Sask.’s top court rules duty of fairness limited at complaint stage where inmate sued a jail nurse

The Saskatchewan Court of Appeal has ruled in a recent professional misconduct case that an administrative investigation committee’s duty of fairness at the complaint stage is limited in scope.

Joey Toutsaint was an inmate at the Saskatchewan Federal Penitentiary. He filed a complaint with the Saskatchewan Registered Nurses’ Association (SRNA) regarding the conduct of Maja Grujic, a registered nurse employed at the prison. SRNA is now known as the College of Registered Nurses of Saskatchewan.

In 2019, Grujic administered Toutsaint’s medication in accordance with a healthcare provider’s instruction. Toutsaint expressed concern about the dosage and demanded to see the empty medication packages. Grujic refused, and the situation escalated with Toutsaint becoming distressed, angry, and threatening self-harm.

Following the incident, Grujic filed a charge form to commence inmate disciplinary proceedings against Toutsaint. In turn, Toutsaint filed a complaint with the SRNA, alleging that in commencing a disciplinary action against him, Grujic had “participated in proceedings which could result in cruel treatment” to an inmate.

Threshold for further investigation was not met

The SRNA’s investigation committee ruled that the matter did not meet the threshold for further investigation, and the evidence did not support professional misconduct or professional incompetence. The Court of King’s Bench dismissed Toutsaint’s application for judicial review of the committee’s decision. Toutsaint then brought the matter to the Saskatchewan Court of Appeal.

Duty of procedural fairness is limited in scope

Before the appeal court, Toutsaint argued that the SRNA owed him, as a complainant, a duty of fairness in handling his complaint. The SRNA acknowledged that it owed a duty of fairness to Toutsaint at the complaint stage, but this duty is limited. The SRNA also emphasized that it is the regulator’s role, not the complainant, to ensure that professional standards of conduct are met.

The appeal court said that a complainant is not a party to the discipline process, is not subject to potential sanctions, and is not entitled to participate in the same manner as the subject of the complaint. In any case, the court agreed that a limited duty of fairness is owed to a complainant at the investigation state. Accordingly, Toutsaint is entitled to challenge the committee’s decision regarding the alleged breach of duty through a judicial review.

No breach of procedural fairness

Toutsaint asserted that the SRNA investigation committee failed to consider the central aspects of his complaint and decide about each one. As a result, he claimed he was denied procedural fairness.

The appeal court explained that the investigation committee regime provides a screening mechanism determining whether a complaint has sufficient merit to be referred to the discipline process. After the committee’s investigation, it will decide whether to take further action and refer the matter to the discipline committee.

Toutsaint asserted that the investigation committee failed to consider the ethical concerns that he raised in his complaint. The SRNA argued that it did consider the salient issues raised in Toutsaint’s complaint.

The court found that the core issues raised by Toutsaint’s complaint were conflict of interest, participation in proceedings which could result in cruel treatment, failure to act in his best interests as her patient, and disclosure of confidential information for discipline. After considering the evidence filed and the context of SRNA investigations, the court ruled that the investigation committee did consider the issues raised by Toutsaint. The court further said that the committee’s decision repeatedly indicated that the investigation committee reviewed all the material before it, which included Toutsaint’s written complaint, which described the core issues raised.

The court said that the investigation committee was aware of the alleged ethical violations and determined that there were no grounds for referring the matter to the discipline committee. It was not necessary for the investigation committee to repeat and explicitly list the specific allegations and provide some substantive analysis at the screening stage. The court concluded that the committee had not breached the duty of procedural fairness it owed to Toutsaint.