The defendants’ appeal to overturn the trial judgment, which held them responsible for shortcomings in prenatal maternal monitoring, was unsuccessful.
The Court of Appeal upholds the trial judge’s findings of negligence in a medical malpractice case, emphasizing deference to factual conclusions and the absence of reviewable errors, as the defendants’ appeal is dismissed.
Background
In this case, a pregnant woman presented at a hospital with symptoms of increasing head and neck pain, visual disturbances, and light sensitivity. She was evaluated and discharged with a diagnosis of neck strain. Two days later, she had an eclamptic seizure and underwent an emergency C-section, resulting in her child being born with severe spastic quadriplegic cerebral palsy. Following weeks of expert testimony, the trial judge determined that the hospital nurse likely did not take the patient’s blood pressure, which would have led to a diagnosis of preeclampsia. The judge also found that the doctor failed to properly assess the patient’s condition. As a result, liability was apportioned 70% to the nurse and the hospital and 30% to the doctor for their failure to meet the expected standard of care.
The Court of Appeal for British Columbia
The defendants appealed the factual findings of the trial judge and the apportionment of liability in this case. The Court of Appeal carefully reviewed the trial judge’s findings and explained that their role was not to determine if the judge was “right” or “wrong,” but rather to assess whether there were any reviewable errors, such as errors of law or palpable and overriding errors of fact.
Regarding the trial judge’s findings on the nurse’s failure to take the plaintiff’s blood pressure, the Court of Appeal acknowledged that one of the reasons for this conclusion was the beeping of the monitoring machine, which the judge interpreted as a sign of an abnormal reading. While the appeal court recognized that the trial judge’s interpretation was a palpable error, they deemed it not to be an overriding error that would substantially affect the findings of negligence. The judge’s conclusion that the nurse did not take the blood pressure was based on multiple factual considerations, and the beeping of the machine played a relatively small role in the overall assessment.
In terms of the trial judge’s assessment of the evidence against the defendant doctor, the Court of Appeal emphasized that the judge made findings of fact based on credibility and the evidence presented. They upheld the trial judge’s discretion in finding that the doctor had not asked the necessary questions to elicit the information required for a proper diagnosis.
Regarding the apportionment of liability, the Court of Appeal found no grounds to disturb the trial judge’s decision. They noted that the nurse’s negligence in failing to take the blood pressure was a significant error in the circumstances of the case, and therefore, the trial judge’s apportionment of 70% liability to the nurse (with vicarious liability for the hospital) and 30% liability to the doctor was not grossly disproportionate.
The Court of Appeal supported the trial judge’s factual findings and reasoning, highlighting the deference owed to the trial judge in weighing evidence and making credibility determinations. They concluded that there were no reviewable errors that would warrant overturning the trial judge’s findings of negligence and the apportionment of liability.
The Court stated that the
“task is not to ask whether the judge got it “right”, but rather to ask whether it has been demonstrated that the judge got it wrong by committing reviewable errors: errors of law or palpable and overriding errors of fact. We must approach this task with a high degree of deference to the factual conclusions reached by the trial judge”
The appeal was dismissed.
Read the full case here or find a case summary on the Ontario Trial Lawyers Association Blog.
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From the Supreme Court of Canada