In September 2023, both CP24 and the Brampton Guardian published coverage of the trial decision in Thompson v Handler, 2023 ONSC 5042. The Honourable Mr. Justice William LeMay of the Ontario Superior Court of Justice released the decision on September 6, 2023, finding emergency physician Dr. Jeffrey Handler negligent in his care of Elisha Shaw, a 34-year-old mother of four young children, and finding that the negligence caused her death. Paul was retained by Mr. Thompson in 2016 and was trial counsel for the plaintiffs through to the September 2023 judgment.
The CP24 article by Abby O’Brien, published on September 11, 2023, ran under the headline “Toronto father wins years-long lawsuit against GTA doctor ruled to have caused wife’s ‘untimely’ death.” The Brampton Guardian piece, published around the same time, ran under the headline “Doctor ordered to pay nearly $500K in damages following 2015 death of Brampton mother.” Together, the two pieces of coverage captured the trial outcome for both a regional GTHA audience and a local Brampton audience.
The case
Elisha Shaw attended the emergency department at Brampton Civic Hospital late in the evening of November 16, 2015, complaining of severe abdominal pain. She had undergone a gastric bypass operation in 2012, a type of bariatric surgery that reduces stomach size and carries an associated risk of internal hernia. Internal hernias in the small bowel can be a surgical emergency: the small bowel may become twisted and lose its blood supply, leading to ischemia, necrosis, and death within days if the obstruction is not relieved.
Elisha was seen by Dr. Handler in the emergency room. He ordered blood tests and a CT scan. The initial radiology report identified no obstruction. Dr. Handler reviewed those results with Elisha and Mr. Thompson at about 4 a.m. on November 17. Elisha’s pain did not abate. Nursing staff described her pain as unmanageable and recorded Mr. Thompson as asking repeatedly for additional medication. At about 7 a.m. on November 17, Dr. Handler discharged Elisha with instructions to follow up with her family physician and her bariatric surgeon and a prescription for abdominal cramps.
Shortly after the discharge, a second radiologist reviewed the CT scan and identified what appeared to be an internal hernia in the small bowel. The radiologist contacted Dr. Handler and communicated the revised finding. Dr. Handler did not contact Elisha or arrange for her return to the hospital.
The next morning, on November 18, Elisha’s pain forced her to return to Brampton Civic by ambulance. The surgeon who saw her, concerned about an internal hernia and a risk of ischemia, performed a laparotomy. By the morning of November 19, a significant portion of her small bowel had developed necrosis and had to be removed. She was transferred to Humber River Hospital for a second surgery, but the necrosis continued to spread. Elisha died at Humber River on November 25, 2015.
The trial decision
The case went to trial over 12 days in Brampton in January 2023. Eight experts gave evidence: two radiologists, two surgeons, two emergency medicine specialists, an accountant, and an economist. Justice LeMay reserved judgment and released his reasons on September 6, 2023.
On standard of care, the trial judge found two distinct failures by Dr. Handler. The first was the failure to contact Elisha after the radiologist’s second review of the CT scan identified the internal hernia. With that information in hand, the standard of care required Dr. Handler to call her back to the emergency department. The second was the failure to refer Elisha’s case to the on-call surgeon for immediate consultation given the combination of her unresolved 10-out-of-10 pain, the CT findings, and her history of bariatric surgery.
On causation, the trial judge applied the “but for” test. The critical question was whether a request to return to the hospital on November 17 would have changed the outcome. The judge found that it would. If the laparoscopic investigation that ultimately took place on November 18 had taken place on November 17 instead, the hernias would have been reduced before any necrosis developed. Elisha’s bowel would have remained healthy. She would have recovered, the judge found, with minimal long-term impairment. The judge’s conclusion was that, but for Dr. Handler’s failure to follow up after the radiologist’s call, Elisha would not have died.
What the CP24 article captured
Abby O’Brien’s CP24 piece set the trial decision in the larger context of Mr. Thompson’s life after the death. Paul described to the journalist the years Mr. Thompson spent working overnight shifts at Walmart so he could be present with the four children, who ranged in age from just over one to seven years old at the time of their mother’s death. The framing was deliberately oriented toward the human cost rather than the legal mechanics: a young family, a wife and mother lost to a preventable medical decision, a single father carrying the household for years while the litigation proceeded.
Paul’s substantive comment to the journalist identified the moment of the failure. The mistake, Paul indicated, was the moment after the radiologist’s call when Dr. Handler had the new information but did not call Elisha back. A surgery that day could have saved her life.
The CP24 article also placed the case in a broader frame. Paul described the structural difficulties of medical malpractice work in Ontario: the cases are complicated and difficult to prove, and the practice depends on the willingness of physicians to be critical of other physicians in expert evidence. Jennifer Zelmer, CEO of Healthcare Excellence Canada, was also quoted in the piece on the importance of being able to speak up about patient safety concerns and having those concerns followed through on.
What the Brampton Guardian piece captured
The Brampton Guardian article, written for a local Brampton audience, foregrounded the regional connection. Elisha and Mr. Thompson lived in the area. Brampton Civic Hospital is the regional hospital. The piece’s framing of the damages figure (“nearly $500K”) reflects the initial liability and non-pecuniary damages award; the trial judge had reserved on the loss-of-income and household-contribution damages, which would be quantified in subsequent reasons.
The damages
At the time the September 2023 articles were published, the trial judge had awarded the estate of Elisha Shaw, Mr. Thompson, and the four children a combined sum of at least $493,000 in non-pecuniary damages (loss of care, guidance, and companionship, plus general damages and funeral expenses) and other immediately quantifiable items. The loss-of-income and household-contribution damages were to be determined in subsequent proceedings. The full damages quantum, when ultimately determined, substantially exceeded the initial figure reported in the September 2023 coverage.
Where to read
- CP24 / CTV News Toronto, “Toronto father wins years-long lawsuit against GTA doctor ruled to have caused wife’s ‘untimely’ death” (Abby O’Brien, September 11, 2023): cp24.com.
- Brampton Guardian, “Doctor ordered to pay nearly $500K in damages following 2015 death of Brampton mother” (September 2023): bramptonguardian.com.
- The trial decision is reported as Thompson v Handler, 2023 ONSC 5042.
The fuller case commentary on Thompson v Handler, with the trial judge’s reasoning on standard of care and causation, is on paulcahill.ca at Paul Cahill Wins Medical Malpractice Trial for Brampton Family.
Context
At the time of the September 2023 trial decision and the related media coverage, Paul was a partner at Will Davidson LLP. The firm restructured later, and Paul is now a partner at Davidson Cahill Morrison LLP. The Court of Appeal subsequently dismissed Dr. Handler’s appeal in a later ruling, which is the subject of a separate post on this site.
