This action arose from a 2014 fatality of a 51-year-old man following a splenic rupture. The plaintiffs were the spouse and sons of a patient who was cleared to return to work in rural Ontario after having been admitted to hospital for abdominal trauma, including a broken rib, from falling at home while doing renovations. The defendants at trial were the general surgeon who saw the patient in hospital and the family physician who saw the patient in follow-up after he was discharged. The patient died of a splenic rupture 14 days after the fall that brought him into the hospital.
The trial judge dismissed the action in July 2022, in a judge alone liability trial (damages were agreed upon). The trial judge found that neither defendant breached the standard of care and that the plaintiffs had not established causation.
The Court of Appeal dismissed the appeal in November 2023. The primary grounds of appeal were the sufficiency of the trial judge’s reasons on the issues of standard of care and causation. The appellants also disputed the trial judge’s analysis of the respondents’ credibility.
Sufficiency of Reasons
The Court held that the trial reasons were sufficient because they did not frustrate appellate review. Nevertheless, Justice Lauwers seemed to acknowledge there was a basis for the appeal as set out as follows in the single footnote to the decision:
This was a complex and emotionally laden case. Even though these reasons were, once supplemented by the record, adequate for the purposes of appellate review, they were inappropriately terse. The reasons did not treat the appellants’ claim with the dignity it deserved, and one can understand how the appellants would, incorrectly, conclude from the reasons that the trial judge had not taken sufficient care to understand the case. The primary audience for a trial judge to keep in mind is the losing party, who is entitled to be treated with due respect, and to know why the decision was reached and why the proffered evidence and arguments were rejected. See Sir Robert Megarry, V.C., “The Judge” (1983), 13 Man. L.J. 189, at p. 194. See also Robert J. Sharpe, Good Judgment: Making Judicial Decisions (Toronto: University of Toronto Press, 2018), at p. 136.
The reasons were sufficient, according to the Court, based on the trial judge’s analyses of the issues of standard of care, credibility and causation.
Standard of Care
The appellants argued that the trial judge erred by not specifically particularizing the standards of care applicable to each defendant because they were both found to have met the standard based largely on a finding that there was no evidence of splenic injury during their care. The Court disagreed and held that “[t]he trial judge’s reasons show that he engaged with the standard of care that was applicable to each Respondent. The trial judge summarized the testimony of the competing experts, and this summary reveals the standard of care owed to Mr. Willick by each respondent.”
Credibility
The appellants argued that the trial judge erred in his treatment of the respondents’ credibility at trial. They argued that the discharge summary and letter to the coroner both signed by the general surgeon referred respectively to hemoperitoneum (evidence of a splenic injury) and an actual splenic injury being treated conservatively in hospital, and that there was no documentation of a key discussion between the general surgeon and a radiologist. The family physician, the appellants argued, based his decision that there was no splenic injury on information they said he did not have at the time of his follow-up appointment.
The Court disagreed, emphasizing the high standard for displacing credibility findings, and was satisfied that the trial judge accepted the respondents’ evidence at trial as the basis for finding that they were credible.
Causation
The appellants argued that the trial judge erred as to causation because:
- an intervening event was not pleaded,
- his conclusion that there was an intervening event was an “irrational inference”,
- he did not clearly specify why he accepted that an intervening trauma had caused the death, and
- he did not address whether being at home rather than at work would have improved the likelihood of surviving.
The Court disagreed and found that the trial judge did not need to make findings as to the cause of death or the likelihood of surviving, having found no breach of the standard of care. The Court was also satisfied with the trial judge’s conclusion that the patient must have suffered another trauma shortly before he died and summary of the evidence on this point.
Conclusion
This case was hard fought over many years. It started in Toronto and was transferred to Welland. It was delayed due to the pandemic, formally adjourned to secure a fixed trial date and went to the Court of Appeal. The result was not favourable for the plaintiffs, but this case emphasizes the importance of written reasons in judge alone trials.
