be rescheduled peremptory on the plaintiff.

The plaintiff sought certification of a products liability action concerning an allegedly defective hip implant as a class proceeding under the Class Proceedings Act, 1992.

The defendants consented to certification.

The court considered the statutory criteria under s. 5(1), including the existence of a cause of action, an identifiable class, common issues, preferability, and adequacy of the representative plaintiff.

The court noted parallel litigation in British Columbia concerning the same medical device and concluded that certification would protect the rights of class members who did not opt into the British Columbia action.

The court found all statutory criteria satisfied and certified the proceeding as a class action.

Two related class actions arising from a tuberculosis exposure incident at a hospital sought court approval of a negotiated settlement and class counsel fees under the Class Proceedings Act, 1992.

The litigation followed exposure notices issued to thousands of individuals after two patients were diagnosed with tuberculosis, leading to claims of negligent failure to diagnose and prevent transmission.

After extensive discovery, expert evidence, and partial summary judgment dismissing claims of uninfected class members, the remaining infected class claims were scheduled for a common issues trial.

The parties reached a $1.7 million settlement establishing a compensation scheme based on varying likelihoods of causation.

The court held the settlement fell within a reasonable range and was in the best interests of the class, and it also approved a 30% contingency fee and honorariums for the representative plaintiffs.

A physician applied under s. 24(1) of the Canadian Charter of Rights and Freedoms for remedies following an unlawful police search of his home computer that uncovered child pornography.

The criminal charges were withdrawn due to an invalid search warrant, but the physician’s professional regulator obtained a copy of the hard drive and commenced disciplinary proceedings.

The applicant sought orders requiring destruction of the copied hard drive and prohibiting the regulator from relying on the evidence in the discipline hearing.

The court assumed serious Charter breaches, including possible bad faith by police, but held that neither destruction nor prohibition was appropriate or just in the circumstances.

The Discipline Committee was best positioned to determine the admissibility of the evidence under s. 24(2) in the administrative proceeding.

The defendants brought summary judgment motions seeking dismissal of a personal injury claim arising from a teeth whitening procedure performed by a dental hygienist.

The court held that allegations concerning negligent performance of the procedure required expert evidence regarding the applicable standard of care.

Because the plaintiff failed to provide admissible expert evidence meeting the requirements of Rule 53.03, the claims for negligent performance and breach of contract were dismissed.

However, the court found a genuine issue requiring a trial on whether the plaintiff gave informed consent, as the parties presented conflicting evidence regarding disclosure of the risk of burns.

The court also held that expert evidence was not required to determine whether the material risk of burns had been disclosed, and that the issue of potential vicarious liability of the dentists for any breach of disclosure duty remained for trial.