Bauer v. Seager,

• Jurisdiction: Manitoba
• Judge: Clearwater, J.
• Neutral Citation: 2000 MBQB 113
• Date: 28 June 2000
• Court: Court of Queen's Bench of Manitoba (Canada)

Bauer v. Seager (2000), 147 Man.R.(2d) 1 (QB)

MLB headnote and full text

Temp. Cite: [2000] Man.R.(2d) TBEd. JL.042

Ellen Julie Bauer, an infant suing by her mother and litigation guardian, Colleen Bauer, and the said Colleen Bauer (plaintiffs) v. Mary Jane Seager, Denise Black and the St. Boniface General Hospital (defendants)

(CI 95-01-93091; 2000 MBQB 113)

Indexed As: Bauer v. Seager et al.

Manitoba Court of Queen's Bench

Winnipeg Centre

Clearwater, J.

June 28, 2000.

Summary:

The infant plaintiff was born in 1994 with severe brain damage resulting from oxygen deprivation allegedly caused by the negli­gence of the attending obstetrician, the senior resident and the obstetrical nurses. The plaintiff suffered from cerebral palsy, was significantly mentally and physically disabled and would require constant care throughout her life. The plaintiff alleged that the defend­ant doctors (1) failed to obtain the mother's informed consent to a vaginal birth instead of caesarean section and (2) failed to proper­ly manage and direct the mother's labour (failed to note high risk features and other factors which called for a caesarean section). The hospital was allegedly liable for (1) the negligence of the obstetrical nurses in failing to properly observe, record, interpret and react to signs of fetal distress; (2) failing to adequately train and/or educate its obstet­rical nurses; and (3) failing to staff its labour floor with properly trained obstet­ri­cal nurses or, alternatively, failing to pro­per­ly supervise them. The defendant doctors and hospital cross-claimed against each other, submitting that the other was the "proximate" cause of the infant plaintiff's injuries. All medical experts testified that the infant plaintiff's injuries resulted from negli­gence. The issues were who was negligent and the quantum of damages.

The Manitoba Court of Queen's Bench found the obstetrical nurses (hospital) negli­gent and 80% at fault for certain acts and omissions respecting the high risk infant. The senior resident was negligent and 20% at fault for delay in contacting the obste­trician. The delays by the obstetrical nurses (in advising the senior resident of full dila­tion and troublesome heart rate decelerations) and the senior resident (in calling the obstetrician) foreclosed the possi­bility of a caesarean section, which would have reduced the extent of brain damage. The obstetrician who delivered the infant was not negligent. The court assessed dam­ages accordingly.

Damage Awards - Topic 102

Injury and death - Head injuries - Brain damage - The infant plaintiff was born in 1994 with severe brain damage resulting from oxygen deprivation - The infant had cerebral palsy, was significantly mentally and physically disabled and would require total and constant care throughout her life (life expectancy of 35 years) - The Mani­toba Court of Queen's Bench awarded $200,000 general damages for nonpecuni­ary loss; $80,000 special damages for the initial outlay for better housing, plus an annual amount for housing costs until the infant reached age 21; $50,000 for a man­agement fee and fixed the manner of cal­culating damages for the cost of future care and the infant's future loss of earnings - Additionally, the mother was awarded $82,500 for loss of past income and $5,000 per year loss of future income until the infant reached age 21 - See paragraphs 108 to 132.

Damage Awards - Topic 489

Injury and death - General damage awards - Cost of future care and treatment - [See Damage Awards - Topic 102 ].

Damage Awards - Topic 489.3

Injury and death - General damage awards - Increased housing costs - [See Damage Awards - Topic 102 ].

Damage Awards - Topic 493

Injury and death - General damage awards - Loss of prospective earnings - [See Dam­age Awards - Topic 102 ].

Damage Awards - Topic 578

Torts - Injury to third parties - Loss of income by parent - [See Damage Awards - Topic 102 ].

Damages - Topic 1548

General damages - General damages for personal injury - Management of fund fee (investment counselling) - [See Damage Awards - Topic 102 ].

Damages - Topic 1567

General damages - General damages for personal injury - Future care and treatment - The Manitoba Court of Queen's Bench reviewed the law respecting general dam­ages for future care, especially with refer­ence to permanently disabled persons - See paragraph 108.

Hospitals - Topic 2102

Liability of hospitals - For acts of others -For acts of nurses - [See Medicine - Topic 4252.2 ].

Medicine - Topic 3048

Relation with patient - Consent to treat­ment - Negligence or fault - Duty of the treat­ing doctor to inform patient - [See both Medicine - Topic 4248 ].

Medicine - Topic 4241.2

Liability of practitioners - Negligence - Causation - [See Torts - Topic 61 ].

Medicine - Topic 4242

Liability of practitioners - Negligence - Standard of care - The Manitoba Court of Queen's Bench reviewed the general prin­ciples respecting the standard of care of medical practitioners - See paragraph 61.

Medicine - Topic 4248

Liability of practitioners - Negligence - Failure to inform or disclose - The Mani­toba Court of Queen's Bench, in generally discussing the law respecting informed consent, stated, inter alia, that "a physician ... is required ... to disclose any special, material, or unusual risks associated with the treatment or a procedure and, in certain circumstances, to disclose alternative treat­ments reasonably available to the patient ... Although a particular risk may be only a mere possibility which ordinarily need not be disclosed, if its occurrence carries seri­ous consequences (i.e., paralysis or death), it is a 'material risk' and requires disclos­ure ... Even if a physician is negli­gent in failing to make required disclosure and obtain an informed consent from a patient, the patient will not succeed against the physician in an action in negligence unless the plaintiff can establish causation using the modified objective test ... that is, a plaintiff must prove not only that he or she would not have consented to the treat­ment if they had received the appropriate infor­mation, but that a reasonable patient, in the plaintiff's position, would not have con­sented to the treatment had the appro­priate information been provided" - See para­graph 37.

Medicine - Topic 4248

Liability of practitioners - Negligence - Failure to inform or disclose - The infant plaintiff was born in 1994 with severe brain damage resulting from oxygen depri­vation before, during and after the vaginal birth - At issue was whether the mother's informed consent to a vaginal birth was obtained, as opposed to a caesarean section - The mother claimed that had she been properly informed of the risks of a vaginal birth in her circumstances (cord compres­sion and oxygen deprivation), she would have elected to have a caesarean section - The Manitoba Court of Queen's Bench held that the mother's informed consent was obtained - The mother was given sufficient information and a reasonable person with the mother's personal charac­teristics would have accepted the recom­mendation to proceed with a trial of labour and vaginal delivery, with the option of delivering the infant by way of caesarean section if circumstances warranted - See paragraphs 37 to 60.

Medicine - Topic 4248.1

Liability of practitioners - Negligence - Consent of patient - [See both Medicine -Topic 4248 ].

Medicine - Topic 4252.2

Liability of practitioners - Negligence - Obstetrical or gynaecological care - The infant plaintiff was born in 1994 with severe brain damage resulting from oxygen deprivation before, during and after the vaginal birth - This was a high risk preg­nancy with the possibility of a caesarean section being performed if a vaginal birth became too risky, given the breech posi­tion of the baby and the known risk of cord compression and oxygen deprivation - The Manitoba Court of Queen's Bench found the obstetrical nurses (hospital) negligent and 80% at fault for delay in notifying the senior resident of trouble­some decelera­tions in fetal heart rate and the fact that the mother was fully dilated and enter­ing the second stage of labour - The resi­dent, after being advised, was negligent and 20% at fault for failing to inform the obstetrician of the critical situ­ation in a timely manner - The delays precluded any opportunity to perform a caesarean section, which would have reduced the extent of the brain dam­age suffered - See paragraphs 62 to 90.

Medicine - Topic 4259

Liability of practitioners - Negligence - Residents or interns - [See Medicine - Topic 4252.2 ].

Medicine - Topic 6866

Nurses - Negligence - Patient care - Negli­gent care - [See Medicine - Topic 4252.2 ].

Torts - Topic 61

Negligence - Causation - Causal connec­tion - The Manitoba Court of Queen's Bench stated that causation was established where the defendant's negligence "materially contributed" to the plaintiff's injuries - The defendant's negligence need not be the "sole" cause - A contributing factor was "material" if it fell outside the de minimis range - Although the plaintiff had the burden of establishing causation, the court recognized that causation need not be established with scientific precision - See paragraphs 25 to 28.

Cases Noticed:

Athey v. Leonati et al. (1996), 203 N.R. 36; 81 B.C.A.C. 243; 132 W.A.C. 243 (S.C.C.), appld. [para. 25].

Laferrière v. Lawson (1991), 123 N.R. 325 (S.C.C.), refd to. [para. 26].

Snell v. Farrell, [1990] 2 S.C.R. 311; 110 N.R. 200; 107 N.B.R.(2d) 94; 267 A.P.R. 94, refd to. [para. 27].

Rothwell v. Raes (1990), 76 D.L.R.(4th) 280 (Ont. C.A.), refd to. [para. 28].

Reibl v. Hughes (1980), 33 N.R. 361; 114 D.L.R.(3d) 1 (S.C.C.), refd to. [para. 37].

Arndt et al. v. Smith, [1997] 8 W.W.R. 303; 213 N.R. 243; 92 B.C.A.C. 185; 150 W.A.C. 185 (S.C.C.), refd to. [para. 37].

Puranen v. Thomson and Lim (1987), 46 Man.R.(2d) 55 (Q.B.), refd to. [para. 37].

Davidson v. Connaught Laboratories et al. (1980), 14 C.C.L.T. 251 (Ont. H.C.), refd to. [para. 37].

Ciarlariello et al. v. Schacter et al., [1993] 2 S.C.R. 119; 151 N.R. 133; 62 O.A.C. 161, refd to. [para. 37].

Rhine v. Millan et al. (2000), 263 A.R. 201 (Q.B.), refd to. [para. 37].

Mangalji et al. v. Graham et al. (1997), 194 A.R. 116 (Q.B.), refd to. [para. 37].

Granger v. Ottawa General Hospital et al. (1996), 7 O.T.C. 1 (Gen. Div.), refd to. [para. 61].

Gill Estate et al. v. Marriott, [1999] O.T.C. 52 (Sup. Ct.), refd to. [para. 61].

Andrews et al. v. Grand & Toy (Alberta) Ltd. et al., [1978] 2 S.C.R. 229; 19 N.R. 50; 8 A.R. 182; [1978] 1 W.W.R. 577, refd to. [para. 108].

Teno et al. v. Arnold et al., [1978] 2 S.C.R. 287; 19 N.R. 1; 83 D.L.R.(3d) 609; 3 C.C.L.T. 272, refd to. [para. 108].

Chow et al. v. Wellesley Hospital et al., [1999] O.T.C. 252 (Sup. Ct.), refd to. [para. 108].

Toneguzzo-Norvell et al. v. Savein and Burnaby Hospital (1997), 162 N.R. 161; 38 B.C.A.C. 193; 62 W.A.C. 193 (S.C.C.), refd to. [para. 119].

Lusignan v. Concordia Hospital et al. (1997), 117 Man.R.(2d) 241 (Q.B.), refd to. [para. 120].

Neuzen v. Korn, [1995] 3 S.C.R. 674; 188 N.R. 161; 64 B.C.A.C. 241; 105 W.A.C. 241, refd to. [para. 121].

Painter v. Rae (1997), 127 Man.R.(2d) 133 (Q.B.), refd to. [para. 128].

Edmison v. Boyd (1987), 77 A.R. 321; 51 Alta. L.R.(2d) 43 (C.A.), refd to. [Schedule B].

Dube v. Penlon Ltd. (1994), 21 C.C.L.T.(2d) 268 (Ont. Gen. Div.), refd to. [Schedule B].

Duncan v. Kemp, [1991] B.C.J. No. 1001 (S.C.), refd to. [Schedule B].

Kenyeres v. Cullimore, [1992] O.J. No. 540 (Gen. Div.), refd to. [Schedule B].

Roberts v. Morana, [1997] O.J. No. 5423 (Gen. Div.), refd to. [Schedule B].

Clyke v. Blenkhorn et al. (1958), 13 D.L.R.(2d) 293 (N.S.S.C.), refd to. [Schedule B].

Elverson v. Doctors Hospital et al. (1974), 49 D.L.R.(3d) 196 (Ont. C.A.), refd to. [Schedule B].

Heidebrecht v. Fraser-Burrard Hospital Society, [1996] B.C.J. No. 3042 (S.C.), refd to. [Schedule B].

Morrison v. Hicks (1989), 49 C.C.L.T. 167 (B.C.S.C.), refd to. [Schedule B].

R. v. Conkie, [1978] 3 W.W.R. 493; 9 A.R. 115 (S.C.), refd to. [Schedule B].

Robertshaw Estate v. Grimshaw et al. (1987), 49 Man.R.(2d) 20 (Q.B.), refd to. [Schedule B].

Shawinigan v. Naud, [1929] 4 D.L.R. 57 (S.C.C.), refd to. [Schedule B].

Sunnyside Nursing Home v. Builders Con­tract Management Ltd. et al., [1985] 4 W.W.R. 97; 40 Sask.R. 1 (Q.B.), refd to. [Schedule B].

White et al. v. Turner et al. (1981), 15 C.C.L.T. 81 (Ont. H.C.), refd to. [Sched­ule B].

Crits and Crits v. Sylvester et al., [1956] O.R. 132 (C.A.), refd to. [Schedule B].

Wilson v. Swanson, [1956] S.C.R. 104, refd to. [Schedule B].

Vancouver General Hospital v. Fraser, [1952] 2 S.C.R. 56, refd to. [Schedule B].

Lapointe v. Chevrette (1992), 133 N.R. 116; 45 Q.A.C. 262 (S.C.C.), refd to. [Schedule B].

Maynard v. West Midlands Regional Health Authority, [1984] 1 W.L.R. 634 (H.L.), refd to. [Schedule B].

Dowey v. Rothwell and Associates, [1974] 5 W.W.R. 311 (Alta. S.C.), refd to. [Schedule B].

Laidlaw et al. v. Lions Gate Hospital et al. (1969), 70 W.W.R.(N.S.) 727 (B.C.S.C.), refd to. [Schedule B].

Stroud v. General Hospital Corp. and Pollett (1993), 110 Nfld. & P.E.I.R. 22; 346 A.P.R. 22 (Nfld. T.D.), refd to. [Schedule B].

Anderson v. Grace Maternity Hospital et al. (1989), 93 N.S.R.(2d) 141; 242 A.P.R. 141 (T.D.), refd to. [Schedule B].

Yepremian et al. v. Scarborough General Hospital et al. (1980), 13 C.C.L.T. 105 (Ont. C.A.), refd to. [Schedule B].

National Justice Compania Naviera S.A. v. Prudential Insurance Co. (The "Ikarian Reefer"), [1993] Lloyd's L.R. 68 (Q.B.), refd to. [Schedule B].

Fellowes, McNeil v. Kansa General Inter­national Insurance Co. et al. (1998), 79 O.T.C. 241; 40 O.R.(3d) 456 (Gen. Div.), refd to. [Schedule B].

Webster et al. v. Chapman et al. (1996), 114 Man.R.(2d) 1 (Q.B.), refd to. [Schedule B].

Larney Estate v. Friesen, [1986] 4 W.W.R. 467; 41 Man.R.(2d) 169 (C.A.), refd to. [Schedule B].

Lindal v. Lindal, [1982] 1 W.W.R. 433; 39 N.R. 361 (S.C.C.), refd to. [Schedule B].

Walaschuk Estate v. Winnipeg (City) (1986), 44 Man.R.(2d) 128 (Q.B.), refd to. [Schedule B].

Tronrud v. French et al. (1991), 75 Man.R.(2d) 1; 6 W.A.C. 1 (C.A.), refd to. [Schedule B].

Tronrud v. French et al. (1989), 56 Man.R.(2d) 284 (Q.B.), refd to. [Sched­ule B].

Milina v. Bartsch (1985), 49 B.C.L.R.(2d) 33 (S.C.), refd to. [Schedule B].

Christie et al. v. Insurance Corp. of British Columbia (1993), 28 B.C.A.C. 262; 47 W.A.C. 262 (C.A.), refd to. [Schedule B].

Meyer et al. v. Gordon et al. (1981), 17 C.C.L.T. 1 (B.C.S.C.), refd to. [Schedule B].

Goguen v. Crowe (1987), 80 N.S.R.(2d) 36; 200 A.P.R. 36 (T.D.), refd to. [Schedule B].

Kungl v. Fallis, [1989] O.J. No. 15 (H.C.), refd to. [Schedule B].

Look v. Himel, [1991] O.J. No. 15 (H.C.), refd to. [Schedule B].

Woollard v. Coles (1998), 132 Man.R.(2d) 271 (Q.B.), refd to. [Schedule B].

Pittman Estate v. Bain (1994), 112 D.L.R.(4th) 257; 35 C.P.C.(3d) 67 (Ont. Gen. Div.), refd to. [Schedule B].

St. Jules v. Chen, [1990] B.C.J. No. 23 (S.C.), refd to. [Schedule B].

Anderson-Redick v. Graham et al. (2000), 258 A.R. 42 (Q.B.), refd to. [Schedule B].

Van Mol et al. v. Ashmore (1999), 116 B.C.A.C. 161; 190 W.A.C. 161 (C.A.), refd to. [Schedule B].

Bachalo v. Robson et al. (1998), 129 Man.R.(2d) 1; 180 W.A.C. 1 (C.A.), refd to. [Schedule B].

Dudas v. Munro et al., [1997] B.C.T.C. Uned. 482 (S.C.), refd to. [Schedule B].

Lacroix et al. v. Dominique (1999), 141 Man.R.(2d) 1 (Q.B.), refd to. [Schedule B].

Elofson v. Davis et al. (1997), 195 A.R. 321 (Q.B.), refd to. [Schedule B].

Lindsay v. Freeman, [1995] O.J. No. 541 (Gen. Div.), refd to. [Schedule B].

Schrump et al. v. Koot et al. (1977), 82 D.L.R.(3d) 553 (Ont. C.A.), refd to. [Schedule B].

Krangle v. Brisco et al. (2000), 135 B.C.A.C. 106; 221 W.A.C. 106 (C.A.), refd to. [Schedule B].

Marchand v. Public General Hospital Society of Chatham, [1996] O.J. No. 4420 (Gen. Div.), refd to. [Schedule B].

Mozersky v. Cushman et al. (1997), 48 O.T.C. 161 (Gen. Div.), refd to. [Sched­ule B].

Elder v. Farrell et al., [1998] B.C.T.C. Uned. C45 (S.C.), refd to. [Schedule B].

Brimacombe v. Mathews et al., [1999] B.C.T.C. Uned. 359 (S.C.), refd to. [Schedule B].

MacLean v. Wallace et al., [1999] O.T.C. 53 (Sup. Ct.), refd to. [Schedule B].

Braun Estate v. Vaughan et al. (2000), 145 Man.R.(2d) 35; 218 W.A.C. 35 (C.A.), refd to. [Schedule B].

Authors and Works Noticed:

American Illustrated Medical Dictionary (22nd Ed. 1951) [Schedule A].

Gray, Roscoe N., and Gordy, Louise J., Attorney's Textbook of Medicine (3rd Ed. 1997), vol. 17, generally [Schedule A].

Picard, Ellen I., Legal Liability of Doctors and Hospitals in Canada (3rd Ed. 1996), p. 157 [para. 37].

Robertson, Gerald, Informed Consent to Medical Treatment (1981), 97 Law Q. Rev. 102, pp. 102 to 126 [Schedule B].

Robertson, Gerald, Informed Consent Ten Years Later: The Impact of Reibl v. Hughes (1991), 70 Can. Bar Rev. 423, pp. 423 to 447 [Schedule B].

Rozovsky, Lorne Elkin, The Canadian Law of Consent to Treatment (2nd Ed. 1997), generally [Schedule B].

Stedman's Medical Dictionary (4th Unabridged Lawyer's Ed. 1976) [Sched­ule A].

Williams Obstetrics (20th Ed.), generally [Schedule A].

Counsel:

Robert L. Tapper, Q.C., and Chris Wul­lum, for the plaintiffs;

G. Todd Campbell and Lori T. Spivak, for the defendants, Seager and Black;

Michael D. Werier and Grant A. Stefan­son, for the defendant hospital.

This action was heard before Clearwater, J., of the Manitoba Court of Queen's Bench, Winnipeg Centre, who delivered the follow­ing judgment on June 28, 2000.