Representing victims of medical malpractice across Ontario
When something goes wrong during pregnancy, labour, or delivery, the consequences can last a lifetime. If you suspect that medical negligence caused your child’s birth injury, you deserve answers — and you deserve a lawyer who has actually tried these cases and won.
Paul Cahill is a Toronto-based medical malpractice lawyer and a Law Society of Ontario Certified Specialist in Civil Litigation. He has represented Ontario families in some of the most complex birth injury claims in the province, including a $11.5 million jury verdict against a negligent obstetrician for a twin born with cerebral palsy.
Consultations are free. There are no fees unless your case is successful.
A birth injury is any harm to a baby — and sometimes the mother — that occurs during pregnancy, labour, delivery, or the immediate newborn period. Some birth injuries are unavoidable. Others are the result of preventable medical errors by obstetricians, family physicians, midwives, nurses, or hospital staff.
When a birth injury is caused by a healthcare provider’s failure to meet the accepted standard of care, it may give rise to a medical malpractice claim. These cases are among the most legally and medically complex in Canadian civil litigation. They almost always require expert medical evidence, detailed forensic review of fetal monitoring strips, and a lawyer who understands both the obstetrical medicine and the law.
Paul Cahill regularly investigates and litigates the following categories of birth injury claims in Toronto and across Ontario.
Cerebral palsy is a permanent disorder of movement and posture caused by damage to the developing brain. While some cases of cerebral palsy are unavoidable, others are caused by preventable oxygen deprivation during labour and delivery. Common negligent acts include:
Ontario courts have consistently recognized that negligent obstetrical management causing cerebral palsy can result in damages awards in the millions of dollars to fund a lifetime of care.
Hypoxic-ischemic encephalopathy is brain injury caused by a lack of oxygen and blood flow around the time of birth. HIE often presents with seizures in the first 24 to 48 hours of life and is typically diagnosed with MRI imaging showing characteristic patterns of brain injury.
When HIE results from a delay in delivery or a failure to recognize fetal distress, it may form the basis of a medical malpractice claim. Babies who survive moderate to severe HIE often go on to develop cerebral palsy, epilepsy, intellectual disability, and other lifelong impairments.
Brachial plexus injuries occur when the bundle of nerves between the neck and shoulder is stretched or torn during delivery. They are most often associated with shoulder dystocia — a delivery emergency where the baby’s shoulder becomes lodged behind the mother’s pubic bone. The standard of care requires obstetricians and nurses to recognize risk factors and use proper manoeuvres (such as McRoberts and suprapubic pressure) rather than excessive lateral traction on the baby’s head.
Permanent brachial plexus injury, including Erb’s palsy and Klumpke’s palsy, can result in lifelong loss of arm function.
Improper or excessive use of forceps and vacuum extractors can cause skull fractures, subgaleal hemorrhage, and intracranial bleeding. The standard of care requires careful assessment of fetal station, proper application technique, and abandonment of instrumental delivery in favour of C-section when the procedure is not progressing safely.
Kernicterus is a preventable form of brain damage caused by severely elevated bilirubin levels in newborns. When jaundice goes unrecognized or untreated — through failure to test, failure to follow up after early discharge, or failure to initiate phototherapy or exchange transfusion — the result can be permanent neurological injury including cerebral palsy and hearing loss.
Midwives provide primary care to low-risk pregnancies under the Association of Ontario Midwives. When complications arise — meconium-stained fluid, prolonged second stage, fetal heart rate abnormalities, postpartum hemorrhage — the standard of care requires timely consultation with or transfer of care to an obstetrician. Failure to escalate appropriately is a common allegation in midwife negligence cases.
Birth injury claims aren’t only about babies. Mothers can be seriously harmed by retained placenta, undiagnosed postpartum hemorrhage, severe perineal lacerations missed at delivery, eclampsia mismanagement, or failure to diagnose preeclampsia and HELLP syndrome. In the worst cases, maternal birth injuries result in wrongful death and devastate families.
Across hundreds of investigations, certain themes recur in negligent birth injury cases:
Parents often sense that something went wrong before they have any way to prove it. Common red flags include:
You don’t need to know whether negligence occurred before you call. That’s our job — we will request and review the medical records, retain medical experts, and advise you on whether you have a viable claim.
When you are choosing a lawyer to represent your family in a birth injury claim, three things matter most: experience, results, and judgment.
Certified Specialist. Paul Cahill is recognized by the Law Society of Ontario as a Certified Specialist in Civil Litigation. Fewer than 1% of Ontario lawyers hold this designation.
Recognized by peers. Paul has been listed in Best Lawyers in Canada for Medical Negligence and Personal Injury Litigation since 2021.
Trial-tested. Birth injury claims are vigorously defended by physician insurers, and most defence counsel know which plaintiff lawyers will go to trial and which will not. Paul has tried birth injury cases to verdict — including the $11.5 million jury verdict for a twin born with cerebral palsy from negligent management of twin-to-twin transfusion syndrome.
Leadership in the bar. Paul is a past director of the Ontario Trial Lawyers Association (2020–2023) and former Chair of its Medical Malpractice Section (2019–2020).
Trial counsel. For select matters, Paul acts as trial counsel to other lawyers handling complex medical malpractice and personal injury claims.
Birth injury claims in Ontario typically unfold over several years. Understanding the process helps families know what to expect.
Step 1 — Free consultation. We listen to what happened and identify whether the case warrants further investigation.
Step 2 — Records review. We obtain the complete labour and delivery, neonatal, and follow-up records, including fetal monitoring tracings.
Step 3 — Expert review. We retain qualified medical experts — typically obstetricians, neonatologists, paediatric neurologists, and life care planners — to review the records and provide opinions on standard of care and causation.
Step 4 — Statement of claim. If the experts support a case, a statement of claim is issued in the Ontario Superior Court of Justice.
Step 5 — Discoveries and mediation. The parties exchange documents, conduct examinations for discovery, and usually attend mediation.
Step 6 — Trial or settlement. Most cases resolve before trial, but defendants — particularly those represented by the Canadian Medical Protective Association (CMPA) — will only offer fair value when they believe the plaintiff’s lawyer is genuinely prepared to try the case.
Ontario’s Limitations Act, 2002 generally requires civil claims to be commenced within two years of when the claim was discovered. For birth injury claims involving children, special rules apply: the limitation period does not start to run while the child is a minor or under disability, and for severely disabled children may be tolled indefinitely.
That said, evidence disappears, witnesses move, and memories fade. Even when the formal limitation period has not expired, delay can damage a case. The earlier you call, the better.
Damages in successful birth injury cases in Ontario can include:
A properly prepared life care plan, prepared by an experienced occupational therapist or rehabilitation consultant, is often the cornerstone of a multi-million-dollar damages claim.
Paul Cahill represents families across Ontario in birth injury claims. Although our main office is in downtown Toronto, we routinely act for clients in:
Toronto · Mississauga · Brampton · Hamilton · Vaughan · Markham · Richmond Hill · Oakville · Burlington · Milton · Ajax · Pickering · Whitby · Oshawa · Bowmanville · Barrie · Huntsville · Sudbury · Ottawa · London · Kitchener-Waterloo · Windsor
You don’t have to know. Most parents only suspect that something went wrong. The way to find out is to have a qualified medical malpractice lawyer review the medical records and retain expert physicians to assess whether the standard of care was met. We do this at no cost to you during the investigation phase.
We work on a contingency fee basis. There is no fee for the consultation, no fee to investigate the claim, and no legal fees unless we recover compensation for your family.
Generally, civil claims must be commenced within two years of discovering the injury under the Limitations Act, 2002. However, for children with birth injuries, the limitation period is tolled while they are minors and may be tolled indefinitely if they lack capacity due to disability. Despite this, you should consult a lawyer as soon as possible — evidence becomes harder to gather over time.
In almost all cases, Ontario physicians are defended and indemnified by the Canadian Medical Protective Association (CMPA), and hospitals are insured by the Healthcare Insurance Reciprocal of Canada (HIROC) or similar insurers. Damages are paid by these insurers, not by the physicians personally.
Yes. The fact that a complication is “rare” or “recognized” does not mean it wasn’t preventable. Many serious birth injuries occur because of failures to recognize and respond to warning signs, even when the underlying complication was a known risk. Only a thorough records review can answer the question.
No. A CPSO complaint addresses professional misconduct or incompetence and can lead to discipline, but does not result in compensation. A civil lawsuit is the only mechanism for recovering damages to fund your child’s care. The two processes can run in parallel.
Most birth injury claims in Ontario take three to five years to resolve. Catastrophic injury cases often take longer because the child’s developmental trajectory must be observed before a reliable life care plan can be prepared.
The vast majority of birth injury cases settle before trial. However, settlements only happen at fair value when the defendant believes the plaintiff is genuinely prepared to go to trial. Choosing a lawyer with real trial experience is the single most important predictor of a strong settlement.
If you believe medical negligence caused your child’s birth injury, contact Paul Cahill for a free, confidential consultation. There is no obligation, and you will not pay a fee unless we win your case.