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.
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.
The Ontario Court of Appeal upheld Paul Cahill’s trial verdict in Hacopian-Armen Estate v Mahmoud, clarifying the foreseeability test in delayed cancer cases.
Paul Cahill won a trial verdict in Hacopian-Armen v Mahmoud where Justice Brown found a gynecologist negligently failed to biopsy and missed a curable cancer.
St. Catharines Standard coverage of the Court of Appeal’s July 2020 affirmance of the Woods v Jackiewicz jury verdict. Bill Sawchuk interviews Paul Cahill.
Three episodes on the Inside Medical Malpractice podcast with Chris Rokosh. Paul on the trials of Hacopian, O’Neill-Renouf, and Woods v Jackiewicz.
Paul Cahill won a trial verdict in O’Neill-Renouf v Ibrahim where Justice Baltman found a urologist negligently injured the obturator nerve during a TVT procedure.
Paul Cahill’s June 2019 Lawyer’s Daily article on when to ask for a jury in Ontario medical malpractice cases, drawing on his trial experience and the law on jury notices and appellate deference.
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