In October 2013, the 27-year-old patient attended the emergency department at the Sault Area Hospital by ambulance and was treated by the defendant emergency physician. The working diagnosis was intoxication and the patient was discharged home. The following morning, the patient reported feeling fine to her parents. When her parents returned home from work, they found her in a significantly worse condition and called an ambulance. Upon arrival at the hospital, it was determined that the patient had suffered a cerebellar infarct and had severe brain swelling compressing her brain stem. Three days later, the patient’s life support was discontinued and she passed away. The patient’s parents, brother and grandfather brought the action.
The plaintiffs’ expert opined that the defendant breached the standard of care in the following ways:
- She failed to investigate the patient’s significantly elevated white blood cell count and failed to make sufficient inquiries into infection;
- She incorrectly concluded the patient’s presentation was consistent with marijuana intoxication;
- She failed to perform a thorough neurological examination, including performing a gait assessment and evaluating the patient’s cerebellar function;
- She failed to consider any differential diagnoses; and,
- She failed to order a CT scan despite the patient’s neurological symptoms.
The trial judge preferred the evidence of the defendant’s expert and found that the plaintiffs’ expert relied on erroneous facts, which the expert admitted were in error on cross-examination. Among other things, the plaintiffs’ expert acknowledged:
- his understanding that the defendant assessed the patient twice was incorrect, when in fact the defendant assessed the patient five times;
- the defendant inquired as to the patient’s respiratory, abdominal, and urinary condition, and infection was not the cause of the patient’s death;
- the patient did not have nystagmus or ataxia of movement or speech, which would tend to point away from a cerebellar cause of presentation;
- he incorrectly concluded the defendant failed to consider differential diagnoses; and
- he incorrectly stated the Patient was dizzy and had a severe headache.
On the issue of causation, the trial judge once again preferred the evidence of the expert called by the defendant. The plaintiffs’ expert opined that the patient suffered a stroke on the date of the first hospital attendance, whereas the defendant’s expert opined the stroke did not occur until the following day. The trial judge found that the plaintiffs’ expert based his opinion on assumptions of facts that were misinterpreted, whereas the defendant’s expert relied on the medical documentation.
The trial judge assessed the Family Law Act damages in the amount of $75,000 each for the mother and father, $40,000 for the brother and $20,000 for the grandfather, who unfortunately passed away before trial.