Hallway medicine is no longer an exception in Ontario emergency departments. When overcrowding contributes to a missed diagnosis, a premature discharge, or a death, the legal question is who is responsible. The short answer: the standard of care doesn’t bend because the system is in crisis.
On July 25, 2024, the Court of Appeal for Ontario dismissed the appeal of an emergency room physician whose negligence in failing to consider a stroke in his differential diagnosis led to delayed treatment and bad outcome for the patient.
On December 1, 2023, the Ontario Superior Court of Justice dismissed a medical malpractice lawsuit brought by a young woman who suffered a stroke after taking birth control medication provided by her family physician who allegedly failed to advise her of the increased risk of stroke associated with that particular brand of birth control pill (Yaz).
On January 8, 2024, the Ontario Superior Court of Justice dismissed a medical malpractice claim arising from an alleged missed diagnosis of stroke in the emergency room that led to the death of a 27 year-old woman.
Stroke misdiagnosis is a major healthcare concern with initial misdiagnosis estimated to occur in 9% of all stroke patients in the emergency setting according to the authors of a 2018 paper entitled Diagnostic Error in Stroke-Reasons and Proposed Solutions published by Current Atherosclerosis Reports.
Two experts testified on the issue of causation. Dr. Louis Caplan, a world-renowned expert in stroke and professor at Harvard University, testified on behalf of the plaintiffs. Dr. David Gladstone, a leading Canadian expert in stroke, testified on behalf of the defendant. The expert evidence revealed the existence of a debate in the medical community around the comparative efficacy of anticoagulation therapy versus antiplatelet therapy in the prevention of secondary strokes stemming from vertebral artery dissections.
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