Halifax Medical Malpractice Lawyer Blog

X-Ray Errors

Central Newfoundland Regional Health Authority has suspended a radiologist for the second time since 2007. Dr. John Ozoh was removed from his duties after a review of 2,500 of Ozoh's radiology reports. 20% of the reports required "edits" and 120 of the errors were:

"...potentially clinically significant,"

according to the Health Authority.

Does "Clinically Significant" Mean Dangerous?

Maybe. Say for example a doctor misreads an x-ray showed signs of lung cancer. Cancer can kill you. So that error would be both clinically significant and dangerous.

But say the x-ray shows what looks like a tumour. A biopsy shows that the tumour is benign (harmless). In that case the mistake was clinically significant, but not dangerous, because the tumour wasn't cancerous.

Sometimes You Can't Tell

The problem is that sometimes (many times) you cannot tell if an abnormality on a diagnostic image is harmless or dangerous without doing further tests.

That is where the problem lies. If Ozoh has misread diagnostic reports that resulted in patients not getting proper medical treatment, people may have been injured, or died, because of his failure to identify "clinically significant" abnormalities.

Doctor Has Not Admitted Doing Anything Wrong

Ozoh has indicated he will appeal his suspension.

Want More Information?

CBC has reported that an information line has been set up for patients. The number is difficult to find since it is buried in the Health Authority website.

If you would like more information, call their toll free number at 1-877-705-6326

Continue reading " NL Radiologist Suspended for Second Time " »

There's an interesting article in today's issue of the Wall Street Journal about how medical malpractice lawsuits help provide better medical care.

According to the article:

“Medical professionals are finding lessons in these and other past malpractice cases. By analyzing the breakdowns in care that led to missed, delayed or incorrect diagnoses, insurers and health-care providers are developing programs to avert mistakes. . . . Diagnostic errors are the leading cause of malpractice suits, accounting for as many as 40% of cases and costing insurers an average of $300,000 per case to settle, studies of resolved claims show. Peter Pronovost, a patient-safety researcher at Johns Hopkins University, estimates that diagnostic errors kill 40,000 to 80,000 hospitalized patients annually, based on autopsy studies over the past four decades.”

The article quotes American statistics, but the issues are the same here in Canada. Medical errors kill up to 24,000 Canadians every year.

In fact, the Canadian Medical Protective Association issues a newsletter notifying doctors about medical negligence lawsuits across the country. The idea is that by educating doctors about mistakes made in cases that lead to a lawsuit, physicians can avoid making similar mistakes in other cases.

Litigation brings problems that might otherwise be hidden to light. Education and awareness helps prevent the problems from happening again.

Many Calls but Few Claims

I get hundreds of calls each year from people who think they have been the victim of medical malpractice.

Often the patient has very serious residual injuries or long term disability.

Sometimes a family member has passed away and the family is wondering if their loved one was a victim of medical malpractice.

But relatively few claims actually proceed to file a lawsuit or go to court. One of the reasons for that was examined in detail in a recent decision by the Ontario Court of Appeal.

No Causation = No Compensation

One of the most difficult concepts to explain to victims of medical malpractice is that their claim for compensation is limited only to the injuries caused by the defendant’s negligent conduct.

Causation is often the most difficult hurtle that a victim of medical malpractice has to overcome in order to receive compensation.

The Ontario Court of Appeal has confirmed this fundamental principle of medical malpractice claims

In Rollin v. Baker the plaintiff broke he wrist. The doctor that treated her in the emergency room was found to be negligent. However, the Ontario Court of Appeal reduced the amount of compensation that she was entitled to receive. The Court of Appeal found that the plaintiff’s damages were limited to the harm caused by the poor medical treatment and did not include all of the damages caused by the broken wrist.

The Court of Appeal summed up the evidence on causation as follows:

“In assessing non-pecuniary damages at $90,000, Dr. Baker submits that the trial judge improperly awarded Ms. Rollin damages for all of the pain and suffering associated with her broken wrist rather than for that resulting from the delayed detection of the displacement during the healing process. The trial judge’s reasons contain only the following sentence with respect to non-pecuniary damages. “After reviewing all of the evidence, it is my view that the appropriate amount under this head of damages would be $90,000.”

While that single sentence does not explain the basis of the amount, the trial judge’s unqualified review of how Ms. Rollin’s injured wrist has affected her life, plus her identification, in para. 14 of her reasons, of one of the issues before her as “the damages that Carole Rollin sustained as a result of the Colles’ fracture of her left wrist”, strongly suggest that the trial judge did assess damages as though Dr. Baker was responsible for all of the injuries his patient suffered as a result of the fall.

Furthermore, as I will discuss below, $90,000 is several times the usual quantum awarded for non-pecuniary damages in the case of a defendant fixed with full responsibility for a broken wrist, however severe the after-affects. Given the lack of reasons for assessing the damages at this amount and the strong suggestion of an error, this aspect of the judgment is not entitled to deference.”

If you want more information about the law of causation as it relates to medical malpractice claims, you can take a look at my book, The Consumers Guide to Medical Malpractice Claims in Canada.

The book is for sale on Amazon.

But, if you live in Atlantic Canada, I will send you a copy of the book free if you contact me through this blog.

I am currently investigating a medical malpractice claim where my client suffered catastrophic injuries after developing pre-eclampsia so this story caught my eye.

CTV News has reported that an international team of doctors claim to have discovered 14 telltale metabolites that appear in the blood in early pregnancy that signal an increased risk for pre-eclampsia.

The researchers hope the discovery could one day mean a simple, cheap blood test for the life-threatening condition.

Man Dies In Hospital Waiting Room
The family of an aboriginal man found dead after spending 34 hours in an emergency department says it will sue a Winnipeg hospital, medical staff, the regional health authority and the Manitoba government.

Brian Sinclair, a 45-year-old double amputee with a speech problem, was found dead in his wheelchair in the Winnipeg Health Sciences Centre's E. R. after spending 34 hours in the hospital's waiting room.

Death Could Have Been Prevented

An autopsy performed shortly after his death by the province's Chief Medical Examiner determined Sinclair died of a blood infection. Dr. Thambirajah Balachandra, said Sinclair's death could have been prevented if the blood infection had been treated.

Sinclair's family is now considering a lawsuit against the Hospital and the Health Authority.

Wait Times a Potentially Deadly Problem

Emergency Room wait times are a constant and growing problem in hospitals across the country. For example see Sick, Injured Patients Flood Halifax Emergency Rooms where the CBC reported that Dr. John Ross, Head of the Emergency Department at the QEII Health Sciences Centre , the province's largest E.R., declared a "code orange" for about an hour, as patients lined the corridors and others waited outside in ambulances because of a lack of suitable hospital beds.

Dr. Ross has since tendered his resignation from Capital Heath.

Delays Increase Costs Decrease Quality of Care

An article published in July in the BMC Emergency Medical Journal confirmed that Emergency Department delays contributed to increased health care costs and decreased quality of care.

There are many reasons for Emergency Room delays. The solutions are not simple. However, as long as Emergency wait times continue to increase, patient care is going to suffer.

What do you think can be done to decrease wait times? Let me know what you think in the comments.

Continue reading " Medical Malpractice Claim Filed After Hospital Waiting Room Death " »

Today the Supreme Court of Canada issued a decision refusing to grant leave (permission) to hear the appeal of a case from Alberta dealing with the issue of standard of care in medical malpractice compensation claims.

The Court of Appeal decision in Nattrass v. Webber reminds us that the practice of medicine is constantly evolving and this may affect the issue of the standard of care.

Four Things You Need to Prove

As I have explained in earlier posts, there are four things that a medical malpractice victim needs to prove in order to succeed with their claim:

Standard of Care: The claimant must prove what the standard of care is with respect to the medical procedure involved in the claim. In other words, what is the standard expected of a reasonably competent doctor (or nurse or other health professional) when conducting the medical procedure that may have caused the claimant’s injury?

Breach of the Standard of Care: The plaintiff must also prove that the defendant failed to meet the standard of care. In other words, that the doctor did something that a reasonably competent doctor would not have done, or the doctor failed to do something that a reasonably competent doctor would have done.

Causation: The plaintiff must also prove that the defendant’s breach is what actually caused the plaintiff’s injuries. Even if the doctor was negligent, if the doctor’s negligence was not the actual cause of the plaintiff’s injuries, the defendant will not be found liable (responsible) for the plaintiff’s injuries.

Damages: Finally, the plaintiff must prove what damages or losses they have suffered as a result of the defendant’s negligence. This would include non-pecuniary damages (what is commonly referred to as "pain and suffering") as well as the economic losses for things like ongoing medical care or loss of income.

The Facts

In the Nattrass case Mr. Nattrass fell and broke his ankle. He had surgery to repair the fracture. The surgery was performed by the defendant physicians, Dr. Webber and Dr. Harley.

Mr. Nattrass was given a blood thinner, Heparin, to prevent unnecessary clotting after his surgery. Dr. Webber and Dr. Harley did not issue any orders to increase the blood tests that Mr. Nattrass was receiving to ensure that he did not have any unusual reactions to the medication.

Unfortunately, Mr. Nattrass developed deep vein thrombosis which is an unusual (although known) adverse reaction to the medication he was receiving. As a result, he ended up having to have both of his legs amputated.

At trial, the judge found that if the doctors had ordered more frequent testing of Mr. Nattrass’ platelet levels, the adverse reaction would have been discovered in time to save Mr. Nattrass’ legs. The trial judge found the defendants negligent.

However, the Alberta Court of Appeal reversed the decision finding that, on the basis of the evidence led at trial, the standard of care at the time that Mr. Nattrass had his surgery, he did not require more frequent blood tests.

Not Perfect Care-Just Competent Care

In other words, although the defendant doctors could have done more to prevent Mr. Nattrass’ injury, they met the standard that was required of them at the time Mr. Nattrass suffered his injury.

The Supreme Court of Canada denied Mr. Nattrass’ leave to appeal, confirming the decision of the Court of Appeal.

No Rear View Mirror in Medical Malpractice Claims

As the saying goes, hindsight is 20/20. In other words, it is very easy to look back after a patient has been injured or died to figure out what could have been done differently to prevent the patient’s injury or death. However, the courts do not look at medical malpractice claims in the rear view mirror.

Judges and juries are required to look at the evidence to determine what the standard expected of the doctor was at the time the patient was injured. Standards of medical practice change over time and patients must be careful that they lead the appropriate evidence and have supporting opinions that establish the standard of care during the appropriate time frame.

Further reading:

Medical Malpractice Claims: Is Expert Evidence Always Necessary?

Doctor’s “Error in Judgment” is not Negligence

The Top 5 Defences to Medical Malpractice Claims