By Patterson MedMal on 4/1/2013 3:17 PM
Edwardson v St Joseph’s Healthcare Hamilton (St Joseph’s Hospital),
2012 ONCA 719, a recent Ontario Court of Appeal case, considered the issue of informed consent when multiple physicians are consulted. The facts of the case are as follows: The plaintiff had a consult with a physician in Nova Scotia for a cervical rhizotomy, a procedure for managing problem nerves. The surgery was performed in Ontario and the plaintiff suffered a stroke as a result of it. The plaintiff sued Dr. Kahn, who performed the surgery, and argues that the doctor failed to obtain informed consent. At trial, the plaintiff was successful and was awarded $200,000 in general damages and $100,000 in future economic loss. Dr. Kahn appealed the decision.
By Patterson MedMal on 3/13/2013 8:21 AM
Section 51 of British Columbia’s Evidence Act provides that a witness in a legal proceeding, whether party to it or not, must not be permitted to answer a question or produce a record related to an investigation into a hospital’s safety, patient care, and practices.
The recent case Parmar v Fraser Health Authority, 2012 BCSC 1596 considered the issue of admissibility of this type of hospital records. The plaintiff in Parmar was the litigation guardian of Harsimran Parmar, an infant who suffered from severe brain damage due to oxygen deprivation prior to his birth. An action was commenced for medical malpractice.
By Patterson MedMal on 3/6/2013 1:59 PM
The Ontario Superior Court of Justice nearly dismissed a recent case, Robbs v. Lee, 2012 ONSC 6853, for delay, as the case was still nowhere near ready for trial over twelve years after the patient’s death which sparked the lawsuit.
In June of 1999, the patient Pamela Robbs died following complications from surgery. Her family commenced a lawsuit in June of 2000, alleging that the doctor primarily responsible for her care and the staff of the hospital where she was treated were negligent in failing to properly monitor her post-operative condition.
The parties were provided with a pretrial conference in April 2007 and the trial was put on the list for September 2008. By August 2008, however, the action was still not ready for trial, as the plaintiffs had failed to secure necessary expert reports, and so it was struck from the trial list. In March 2009, the defendant hospital and doctor arranged a discovery of the main plaintiff. No steps had been taken to advance the action between March 2009 and February 2012, and the defendants brought a motion seeking an order to dismiss the action for delay.
By Patterson MedMal on 1/28/2013 3:49 PM
When a patient gives consent to a medical procedure, it must meet the standard of informed consent. It is important that patients have a clear understanding and appreciation of the risks involved in medical care. The issue of informed consent arises in many medical malpractice cases and recently, the British Columbia Supreme Court considered the issue in Rasman v Regan
, 2012 BCSC 1650.
, the patient had broken his collar bone while snowboarding. He was seen by Dr. Regan, an orthopedic surgeon, who recommended surgical repair. The surgery, as well as its risks and complications, were explained to the patient, and the patient signed a consent form acknowledging such.
By Patterson MedMal on 1/17/2013 11:16 AM
As discussed before on this blog, medical malpractice cases typically involve complicated medical evidence beyond the understanding of the ordinary trier of fact (judge, or judge and jury), so medical experts are often called to help explain the issues and provide their opinion on the case. Before the expert’s opinion will be considered by the court, he or she must be qualified as an expert in the relevant field by proving to the court that he or she has the background, training and experience necessary to provide a useful opinion.
A medical expert is not someone simply picked off a shelf. In medical malpractice cases, lawyers carefully select the expert whose evidence they believe will be accepted by the court. Factors which may lead the court to accept the evidence of one expert over another include the expert’s knowledge and relative expertise in the area as well as his or her presentation in court – to be taken seriously by the judge, experts must be objective and fair in giving their evidence.
By Patterson MedMal on 1/17/2013 9:36 AM
One important consideration to be made in pursuing a medical malpractice case is which parties to involve. Depending on the circumstances, a medical malpractice claim could not only involve one or more doctors, but nurses, equipment manufacturers, hospitals, clinics, and health authorities as well.
A recent British Columbia Supreme Court case, Basil v Interior Health Authority, 2012 BCSC 1158 (BCSC), raises the issue of a hospital’s vicarious liability for negligent treatment of patients by its employees. Vicarious liability is when liability for a person’s negligence is imposed on another party. Claiming against a party for vicarious liability can be appealing to plaintiffs as it may increase the chance of financial recovery.
By Patterson MedMal on 12/14/2012 3:17 PM
All medical malpractice cases involving alleged negligence consider the standard of care. Negligence is not found when there is no breach of the standard of care, so it is very important to know what that standard is. Generally, the standard of care is that all medical practitioners must uphold a reasonable level of skill and knowledge, and exercise a reasonable degree of care expected of a normal, prudent practitioner. However, the standard of care for medical practitioners specializing in a certain field is that of a normal, prudent practitioner of the same experience and standing. Specialists are expected to have a higher degree of skill, training, and ability in their area of practice.
Adams v. Taylor, 2012 ONSC 4208, a recent case from Ontario, considered the standard of care expected of specialists, and how the court should assess standard of care generally. In Adams, the Plaintiff had been seen by her family doctor for a lesion between her toes which the Plaintiff had for about a year by that time. She was referred to a dermatologist who was asked to see the Plaintiff ASAP to rule out melanoma. The dermatologist, Dr. Taylor, diagnosed the lesion as “probably benign” but suggested it was better off than on. Due to the location of the lesion, Dr. Taylor thought a plastic surgeon should do the excision and made a referral to Dr. de Kleer. Dr. Taylor did not specify in her letter to Dr. de Kleer that melanoma was a possibility, or that excision should be urgent. She also did not include the referral letter from that Plaintiff’s family doctor asking her to rule out melanoma.
By Patterson MedMal on 12/12/2012 3:22 PM
Experts are often called to testify in medical negligence cases to assist the trier of fact in making various determinations surrounding evidence, which is outside of their range of experience, to rule on the issues put before them.
The decision Gutbir v University Health Network, 2010 ONSC 6394 involved a medical negligence claim against a hospital and its employees surrounding the birth of Zmora Gutbir. This matter was tried by jury, and experts were called to provide evidence with respect to liability and causation relating to the brain injury Zmora suffered following her birth.
At trial, the Plaintiffs intended to call Dr. Max Perlman, a neonatologist, to testify about his treatment of Zmora as well as to have him qualified as an expert in order for him to give an opinion regarding the cause of Zmora’s brain injury and disability. The Defendant Hospital objected to the qualification and submitted that given the nature of Dr. Perlman’s evidence and the fact that he was a treating physician, he lacked the necessary objectivity to testify as an expert. It was further submitted that given the complexity and scientificity of the evidence, it would be difficult for the jury to distinguish between Dr. Perlman’s factual evidence as a treating doctor and opinion evidence as an expert witness. In contrast, the Plaintiffs argued that the Dr. Perlman did not have an interest in the outcome of the matter, that his objectivity as an expert was not lacking regardless of being a treating physician, and that the fact that this was a medical negligence case did not signify that a jury would not be able to properly comprehend his evidence.
By Patterson MedMal on 12/5/2012 9:12 AM
Where a patient being treated for a mental illness is injured during a hospital stay, courts have generally been cautious about finding negligence on the part of the hospital, sometimes even where the treating psychiatrist or other hospital staff truly have made errors of judgment.
One reason it can be harder to make out a claim for an injury to a patient staying at a psychiatric hospital is due to the kinds of facts involved in these cases, which often differ from those in other medical malpractice litigation. This can make it harder for psychiatric patient plaintiffs to prove their injury is a result of the negligence of the health professional or facility. For example, rather than legal issues of causation or whether there was consent, which are normal in a typical doctor-patient medical malpractice case, cases alleging negligence on the part of a psychiatric hospital frequently involve issues of foreseeability.
Basically, to prove negligence, your particular injury must have been a foreseeable result of the actions of the other party. For example, it is foreseeable that if a patient at a hospital is given too much medication, that patient may be injured or die from an overdose. It is a natural and probable consequence of the breach, and negligence is made out.
By Patterson MedMal on 11/23/2012 2:56 PM
Plaintiffs pursuing medical malpractice claims must file their claim with the court before the end of what is called the limitation period. Nova Scotia’s Limitations of Actions Act
RSNS 1989 c 258, states that claims in medical malpractice must be initiated within two years
of the termination of medical services. The Act
does allow judges to waive the limitation period if the merits of the case outweigh prejudice to the other party, but judges are only permitted to use their discretion if the action is commenced within four years
of the expiry of the limitation period.
Some jurisdictions, such as Ontario, apply the rule of discoverability to medical malpractice cases. Discoverability means that the limitation period does not begin until a potential claim is discovered (or ought to have been discovered) by the plaintiff.