Timely imaging and treatment would have likely led to a good outcome for the victim: court
The Ontario Court of Appeal upheld a ruling finding a doctor negligent in treating a stroke victim, causing permanent injuries.
The trial judge had previously determined that the doctor's breach of the standard of care in the emergency department at a Mississauga hospital led to a delay in diagnosis and treatment, resulting in severe long-term damage. The parties had agreed on the damages, leaving the question of liability as the focal point of the appeal.
The court’s review highlighted that the victim, who initially sought medical attention for dizziness, nausea, and vomiting, was misdiagnosed with peripheral vertigo and discharged without proper neurological consultation or a CT angiogram. The doctor's failure to follow up on a referral note suggesting the possibility of a stroke and his subsequent actions were deemed negligent.
On appeal, the doctor accepted the finding that the stroke was caused by a blood clot and that proper treatment would have been initiated if he had met the standard of care. However, he contested the trial judge’s conclusion that his negligence directly caused the victim’s injuries. The appellant argued that the plaintiffs failed to prove which specific treatment would have been administered and that it would have prevented the stroke’s damaging effects.
The Court of Appeal dismissed this argument, affirming the trial judge’s application of the “but for” causation test. The trial judge’s detailed analysis, grounded in expert testimony, established that the victim would have been assessed by a neurologist and received appropriate treatment if not for the doctor's negligence. The court noted that timely imaging and treatment, including recanalization procedures available at the hospital, would have likely led to a good outcome for the victim.
The ruling emphasized the robust and pragmatic approach required in medical malpractice cases, where the plaintiff must show on a balance of probabilities that the defendant’s negligence caused the injury. The court found no error in the trial judge’s reliance on expert evidence and rejection of the defence’s alternate theories.
In conclusion, the Ontario Court of Appeal upheld the trial judge’s decision, confirming that the doctor's negligence caused the victim’s debilitating injuries. The appeal was dismissed, and costs were awarded to the respondents in the agreed amount of $60,000.
