Ontario Court of Appeal upholds anesthesiologist’s liability in severe birth complications case

The Ontario Court of Appeal found an anesthesiologist liable in a medical malpractice case involving severe birth complications.

In Hemmings v. Peng, 2024 ONCA 318, Sophia Hemmings experienced a cardiac arrest while undergoing a cesarean section, resulting in permanent brain damage. She was 29 at the time of the incident. The case has focused on determining the liability of the involved healthcare practitioners and the hospital.

The lawsuit initially named several defendants, including Dr. Lloyd Padmore, Dr. Carol Peng, Dr. Sharon O’Brien, Dr. Neil Jamensky, and Scarborough Hospital. However, the trial judge dismissed the claims against Drs. O’Brien and Peng, leaving Drs. Padmore, Jamensky, and the hospital to share the liability.

On appeal, the court found for Dr. Padmore and the hospital. Still, it upheld the liability of Dr. Jamensky, the anesthesiologist, who converted Hemmings from regional to general anesthesia during the operation. This decision was crucial as complications during this conversion likely contributed to the cardiac arrest.

The court dissected various aspects of the care provided, scrutinizing the actions taken before and during the surgery. Notably, it focused on whether the medical staff involved could have anticipated the complications that arose. The appellate decision detailed the sequence of events and the rationale behind the anesthesia change, emphasizing the challenges in managing a high-risk pregnancy in a patient with morbid obesity.

Dr. Jamensky's appeal centred on the argument that he was not solely responsible for the outcomes, suggesting other factors, including possible amniotic fluid embolism, could have played a role. However, the court dismissed this, pointing to the lack of supporting evidence for such a scenario and maintaining that the immediate cause of the cardiac arrest was related to the anesthesia complications.

This judgment clarified the responsibilities of healthcare providers in high-risk procedures, emphasizing the need for thorough assessment and adherence to standard care protocols. The decision also underscored the judiciary's role in interpreting complex medical evidence and its impacts on patient care standards.

Ultimately, the court reaffirmed medical practitioners' legal obligations to foresee and mitigate potential risks during surgeries. The ruling partially closes a prolonged chapter of legal battles for Hemmings and her family, who have waited over a decade. However, it leaves them with a split resolution regarding the hospital and Dr. Padmore's involvement.

The hospital was awarded the appeal costs, with the other parties bearing their own costs due to the mixed outcome. The case has been remitted back to the trial judge to reassess the cost orders in light of this judgment, potentially adjusting the financial responsibilities of the involved parties.