On August 8, 2023 the Court of Appeal for British Columbia dismissed the appeal of a psychiatrist, Dr. Rajeev Sheoran, who suffered severe injuries after being assaulted by a psychiatric patient at the Penticton Regional Hospital. Dr. Sheoran alleged that the Interior Health Authority (IHA), the agency that managed and operated the hospital, had been negligent in failing to properly address the risk of violence posed by patients.

Dr. Sheoran’s lawsuit had been dismissed at trial. In dismissing his claim, the trial judge relied on medical malpractice cases to inform his assessment of the standard of care and found that the hospital did not fall below that standard. 

ISSUES

An important issue in this appeal was whether the trial judge erred in framing the lawsuit as a claim in medical malpractice given that it was a claim by a physician against a hospital arising from an assault by a patient.

FACTS

In November, 2014, Dr. Sheoran met the patient, Mr. Nield for the first time.

Mr. Nield was suffering from hypomania and elation. He had been using psilocybin mushrooms, had not been sleeping, had mood swings, was erratic and confrontational. The hospital staff had been advised early on by Mr. Nield’s family that he was a mixed martial arts fighter and was highly skilled in Brazilian jiu-jitsu. The family also warned hospital staff that they should be careful because Mr. Nield could get angry and hurt someone. Mr. Nield was admitted to hospital but had episodes of leaving and coming back with improvements and setbacks in his psychiatric condition.

On December 5, 2014, a nurse advised Dr. Sheoran that Mr. Nield was doing much better and asked him to reassess him. Later in the day the same nurse noted that Mr. Nield was “feeling hyper” but this information was not verbally communicated to Dr. Sheoran.

In the late afternoon, Dr. Sheoran accompanied Mr. Nield into a treatment room to conduct an assessment. 

As they sat across from each other, Mr. Nield leaned down as if he had dropped something and, without warning, he punched the doctor in the face. The doctor tried to reach for a panic button but was then hit again and lost consciousness.

When a nurse, having heard a loud banging noise, went to the room to see what was happening, Mr. Nield left the room, saying, “I think he might be dead”. The doctor was unconscious, slumped onto the desk in the corner of the room, seated on a chair, and there was a lot of blood. His jaw was broken in two places and his right eye was badly injured.

Dr. Sheoran had to undergo surgery to repair those injures. He has since suffered from both depression and post‑traumatic stress disorder. His life has been dramatically affected by the injuries Mr. Nield inflicted upon him.

DECISION

The appeal court found no error in the trial judge’s decision to dismiss the claim. In dismissing the claim, the trial judge was informed by medical malpractice law which generally requires expert evidence to prove a breach of the standard of care. Essentially, the trial judge was not convinced that the evidence established that the hospital failed to act reasonably to protect the physician from harm in this case.

The appeals court found no error by the trial judge in relying on medical malpractice claims to describe the standard of care (at. para. 82):

The standard is a question of law but its content is always contextual. The duty one owes to one’s neighbour is not absolute; it is framed in terms of reasonable care in the circumstances. While the jurisprudence to which the judge referred when formulating the standard of care was not particularly apt, because some of the cases referred to addressed the duty of care a physician or hospital owes to a patient, he clearly stated that he was seeking to establish the duty the IHA owed to protect the health and safety of its medical staff. The cases he relied upon were examples of the nature of the duty of care a hospital owes to anyone who may be injured on the premises. 

Decision Date: August 8, 2023

Jurisdiction: Court of Appeal for British Columbia

Citation: Sheoran v. Interior Health Authority, 2023 BCCA 318 (CanLII)