Unfortunately, medical malpractice can result in devastating outcomes for individuals and their loved ones. Negligence could result in pain and suffering, or even permanent injuries or death. It often has far-reaching implications for the victim and their family.

This article looks at the recent hospital malpractice decision of the Court of Appeal for Ontario in Stevenhaagen Estate v Kingston General Hospital. In the case, a deceased’s estate trustee claimed that two doctors had caused the deceased serious injuries after failing to consult with a cardiovascular surgeon.

Deceased suffered serious injuries following an angioplasty procedure

The deceased had a congenital heart condition. In 2002, she underwent an angioplasty procedure at the Toronto General Hospital performed by Dr. McLaughlin. The balloon used in the procedure burst and ruptured the deceased’s aorta, creating a serious emergency.

Dr. McLaughlin paged Dr. Sternbach, and the two decided to insert a covered stent into the aorta to attempt to stop the bleeding. This resulted in a temporary stabilization, but the deceased remained seriously compromised. A cardiovascular surgeon was paged twice and attended to but was sent away without any meaningful consultation.

The deceased was later transferred to a different unit, and the cardiovascular surgeon was paged for a third time. He diagnosed ongoing bleeding from the aortic arch and a gathering hematoma in her chest and feared she may have already sustained neurological injury. The deceased was then rushed to surgery, where the aortic tear was repaired.

Unfortunately, the deceased suffered serious injuries, including paraplegia and neurological abnormalities. She died in 2012 and, according to the trial judge, spent “the last decade of her life as an invalid.”

Trial judge found the two doctors liable for the deceased’s injuries

As we have reported previously, for a successful medical negligence case, the plaintiff must show that the defendant breached the standard of care, that the plaintiff sustained damage, and that the damage was caused by the defendant’s breach.

The trial judge found that Dr. McLaughlin and Dr. Sternbach did not meet the required standard of care because after deploying the stent, they failed to immediately consult with the surgeons, which caused the deceased to arrive at the operating room later.

The trial judge also decided that the delay in performing open-heart surgery caused the deceased’s injuries.

As a result, the doctors were held liable for the deceased’s injuries. The amount of damages was agreed upon between the parties. The two doctors appealed the trial judge’s decision.

Court of Appeal agreed that the doctors did not meet the required standard of care

The doctors argued that a surgeon, Dr. Sternbach, was already involved in the deceased’s care.

Justice of Appeal Trotter agreed with the trial judge that the doctors fell below the required standard of care. His Honour concluded:

…in 2002, the “gold standard” in these circumstances was open-heart surgery. Yet, in the face of a catastrophic mishap during an angioplasty procedure, no thought was given to consulting with a cardiovascular surgeon. I agree with the trial judge’s conclusion that this was “inexcusable” given the vast resources available at TGH…

Further, the doctors’ omissions caused the deceased’s injuries

The doctors argued that the deceased’s injuries occurred due to the open-heart surgery and that she would not have been taken to the operating room any earlier if the consultation had occurred sooner.

Justice of Appeal Trotter agreed with the trial judge’s causation analysis. His Honour noted that the trial judge focused on what happened after the deployment of the stent, as any injury that happened before this time would not have been caused by a negligent act of the doctors, and was satisfied that the doctors consulted and arranged to move the deceased to the operating room, she would not have suffered neurological injuries. 

Finally, it was open to the trial judge to accept evidence from the plaintiff’s expert that cardiovascular surgery was inevitable and urgently required. There was also evidence that the trial judge could conclude that, had a timely consultation occurred, the deceased would have received the emergency surgery she required. 

Dr. Sternbach joins in the critical decision not to refer the deceased to a cardiovascular surgeon

Dr. Sternbach argued that he should not be liable for merely supporting the decision not to arrange for a consultation with a cardiovascular surgeon.

Justice of Appeal Trotter held that it was open to the trial judge to find Dr. Sternbach sufficiently involved in the decision-making to warrant a finding of liability. His Honour said that the two doctors consulted each other before deciding not to refer the deceased to a cardiovascular surgeon. Even though Dr. McLaughlin was “the most responsible physician”, his Honour concluded, after noting that Dr. Sternbach suggested that a thoracic surgeon be consulted due to an accumulation of blood on the deceased’s chest:

…Dr. Sternbach did not disagree. He was not only supportive of Dr. McLaughlin’s decision; he played a critical role in facilitating it. As his suggestion regarding thoracic surgery indicates, he did not advise Dr. McLaughlin to seek cardiac surgery nor did he view it as necessary.

The Court of Appeal for Ontario dismissed the appeal. Dr. McLaughlin and Dr. Sternbach were found liable for the deceased’s injuries.

Contact Tierney Stauffer LLP for Advice on Medical Malpractice Claims 

At Tierney Stauffer LLP, we know how overwhelmed you may feel about the prospect of launching a hospital malpractice lawsuit. If you have a valid claim against a hospital, you need a strong advocate by your side to fight the hospital’s insurers and lawyers. It is important that you seek prompt advice from our personal injury lawyers, who have a great deal of experience working with clients on medical malpractice claims throughout Ontario. Call us at 1-888-799-8057 or reach out online to set up a consultation today.

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