Causation is the second element a plaintiff must prove in an Ontario medical malpractice claim, after standard of care and before damages. The plaintiff must show that the defendant’s negligence caused the injury, ordinarily by satisfying the “but for” test: but for the negligent act or omission, the injury would not have occurred. The Supreme Court of Canada confirmed this approach in Clements v Clements, 2012 SCC 32, [2012] 2 SCR 181, while recognizing a limited “material contribution to risk” exception in narrow circumstances.
In medical cases, causation is often the most contested element. A plaintiff who proves a clear breach of the standard of care may still lose at trial if expert evidence cannot bridge the gap between the breach and the injury. Lost-chance arguments, delayed-diagnosis fact patterns, and cases involving multiple potential causes raise some of the hardest causation questions in Canadian tort law.
Posts tagged Causation analyze how Ontario courts have approached these issues across obstetrical, oncology, emergency, and surgical fact patterns, including appellate decisions that shape how trial judges instruct themselves on the test.
A negligent stroke discharge that failed at causation. The Ontario Court of Appeal upheld the dismissal of the action, despite an admitted breach of standard of care.
I represented the plaintiff in this surgical malpractice case. The trial judge found a breach of the standard of care, but the claim failed at causation.
The Court of Appeal upholds the use of epidemiological evidence to infer causation across a class of patients harmed by a physician’s IPAC failures.
A missed diagnosis of compartment syndrome cost a patient her leg. The trial judge found the ER physician breached the standard of care.
The essential evidence required to prove a medical malpractice claim in Ontario. From a 2023 guest lecture at the University of Windsor Faculty of Law.
Reflections on two medical malpractice trials in post-COVID Ontario, one jury and one judge-alone. From Gluckstein’s 2022 Risky Business CLE.
On Inside Medical Malpractice with Chris Rokosh: medication errors as Never Events, the 10 rights of medication administration, and what they mean in litigation.
A settlement involving a 65-year-old man whose ankle fracture went 40 days without orthopedic follow-up, leading to joint infection and below-knee amputation.
Where literature, medicine, and the law intersect at a medical malpractice trial in Ontario. From a 2022 OTLA medical malpractice conference panel.
Paul as guest on Justice in Pieces, the legal education YouTube series with John-Paul Rodrigues. On the realities of plaintiff-side medical malpractice practice.
Why screening medical malpractice cases matters at intake, and what to recommend patients when civil litigation is not economical. From a 2021 CLE panel.
A jury verdict of $11.5 million for cerebral palsy, upheld at the Court of Appeal, following a community obstetrician’s failure to recognize and refer twin-to-twin transfusion syndrome.
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