Receiving high-quality healthcare is one of the most important concerns for Canadians. For most people, most of the time, the system delivers. For a small but meaningful minority, it does not. As a medical malpractice lawyer, I only see the patients who are left to put their lives back together after falling through the cracks of an imperfect system. For many of them, the consequences are devastating and permanent.
A question I get asked often, by clients, by physicians, by journalists, by other lawyers, is whether medical malpractice is on the rise in Canada. The simple answer is that my own intake numbers have been climbing steadily for years, which gives me a strong working impression that the answer is yes. The more careful answer is that the public data tells a slightly more complicated story, and the story has shifted meaningfully even in the past two years.
When I first wrote about this question in 2024, the most recent CMPA data ended at 2023. We now have the 2024 numbers, and the most recent CIHI hospital harm data covers 2024-2025. Looking at the two sources together, the picture is this: the number of medical malpractice lawsuits each year has more or less stabilized, but the compensation paid to patients keeps going up; and the rate of preventable harm in Canadian hospitals has stabilized above its pre-pandemic baseline rather than returning to it. The cases are not necessarily more numerous, but they are more serious. And the system has settled into a higher rate of harm than it was producing before the pandemic.
What follows is a tour of the most recent data, what it says, what it does not say, and what I take from it as someone who has spent two decades doing this work.
What counts as medical malpractice
Anyone who has ever been to a doctor or a hospital will have an opinion about what counts as medical malpractice. Some people believe any bad outcome from medical care is malpractice. That is not the law.
Medical malpractice in Canada is a creature of tort law. It allows a patient to recover financial compensation from another party who has negligently caused them harm. The general test has three components:
- The healthcare provider owed the patient a duty of care. This is almost always met where there is a treating relationship.
- The provider breached the standard of care. That is, the care fell below what a reasonably competent provider would have delivered in the same circumstances.
- The breach caused the patient compensable harm. Not every error causes injury, and not every injury is caused by error.
The standard of care can include errors in diagnosis, treatment, medication, surgical performance, communication, or follow-up. Whether a particular bad outcome counts as malpractice in this legal sense is a separate question, and one I cover in detail in Suing for Medical Malpractice in Ontario: What You Need to Know and Six Common Misunderstandings About Medical Malpractice in Ontario.
Two reliable data sources
To answer whether malpractice is actually rising in Canada in a quantifiable way, the two most useful public sources are:
- The Canadian Medical Protective Association (the “CMPA”), which is the not-for-profit medical defence organization that handles legal claims and complaints against the country’s physicians.
- The Canadian Institute for Health Information (the “CIHI”), which is the independent body that tracks healthcare data across Canada including a national measure of unintended harm during hospital stays.
Each has limitations, which I will get to. Together they give a reasonably defensible picture of the trend.
The CMPA data
The CMPA is the mutual defence organization for the great majority of Canadian physicians. It is not, technically, an insurance company. It collects fees from member physicians and uses those fees, with investment returns, to compensate patients who have been proven to have been harmed by negligent care, to defend physicians facing legal or regulatory action, and to fund patient safety research.
The CMPA publishes annual reports each year. These reports are the closest thing the country has to a national scorecard on physician malpractice. The three most useful datasets are:
- The number of new legal actions commenced each year against Canadian physicians
- The number of regulatory College matters opened against Canadian physicians
- The total compensation paid each year to patients found to have been harmed by negligent care
As of the 2024 annual report, the picture for these three metrics looks like this.
Number of new legal actions. Between 2019 and 2023, the number of new lawsuits commenced against Canadian physicians went from 854 to 979, a 15% increase over five years. The 2024 CMPA annual meeting framed the trend somewhat differently going forward. The CMPA itself reported that “the number of medico-legal and civil cases has remained stable over the past few years.” The growth from the early pandemic years now appears to have plateaued.
Put against the population, the number of lawsuits is small. Canada has approximately 41.5 million people. The CMPA’s membership has grown to over 117,000 physicians. Roughly a thousand new lawsuits per year against more than a hundred thousand physicians who collectively see millions of patients is a small fraction of all medical encounters. That should be remembered when reading the data: most physicians never face a lawsuit, and most patients never sue.
Number of College complaints. The CMPA tracks how many regulatory College matters it opens in a given year. A regulatory College matter could arise from any kind of allegation against a physician, including substandard care, billing issues, sexual misconduct, or other professional conduct. From 2019 to 2023 the number of College matters opened by the CMPA went from 4,827 to 5,135, a modest 6% increase. There was a notable drop in 2020 that almost certainly reflects the early pandemic period.
The CMPA reported at its 2024 annual meeting that the College of Physicians and Surgeons of Ontario, which had previously been the most active regulator in the country, has experienced a considerable decrease in the number of matters it is pursuing. The Collège des médecins du Québec is now the most active, followed at a distance by some of the other provincial Colleges. The picture by province is uneven and changing. If you are thinking about whether to make a regulatory complaint about a physician, I cover the practical considerations in Health Care Complaints in Ontario: a patient’s guide.
Compensation paid to patients. This is probably the strongest single metric for understanding whether actionable malpractice is rising. Lawsuits and College complaints can be brought without merit; many are. Compensation is only paid where malpractice has been proven, either through a negotiated settlement with the CMPA or through a judgment after trial. It tracks outcomes, not allegations.
The numbers here continue to climb:
- 2019: $223 million paid in compensation
- 2023: $308 million paid in compensation (a 38% increase over five years)
- 2024: $322 million paid in compensation (a further increase year-over-year)
Over the ten years from 2015 to 2024, the CMPA paid out a total of approximately $2.5 billion in compensation on behalf of its members. That averages to about a quarter of a billion dollars a year. The trajectory is unambiguously upward.
The 2024 annual meeting offered an additional and important nuance. The CMPA reported that while case volumes have stabilized, “an increase in the severity and costs of individual cases has been observed both in Canada and elsewhere in the world.” In plain terms: the dollar value of compensation is going up not because there are dramatically more cases, but because each case is more serious. The injuries are worse, the compensable harm is larger, the long-term care costs are higher.
That observation matches what I see in my own practice. The cases that come through my door are increasingly catastrophic. Severe and permanent brain injuries. Life-altering surgical complications. Missed diagnoses that turn treatable conditions into terminal ones. Catastrophic outcomes in maternity care. The plaintiffs are younger; the care needs are greater; the lifetime cost projections are very large.
Important limitations of the CMPA data. It is worth being explicit about what this data does not capture:
- Physicians only. The CMPA’s mandate covers physicians. It does not cover claims against nurses, dentists, chiropractors, physiotherapists, midwives, optometrists, naturopaths, technologists, or hospitals as institutional defendants. A meaningful fraction of malpractice activity, particularly cases involving hospital nursing care, occurs outside the CMPA’s reporting.
- Allegations, not always findings. The lawsuit and College numbers reflect matters commenced, not necessarily matters that resulted in liability or discipline. Many lawsuits are abandoned, dismissed, or resolved without a finding of fault. Many College complaints result in no further action.
- The merit gap. On the other side of the ledger, not every meritorious complaint becomes a lawsuit. Plenty of patients who have been genuinely harmed by negligent care never bring a claim, often because they cannot find a lawyer to take it, cannot afford the front-end cost, or do not recognize what happened as actionable. The CMPA data captures the tip of the iceberg, not the iceberg.
The CIHI hospital harm data
The Canadian Institute for Health Information takes a different angle. It does not look at lawsuits or compensation. It looks at the actual rate of unintended harm to patients during their hospital stays.
CIHI defines “hospital harm” as an unintended outcome of medical care that could have been prevented by implementing known best practices and that was identified and treated in the same hospital stay. The measure captures 31 different types of preventable harm including infections, surgical complications, medication errors, pressure injuries, falls, electrolyte imbalances, urinary tract infections, delirium, aspiration pneumonitis, and post-procedural complications. Notably, the measure excludes Quebec data and certain mental health cases due to differences in data collection, so the national picture is incomplete in those respects.
The metric is reported as a rate per 100 hospitalizations. Here is the trajectory:
- 2014-15 to 2019-20: stable at approximately 5.3 to 5.4 harmful events per 100 hospitalizations
- 2020-21: rose to 5.9 (the first pandemic year)
- 2021-22, 2022-23, 2023-24, 2024-25: has held at 6.0 per 100 hospitalizations for five consecutive years
In its most recent reporting on 2024-2025 data, CIHI noted that the rate has now been stuck at 6.0 for five consecutive years and that progress on hospital harm reduction has “plateaued.” In absolute terms, the 6.0 rate means about 153,000 hospital stays out of approximately 2.6 million involved at least one harmful event in 2024-2025. About one in seventeen hospitalizations. In a quarter of those cases, the patient experienced more than one harmful event during the same stay.
The pre-pandemic baseline was 5.3 to 5.4. The current rate is 6.0. The difference is not enormous in percentage terms, but with millions of hospital stays a year, it represents tens of thousands of additional patients each year being harmed in ways that known evidence-based practices could have prevented. And it has stayed elevated rather than returning to where it was.
What is driving most of it. The CIHI data identifies the most common categories of preventable harm:
- Electrolyte and fluid imbalances
- Urinary tract infections (often catheter-associated)
- Delirium (particularly in older patients)
- Aspiration pneumonitis
- Post-procedural infections
- Hospital-acquired pneumonia
These are not the dramatic “never events” that occasionally make the news, like operating on the wrong limb or retained surgical instruments. Those are real and they do happen, but they are a small fraction of total hospital harm. The bulk of preventable harm is more ordinary clinical care that goes wrong in predictable ways: complications of immobility, complications of indwelling devices, breakdowns in monitoring, lapses in basic infection prevention.
The equity dimension. A CIHI analysis released in October 2024 added an important layer to the harm data. The risk of experiencing preventable harm in hospital is not evenly distributed:
- Patients who do not speak English or French are 30% more likely to experience a harmful event during their hospital stay than patients who speak one of those languages.
- Patients with less than a high school education are 20% more likely to experience a harmful event than those with high school or more.
- Patients age 85 and older are roughly five times more likely to experience a patient safety event than patients younger than 20, which translates to approximately 8.5 additional cases of harm per 100 hospitalizations for the oldest patients.
The pattern is consistent with what is known about other patient safety failures. Effective communication is a recognized safety practice. Where the system has trouble communicating with a patient, the patient is at greater risk. Where the patient cannot effectively advocate for themselves, the patient is at greater risk. Frailty, cognitive decline, multiple comorbidities, polypharmacy, and prolonged hospitalization all compound.
Putting the two sources together
The two data sources tell complementary stories:
From the CMPA: the volume of claims has roughly stabilized but the dollar value of compensation has continued to climb because individual cases are more serious. The number of new lawsuits per year now sits at a fairly steady ratio against a growing physician population. The College complaint volume is broadly flat with shifting provincial composition. The compensation paid in 2024 reached an all-time record of $322 million.
From CIHI: the rate of preventable hospital harm rose during the pandemic and has now plateaued above pre-pandemic levels for five consecutive years. The system has settled into a higher steady-state rate of harm. The most common types of harm are infections, electrolyte issues, delirium, and post-procedural complications. The risk of harm is meaningfully higher for patients with communication barriers, lower education, and advanced age.
Read together, the simplest synthesis is this: medical malpractice has not exploded in volume in Canada. But the harms that are occurring are more serious, more concentrated in vulnerable populations, and not falling. The cases that reach the legal system are growing in cost and severity. The cases that never reach the legal system are not going away.
My own working theory
After two decades of doing this work, I have a working theory about what is driving the data. I do not believe physician or nursing competency has materially declined. Canada continues to train and credential excellent clinicians, and the people I deal with on the other side of the file are by and large skilled professionals doing difficult work in difficult conditions. I have, however, seen a marked shift in the kinds of cases that come into my office, and I attribute it to a few converging factors.
A growing and aging population requiring more care. Canada has roughly 41.5 million people. The population is older than it was a decade ago, with more chronic and complex disease. Demand for hospital and physician services has risen. The healthcare system has not expanded at the same rate.
A strained system operating closer to the edge. Hospitals running at or near capacity. Emergency departments running well beyond capacity. Hallway medicine that is now routine rather than exceptional. Surgical and diagnostic backlogs. Family physician shortages. Long waits for specialist consultation. Patients being moved between facilities for definitive care, and being moved late. Each of these factors creates opportunities for delay, miscommunication, dropped follow-up, and missed escalation. I cover the legal implications of one piece of this picture in Hallway Medicine in Ontario: When Overcrowded Emergency Rooms Lead to Medical Malpractice.
Patients who are better informed of their rights. Patient access to their own health information has improved substantially. Patients are more likely to ask hard questions when something goes wrong, more likely to request records, more likely to seek a second opinion, and more likely to consult a lawyer. That does not mean every consultation produces a lawsuit, but it does mean fewer harms are quietly absorbed. There is a market for accountability that did not exist twenty years ago.
The kinds of cases I see. Subjectively, I have seen an increase in cases that involve systemic failures rather than individual clinical errors. Cases where the issue is not that the surgeon’s hand slipped but that the patient was not transferred for definitive care in time. Cases where the issue is not that the emergency physician missed a finding but that the patient sat in the waiting room for six hours before being assessed. Cases where the post-operative complication was identifiable for hours before anyone acted on it. The “systemic” cases are technically harder to litigate but they are also increasingly common.
In other words: the system is doing more work with similar resources, and the cracks are wider.
What the data does not tell us
A few things the data is silent on, and which any honest answer to the question has to acknowledge:
The denominator is moving. Lawsuits per year sit around 1,000. Physicians number 117,000. Patient encounters number in the hundreds of millions. The CMPA data does not tell us whether the per-encounter or per-physician risk of malpractice is higher or lower than it used to be.
Quebec is partly excluded. CIHI’s hospital harm measure excludes Quebec for data-comparability reasons. The CMPA’s data covers Quebec on a fault-based rather than negligence-based framework. National pictures that exclude or transform Quebec data should be read accordingly.
Severity is going up but the reasons are debated. The CMPA attributes increasing case severity in part to general trends that are also visible internationally. Inflation in healthcare costs, longer life expectancies (which increase lifetime care projections in catastrophic injury cases), and improved damages awards may all contribute. The increased cost per case does not necessarily mean the underlying clinical error is more severe; it may mean the legal system is now better at compensating it.
Non-physician malpractice is underreported. Nursing care, midwifery, dental practice, diagnostic imaging, and pharmacy errors are not captured in the CMPA data. The full scope of malpractice in Canada is larger than the CMPA’s reporting universe.
What it means for prospective clients
If you are reading this because you think something has gone wrong with your or a family member’s care, a few practical observations.
Rising compensation paid does not mean it is easier to bring a case. The compensation figures reflect cases that succeeded. They do not reflect the difficulty of getting to that point. Most malpractice cases are still hard to bring, hard to prove, and hard to fund through to trial. The threshold for taking a case seriously remains high, and many meritorious cases still get screened out. For a candid discussion of how I evaluate cases, see Suing for Medical Malpractice in Ontario: What You Need to Know.
A bad outcome is not the same as malpractice. Bad outcomes happen for many reasons that do not involve negligence. Disease can progress despite competent care. Procedures can have recognized complications that occur even with proper technique. The question is not whether something bad happened. The question is whether the care fell below standard and whether the breach caused compensable harm. I cover this distinction in detail in Six Common Misunderstandings About Medical Malpractice in Ontario.
The earlier we look at the records, the better. Limitation periods in Ontario are short. The Limitations Act, 2002 generally gives a plaintiff two years from when they knew or ought to have known about the claim. Medical malpractice cases routinely take years to investigate, and the front-end legal work is significantly easier when the records are obtained promptly. If you think you may have a case, do not wait.
Not every case is one I will take. I screen carefully. The candid advice for many prospective clients is to think very carefully before going forward, and in some cases not to go forward at all. That is not because their experience does not matter; it is because litigation has costs that can outweigh its benefits for some kinds of claims. For more on this, see the foundational posts linked above.
What it means for physicians and healthcare leaders
A few observations from the other side of the table.
Severity is the risk frontier. Total case volume is no longer climbing the way it was. The dollar values are. Individual catastrophic cases now carry much larger compensation exposures than they did a decade ago. The risk management focus shifts accordingly. The cases that produce the largest losses are increasingly those involving systemic failure, delayed escalation, missed handovers, and inadequate response to clinical deterioration.
Documentation has always mattered. It matters more now. Contemporaneous documentation of vital signs, clinical reasoning, consultation considerations, and communication with patients and families is essential not just for clinical care but for evidentiary protection. Several recent cases in my own practice and in the published Ontario jurisprudence have hinged on documentation gaps that the trial judge resolved through adverse inferences against the defendant physician.
Hospital harm rates have plateaued at six per cent for five years. That number is not coming down on its own. Whatever combination of staffing pressure, occupancy pressure, system fragmentation, and operational complexity is producing it is now a steady state rather than a transient pandemic effect. Closing the gap back to pre-pandemic levels will require active work, not patience.
The equity findings should be uncomfortable reading. Patients with language barriers, lower education, and advanced age experience materially higher rates of preventable harm. Those are populations with weaker capacity to advocate for themselves. They are the patients least likely to bring a claim and most likely to be harmed. The reputational and ethical exposures here run well past the malpractice frame.
Conclusion
Is medical malpractice on the rise in Canada? My short answer is still yes, but the answer is more nuanced than it was two years ago. Actionable malpractice is producing more compensation each year than it ever has. Individual cases are more serious. The system has settled into a hospital harm rate that exceeds its pre-pandemic baseline and is not falling. The number of lawsuits is roughly stable, which is not the same as malpractice being stable.
My twenty years of practice tell me the kinds of cases now coming through my door are different from the kinds I saw at the start. There is more system in them. More delay. More cracks. The patients I see have often been failed not by a single clinical error but by an accumulation of pressures and shortcomings that the system tolerates because it has no other choice.
If you think something has gone wrong, the worst thing you can do is wait. The records get harder to obtain. Memories fade. Limitation periods run. The earlier the conversation, the better.
