The injury is exceptional and indicative of a breach of standard care: court
The Ontario Superior Court of Justice has ruled in favour of the plaintiff in a medical malpractice lawsuit, finding that surgical negligence during a shoulder replacement procedure caused significant nerve damage.
In Dallner v. Gladwell, 2024 ONSC 6557, the plaintiff sought damages after sustaining a brachial plexus injury during shoulder replacement surgery performed in 2018. The injury resulted in severe and permanent nerve damage, impacting the plaintiff's mobility and quality of life. The court’s judgment turned on whether the surgeon had breached the standard of care required during the operation.
The court concluded that the injury was more likely than not caused by excessive force or prolonged stretching of the plaintiff’s arm during the procedure, specifically during the exposure of the glenoid socket. While acknowledging that nerve injuries can occur even when appropriate precautions are taken, the court found the extent and severity of the plaintiff's injury to be exceptional and indicative of a departure from the standard of care.
The parties presented experienced orthopaedic surgeons as witnesses. The plaintiff’s expert argued that the injury was highly unusual and likely resulted from excessive force or prolonged positioning. On the other hand, the defence maintained that the surgery adhered to established protocols and that the injury could have been due to factors unrelated to negligence, such as the plaintiff's anatomy or prior injuries.
The court found the defence’s alternate explanations unconvincing, noting that the plaintiff was deemed a suitable candidate for surgery with no pre-existing vulnerabilities identified. The court also highlighted inconsistencies in the surgeon’s account and a lack of documentation regarding the duration of arm positioning during the procedure.
The Superior Court emphasized that while surgeons must exercise professional judgment, errors in judgment that lead to preventable injuries may constitute negligence. The court rejected the defence’s argument that the injury resulted from a rare but unavoidable complication, concluding that a breach of the standard of care occurred.
Ultimately, the court held the surgeon liable for the plaintiff’s injury and awarded damages, which had been agreed upon by both parties before the ruling.
