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HEALTH CARE PROFESSIONALS - Liability (malpractice) - Negligence - Standard of care - Particular professions - Nurses

Friday, June 30, 2017 @ 8:29 AM  

Appeal by the plaintiffs, an infant and mother, from the dismissal of their medical negligence action against the defendants. The infant plaintiff suffered a profound brain injury due to ischemic hypoxia one hour before her birth. The plaintiffs alleged the obstetrical nurses were negligent in respect of the monitoring of the infant's fetal heart rate. Competing expert evidence was adduced regarding the applicable standard of care, whether it was met by the defendants, and whether the accurate recording of the infant's fetal heart rate would have revealed the effects of the hypoxia prior to birth, leading to intervention. The trial judge concluded that the defendant nurse did not breach the applicable standard of care with respect to the type of fetal heart monitoring and the accuracy of the recording. The judge's conclusion undermined any assertion of the need for earlier intervention based on the infant's heart rate. The plaintiffs appealed.

HELD: Appeal dismissed. The trial judge did not misapprehend the expert evidence or make internally inconsistent factual findings in reaching a conclusion regarding the standard of care. If a prima facie case was made out by establishing that the infant suffered an acute and near total injury in the 50 minutes before her birth, it was answered by evidence that the nurse accurately recorded the fetal heart rate as generally normal, without apparent need for intervention. To the extent the nurse's evidence was challenged, there was expert evidence that answered the challenge. The plaintiffs' case that the nurse breached the standard of care was based principally on circumstantial evidence. The trial judge was in the best position to weigh the credibility of witnesses, and the findings in that regard were owed deference. The trial judge's conclusions were supported by the evidence. No palpable and overriding error in the judge's findings was established.

Allen (Litigation guardian of) v. Bishop of Victoria (c.o.b. St. Joseph's General Hospital), [2017] B.C.J. No. 1166, British Columbia Court of Appeal, I.T. Donald, P.M. Willcock and J.E.D. Savage JJ.A., June 20, 2017. Digest No. TLD-June262017009