The Dial-A-Law library is prepared by lawyers and gives practical information on many areas of law in British Columbia. Script 420 gives information only, not legal advice. If you have a legal problem or need legal advice, you should speak to a lawyer. For the name of a lawyer to consult, call Lawyer Referral Service at 604.687.3221 in the lower mainland or 1.800.663.1919 elsewhere in British Columbia.
Legal duty to give proper medical care
All doctors, nurses, hospitals, and other healthcare providers have a legal duty to provide proper medical care to patients—and to any other people who need emergency medical care. But doctors do not have to accept everyone as a patient. They can refuse to take a person as a patient for legitimate reasons. For example, a doctor may lack medical knowledge and experience in a particular area. Or a doctor and person may disagree on the right medical treatment for the person. But doctors cannot refuse to take a person as a patient because of age, gender, marital status, medical condition, national or ethnic origin, physical or mental disability, political affiliation, race, religion, or socioeconomic status.
If a doctor fails to provide proper medical care, a person can sue them for medical malpractice. At the same time, the person can also complain to the College of Physicians and Surgeons of BC, the body that licenses all BC doctors, enforces standards for them, and handles complaints against them. But the College cannot order a doctor to pay you money—only a court can do that. Script 423, called “Making a Complaint Against Your Doctor” explains how to file a complaint.
The two main types of medical malpractice are negligence and failure to get a patient’s informed consent. And in some cases, the failure to get informed consent may also be an assault.
Doctors or healthcare providers are negligent if they fail to provide the standard of care that a reasonable doctor or healthcare provider practicing in the same area would provide in similar circumstances. If the negligence causes injuries or illness to a person, then the doctor or healthcare provider may be liable to pay damages (money to pay for the harm done) to the person. It’s no excuse for a doctor to say, “I did my best. I just didn’t know any better.” If the doctor should have known better, they may be liable. For example, let’s say that you see your doctor because you are not feeling well and your doctor prescribes a drug to treat the symptoms you described. You take the drug and it harms you. It turns out that it was not appropriate, considering your medical history and the other drugs you were already taking. If other doctors with a similar practice would not have prescribed the drug, your doctor may be negligent.
Not every mistake or bad result means there was negligence—doctors and healthcare providers are not liable for every mistake. The law realizes that doctors often have to make quick decisions without the best information. The key question is this: did the doctor make a reasonable decision that other reasonable doctors would have made in the same situation—even if later it turns out to be the wrong decision that caused a bad result. For example, you complain to your doctor of severe head pain. They pay attention and examine you. They carefully take your medical history, listen to you describe your symptoms, and order the right tests. Using the results of this examination, they decide that you have an ordinary tension headache that will go away. Later, it turns out that your doctor was wrong, and the pain was not caused by a tension headache. The doctor’s diagnosis was wrong. But your doctor still provided the proper standard of care, the same care that other doctors would have provided in this case. The doctor was not negligent and you probably won’t win if you sue the doctor for malpractice.
The standard of care—this varies with the level of specialty of the doctor—the standard may be higher for specialists. And it varies with time—today’s standard may not be good enough next year. You can’t always expect the best care available at the most sophisticated research hospital. The standard of care may be affected by the level of hospital that treats you.
In summary, not every mistake or bad result automatically means there was negligence. A doctor may take all the right steps and still make a mistake or get a bad result.
Damages for negligence—if you prove there was negligence and the negligence caused your injury or illness, a court may order the doctor, hospital, or healthcare provider to pay you damages for the harm the negligence caused. This can include lost earnings, medical and other expenses, pain and suffering, and loss of enjoyment of life. This last category is the court’s attempt to compensate you for the effect of the negligence on your life, in general. The doctor is responsible only for the harm that their negligence caused. For example, say you consented to surgery that would require you to take 2 months off work to recover, if done properly. But the surgeon was negligent and as a result you had to take 6 months off. In this case, you would be paid only for the extra 4 months of lost earnings caused by the negligence. You would not be compensated for the first 2 months off because you had consented to that. And you still would have had to take the 2 months off if the surgery had gone as planned.
Delayed diagnosis—if a doctor fails to diagnose a medical condition that a reasonable doctor in the same situation would have diagnosed, they would be negligent. The question then becomes whether the failure to diagnose caused any injury or loss to the patient. Sometimes, a delay in diagnosis can mean the difference between being curing or not curing the condition. Other times, a delay in diagnosis may not have made a difference. In that case, the patient could not recover anything from the doctor.
Others may be responsible—if a doctor delegates work to someone else, the doctor may still be legally responsible for the work. If a doctor leaves a patient in the care of another doctor, both doctors may be responsible. If an inexperienced intern performs the duties of a doctor, the intern has to give the same medical care the doctor would give. But a doctor can rely on the employees of a medical facility and expect that they’ll meet the standard of care required in their jobs. So if a doctor leaves proper instructions with a nurse who doesn’t follow them, the nurse, not the doctor, may be responsible. Or both may be. If a person is harmed by the negligence of another healthcare professional, they can sue that professional. They can also file a complaint with the regulatory body for that profession. For example, the College of Registered Nurses of BC licenses nurses. The Emergency Medical Assistant Licensing Board licenses paramedics.
Hospitals’ duties—hospitals have a duty to exercise a proper standard of care. A hospital’s duty is to take reasonable care in running the hospital to avoid harming patients. This includes appointing enough competent staff, ensuring that the staff act within their competence level, ensuring timely treatment, and taking the right steps to protect patients from infections from other patients. Hospitals normally have someone to handle complaints about healthcare they provide.
Complaints that hospitals can’t resolve—each health authority has a Patient Care Quality Office to deal with complaints that hospitals cannot resolve. Each health authority also has a Patient Care Quality Review Board. They review complaints that the Patient Care Quality Offices have not resolved. For more information, call 1.866.952.2448 or see the Boards’ website.
Patients are responsible too—as a patient, you have the power to manage your healthcare. You must give the doctor all the important information about your condition, your medical history, and any other relevant information. If you don’t, and that leads to an error in diagnosis or treatment, it will be your fault, not the doctor’s. As well, a doctor is not responsible for problems if you don’t follow the doctor’s advice and your failure causes the problem. For example, if you get sick after surgery, it would be hard to prove that a surgeon was negligent in operating on you, if you don’t follow the surgeon’s instructions for recovery.
Failure to get a patient’s informed consent
A doctor has to tell you about your condition, the nature of the proposed treatment, the risks of the treatment, and other options that you may have. You can’t consent to treatment unless the doctor gives you all this information. A doctor does not have to explain every possible risk, just the risks that a reasonable patient would want to know before deciding on treatment. This includes explaining what could happen and the likelihood of it happening.
If you suffer an injury or illness after medical treatment, and it was a known risk that your doctor did not tell you about before you agreed to the treatment, it could be malpractice. A court will consider whether a reasonable person would have consented to the treatment if they had been told of the risks. In some cases, the failure to get any consent at all may also be an assault or battery. If you have experienced an assault during medical treatment, you can contact the police.
A third, complicated type of malpractice
Besides negligence and lack of informed consent, there is a third type of malpractice. Recently, courts have said doctors may be responsible if they break the patient-doctor contract. This is a complicated area of malpractice law, not covered by this script. For example, one issue may be who has a contract with the doctor: you or the Medical Services Plan. You would need a lawyer to see if this applies to your case.
Suing because of malpractice—legal advice and time limits
If you have questions or concerns about your treatment, talk to your doctor. Then, if you feel that you’ve been the victim of medical malpractice, get legal advice right away.
Generally, you must start a malpractice lawsuit within 2 years of when the malpractice occurred. This is called the limitation period. More precisely, it’s within 2 years of when a reasonable person would realize that they suffered an injury from a doctor’s actions and the court system is the right place to seek a remedy. Even if you’re well during this time, you should act quickly—while witnesses are still available and their memories are fresh. This is the general rule, but there are exceptions when the 2-year limitation period starts running at a different time. You would need to speak to a lawyer about this.
Suing for malpractice can take a long time—often 2 to 5 years or more from start to finish.
Costs of suing—some lawyers will work for a contingency fee, meaning the fee depends on the result of the case. If you lose, the lawyer gets nothing. If you win, the lawyer gets part of your compensation award. Win or lose, though, you usually have to pay the expenses of suing, which can be thousands of dollars, especially if you have to hire experts to help prove your case. The Law Society regulates contingency fee contracts to ensure they are fair to clients. For more information about lawyers’ fees, check script 438, called “Lawyers’ Fees”.
Complaining to the College at the same time as suing
You can file a complaint with the College of Physicians and Surgeons of BC. There is no time limit for complaining to the College. And you can do this at the same time as you sue for malpractice and contact the police if you think you were assaulted. But the College cannot order a doctor to pay you money—only a court can do that. Script 423, called “Making a Complaint against Your Doctor” explains how to file a complaint. Contact the College through its website or call it at 604.733.7758 in Vancouver and 1.800.461.3008 elsewhere in BC.
You can also seek a review of the College’s decision by the Health Professions Review Board, within 30 days of receiving the College’s decision. The Board assesses the adequacy of the College’s investigation and reasonableness of its decision.
[updated June 2018]
The above was last reviewed for accuracy by Lindsay Johnston and Dionne Liu, and edited by John Blois.
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