Halifax Personal Injury Lawyer Blog

Perhaps the biggest myth of brain injury is that mild traumatic brain injuries are not disabling.

They Look Okay

Since persons with traumatic brain injuries do not look obviously injured and many can function reasonable well in society, there is a common misperception that a traumatic brain injury is not as disabling as more obvious physical injuries.

But They're Not Okay

However, the National Institute of Health concluded that the consequences of traumatic brain injury can include a dramatic change in the patient’s life course, profound disruption of the family, enormous loss of income or earning potential and significant expenses over a life time.

Consequences Can be Devastating

The social consequences of mild, moderate and sever brain injury are significant and serious and include increased risk of suicide, divorce, chronic unemployment, economic strain and substance abuse.

Continue reading "Brain Injury Myth: Mild Traumatic Brain Injury is not Disabling" »

There are generally two types of losses that your personal injury lawyer will try to recover on your behalf.

Non Pecuniary Losses

Non pecuniary losses are losses or harms that cannot be precisely measured or valued. For example, the most common type of non-pecuniary loss is compensation for “pain and suffering”.

See for example Nova Scotia Personal Injury Claims: How Much Is My “Pain and Suffering” Worth?

Pecuniary Losses

On the other hand pecuniary losses are financial losses that can be precisely measured. They may involve out of pocket expenses for things like medical treatment, travel expenses or funeral expenses.

The largest pecuniary loss that most personal injury victims suffer is their loss of income. If someone is seriously injured as a result of someone's negligence they are entitled to be compensated for their pecuniary losses for their past loss of income to the date of settlement or trial, as well as any ongoing income losses they may continue to suffer in the future.

In wrongful death cases, family members are entitled to recover for the pecuniary loss of income that the deceased family member provided to support the family.

Expert Evidence

Pecuniary losses may be difficult to calculate. Typically this part of the claim requires the services of an expert. See for example, Experts in Personal Injury Claims.

In most cases your personal injury lawyer will hire an economist or an actuary to figure out exactly what your pecuniary losses have been to date and how much your pecuniary losses will be in the future. Economist and actuaries use tables, guidelines and statistics to help determine how much money you would have earned over your lifetime. Obviously, there is no such thing as a crystal ball and future losses can never be determined with absolute certainty.

Your lawyer will take into account what are called negative contingencies. For example, the chance that you may have been fired, that your company would go bankrupt or that you may have been injured in some other way.

On the other hand, the expert will also determine the “positive contingencies” like raises, bonuses and promotions that might have increased your income in the future.

Continue reading "What is a Pecuniary Loss in a Personal Injury Claim?" »

"Do I have to pay income tax on my personal injury award?"

I get asked this question a lot. The short answer is, at least until the government changes the Income Tax Act, personal injury awards in Canada are not taxable.

In Canada, compensation for non-pecuniary damages (what is typically referred to as “pain and suffering”) is not considered taxable income. However, if you invest the money that you receive, any interest, profit or gain that you receive from those investments is taxable.

For example, say you receive $100,000.00 in compensation for your “pain and suffering” claim. The entire award is tax free.

However, if you take that $100,000.00 and buy an investment that earns 5% interest per year, the $5,000.00 you earn each year will be considered taxable income.

There are tools that your personal injury lawyer can use to ensure that investments from your injury settlement are tax free.

In certain circumstances your personal injury lawyer may recommend that you place your settlement funds into an investment known as a “structured settlement”.

A structured settlement is a type of investment, known as an annuity, where you purchase an insurance contract that entitles you to receive periodic payments (usually monthly) over a specific time frame (which may be a specific number of years or even your entire life).

All of the payments, including any increase in value of the payments over time, are tax free.

Structured settlements are not right for every personal injury claim. There are advantages and disadvantages that you will need to discuss with your personal injury lawyer.

Structured settlements can be complicated and your lawyer will probably retain the services of an expert to determine whether a structured settlement is right for you and what the appropriate terms of the structured settlement should be.

Dr. R. Menon tried to stop a class action filed against him by patients whose test results were mis-read by Menon.

The New Bruswick Court of Appeal ruled last week that the class action can proceed.

I have been following this fiasco for the last two years. For more information you can take a look a some of my past posts:

Pathologist Menon Should Have Been Fired Years Ago: N.B. Inquiry

Disgraced Pathologist Menon “Sorry” but Blames Everyone in Sight

Disgraced Pathologist Menon's Work had 'Big Problems': New Brunswick

Health Authority Knew About Pathologist's Problems: Miramichi

Perhaps now the parties can get down to the real issue. Compensating the victims who were injured or died, because they didn't receive treatment for cancer, because of the problems with Menon's work.

Defence Lawyers on Facebook

Everybody seems to be interested in Facebook, Twitter and all the other social media networks these days. That includes lawyers who represent insurance companies. There have been a series of cases across Canada where lawyers for insurance companies have demanded production of plaintiffs' Facebook pages in order to use the information against the plaintiff.

Depressed Victim Looked Too Happy

In a recent case in Quebec, Nathalie Blanchard was on disability for depression. She had her benefits terminated because her insurance company, Manulife found pictures on her Facebook page where she was smiling and looking like she was having a good time. In other words, she didn’t look depressed so the insurance company cut off her benefits.

Blanchard is now suing Manulife to reinstate her disability benefits.

In New Brunswick the Court of The Queens Bench recently ordered a plaintiff to produce the contents of her Facebook page to the lawyers representing the defendant’s insurance company.

Online Information Must be Disclosed?

Court rules in each province require the parties to disclose any information they have that may be relevant to the matters at issue in litigation. This now includes any electronic information in possession of the parties. While this commonly refers to things like e-mail or digital documents, the courts have been extending the reach of this disclosure obligation to include online information.

In Leduc v. Roman the Ontario Court required the plaintiff to produce information from a “private” Facebook account. The judge in that decision stated:

“It is now incumbent on a party’s counsel to explain to the client, in appropriate cases, that documents posted on a party’s facebook profile may be relevant to the allegations made in the pleading.”

Facebook May Be Used For Cross Examination

In a recent case in Newfoundland, Terry v. Mullowney, the lawyer for the defendants used excerpts from the plaintiff’s facebook page to cross examine the plaintiff about his social life.

The judge commented on the use of this information:

“While not getting into the details of the excepts, they convince me that Mr. Terry (at least in the few months prior to his testimony in court) recorded on facebook had a rather full and active social life…I find it incredible that Mr. Terry’s social life miraculously improved in the few months he was communicating on facebook and that for the remainder of the time from 2001 to 2007 he essentially had little or no social life. Without this evidence I would have been left with a very different impression of Mr. Terry’s social life.”

Disclosure Obligations Extend Online

So in the future you can expect parties in litigation to demand complete disclosure of Facebook pages, Linkedin profiles, Twitter accounts and public Blogs. In short, any information that you post online can and may be used against you. Beware.

Continue reading "Facebook Being Used Against Personal Injury Victims" »

The Discovery Process

One of the most important steps in any personally injury claim is the oral discovery. If you file a lawsuit for compensation for personal injuries you will be required to testify about your knowledge of the event that lead to the lawsuit and your knowledge of the injuries that you have suffered.

In other words; what happened? How badly were you injured? How have the injuries effected your life?

A discovery is basically a question and answer session where you swear (or affirm) to tell the truth. The question and answer session is recorded by a court reporter who will type up a transcript of all the questions and answers. That transcript can be used later in court.

Since more than 90% of civil lawsuits settle before trial, the oral discovery is probably the most important step in the litigation process. As the name implies, the discovery process allows each side to “discover” all there is to know about the other side’s case. Each side gets a better understanding of the strengths and weaknesses of their claim and their opponents claim. They are able to judge how the plaintiff and defendant will appear if they have to testify in court.

In short, the discovery process provides a “dry run” for how the witness will testify at trial.

Before your discovery your lawyer will meet with you to prepare you for the discovery. I have prepared a report for all of my clients who are getting ready for discovery so that they can read it at their leisure and we can discuss any questions that they have. If you would like a copy, feel free to contact me through this blog.

Continue reading "What is a “Discovery”? Halifax Personal Injury Lawyer Explains" »

2 Important Questions

There are two questions that almost every single client asks me during our first meeting. They are questions that I think every person who has suffered a personal injury should ask their lawyer before they decide to hire them.

The two questions are:

1. How long will this take?

2. How much will I get?

The honest answer to both of these questions (at least during the initial interview) is: “I don’t know”.

How Long Will This Take?

The golden rule of any personal injury claim is that you should never settle your claim until your injuries have completely resolved or until you know the full extent of any future residual disability that you may be left with as a result of your injuries. In other words, don’t settle your claim until you know how your injuries are going to affect you in the future.

It is often very difficult to tell, shortly after an accident, how long a person’s injury will last. It is usually impossible to tell what kind of long term residual problems they will have as a result of their injuries.

That means it is difficult if not impossible to determine how long it will take you to recover, how long it will take your doctors to provide a medical-legal opinion as to what your future limitations will be, what affect it will have on your future employment, what, if any, future rehabilitative or medical treatment you will require.

It is also impossible to say, in the early stages of a lawsuit how long it will take to complete document disclosure, complete discoveries of the parties, and get a trial date from the court.

While most experienced personal lawyers will be able to tell how long it takes to resolve a typical injury claim, your claim may not be “typical”. Every personal injury claim is unique and the best course of action depends on the particular facts of each individual case.

If a lawyer tells you in your first meeting exactly how long it is going to take before your claim is settled or how long it will be before you get to trial, ask them to put it in writing. Then you may want to consider talking to another lawyer.

How Much Will I Get?

The amount of compensation you will be entitled to receive for non-pecuniary damages (what is typically referred to as compensation for “pain and suffering”) depends a great deal on how long it takes you to recover from your injuries.

As I have explained above, it often takes months, sometimes years, for doctors to determine what the full extent of a patient’s injuries are and what the long term affects will be. That means it will take time to determine the full extent of the compensation you are entitled to receive for your non-pecuniary damages.

You are also entitled to recover compensation for things like loss of housekeeping capacity, loss of income, medical expenses and any other out of pocket expense you may have suffered as a result of your injuries.

In short, it will usually take a great deal of time and investigation to determine the full value of your claim.

If a lawyer tells you in your first meeting: "your claim is worth millions", ask him or her to put it in writing. When they won't, you may want to consider talking to an experienced personal injury lawyer.

Continue reading "2 Questions To Ask Before You Hire a Personal Injury Lawyer" »

Landmark Ruling Regarding Loss of Housekeeping Capacity

In the 1991 decision of the Saskatchewan Court of Appeal in Fobel v. Dean, the court confirmed that loss of housekeeping capacity has value and an injured plaintiff is entitled to be compensated for the loss of that capacity.

Nova Scotia Confirms Claims for Loss of Housekeeping

In 1998, Nova Scotia Court of Appeal confirmed that the loss of housekeeping capacity is a separate and distinct head of pecuniary damages and must be compensated for accordingly. In Carter v. Anderson, Justice Roscoe stated:

“Future loss of capacity, where proved, should be compensated separately, whether or not replacement help has been paid in the past … the partial or total loss of that ability has economic value which should be recognized.”

In the 11 years since the Carter v. Anderson decision there has been a tremendous amount of confusion experienced by lawyers, insurance companies and the courts as to how to properly calculate a loss of housekeeping capacity.

Groundbreaking Decision in Ontario

The National Post has reported on a recent "groundbreaking" decision by the Ontario Court of Appeal that helps to provide some clarity. In McIntyre v. Docherty the Court of Appeal stated that in order:

"...to avoid this kind of confusion in future cases where different scenarios of housekeeping losses arise, it will be helpful if the jury can be specifically instructed regarding the type of loss at issue and the evidence in support of that loss."

Three Types of Housekeeping Losses

The court goes on to classify three different types of housekeeping losses.

Pre-trial: Work Left Undone

Justice Susan E. Lang for the Court of Appeal:

"Where the injured plaintiff is unable to perform some or all housekeeping tasks, and where a third party [i.e. a housekeeper] does not do the work in the injured person's stead, work will be left undone...In that situation, the injured plaintiff will experience two sorts of intangible losses compensable in an award of non-pecuniary [i.e. general] damages."

Pre-trial: Work Can Be Done, But with Difficulty/Pain

"A plaintiff may continue to undertake housekeeping but may experience pain or difficulty in doing so…He or she may be required to work more hours post-accident to accomplish the same amount of pre-accident housekeeping. If a plaintiff thus works 'inefficiently,' he or his non-pecuniary award would be increased to reflect any increased pain and suffering."

Pre-Trial: Work Done by Third Parties

"The law is well-established that where a plaintiff incurs a pre-trial, out-of-pocket loss by hiring a replacement homemaker, the plaintiff may claim the reasonable replacement costs of that homemaker as special [i.e. pecuniary] damages."

Decision Provides Clarity

The decision of the Ontario Court of Appeal is reasonable and, for the most part, mirrors the approach taken by most judges in the Nova Scotia courts. However, this decision is the first one that I have seen that clearly explains how to appropriately calculate different types of loss of housekeeping capacity.

Continue reading "Ontario Court of Appeal Tries to Bring Clarity to Calculating Loss of Housekeeping Claims" »

Last week I had the pleasure of golfing in the Brain Injury Association of Nova Scotia's 18th annual 18 Holes for Hope Golf tournament.

Brain Injury Awareness Month

The tournament is one of BIANS's major fundraisers and I was happy to be part of the organizing committee.The tournament is held in June every year as part of Brain Injury Awareness month.

BIANS: Helping Survivors and Their Families

Over the past 20 years, BIANS has helped provide a community of support for survivors of brain injury by bringing together brain injury survivors, family members and health professionals.

BIANS has established a chapter network at the grassroots community-level to provide support and information to survivors and their families.

BIANS is a source of information about the effects of brain injury and has worked to increase injury prevention and awareness of brain injury.

BIANS established Aiseirigh House (now operated by the Moving In New Directions Society) a residential assisted living facility for brain injury survivors, and the Inroads Program; a community-based program for survivors which teaches cognitive skills and strategies in a combination of one-on-one tutoring, workshops/classroom and social settings.

Living With Brain Injury

I have dedicated my career to helping persons with serious injuries receive fair compensation. To get some idea of the effects, and extraordinary needs of brain injury survivors, take a look at this lecture about living with a traumatic brain injury.

How to Make a Donation

If you want to help support BIANS you can make a donation here.

Continue reading "June is Brain Injury Awareness Month" »

One of the challenges that I face as a Nova Scotia personal injury lawyer is explaining to people who have been seriously injured how much compensation they are entitled to receive.

Pain and Suffering

One of the heads of damages that the court will consider when awarding compensation is what lawyers refer to as “non-pecuniary damages”. Most people refer to this type of damages as “pain and suffering”.

How Do Courts Calculate “Pain and Suffering”?

There is no such thing as a “Pain-O-Meter”. An injured victim cannot be hooked up to a machine that prints out the financial value of their pain. What a judge does when determining compensation for pain and suffering is use his or her experience and discretion to consider how the injury has affected the victim’s ability to function and how the injury has effected the person's enjoyment of life.

In other words, how have your injuries affected your normal day to day activates; your ability to work; and your normal amenities of life?

Financial Awards in Canada Different than the United States

Many of my clients have read news stories from the United States where injured victims have been awarded millions of dollars (sometimes tens of millions of dollars) for their “pain and suffering” from catastrophic injuries. Unfortunately, those types of damage awards cannot happen in Canada.

Supreme Court of Canada Caps Pain and Suffering Awards

The Supreme Court of Canada has placed a cap on the amount of compensation that injured victims are entitled to receive for non-pecuniary damages for pain and suffering.

In 1978, in a case known as Teno v. Arnold, the Supreme Court of Canada created a barrier to recovery for innocent victims who have been injured as a result of someone else’s negligence. In the Teno case, the Supreme Court ruled that no matter how seriously injured you are the maximum compensation that you can receive for your “pain and suffering” is $100,000.00.

Maximum Award for Pain and Suffering

Taking inflation into account, the cap on pain and suffering awards is currently considered to be slightly more than $300,000.00. But that maximum amount is only paid to the most catastrophically injured victims (quadriplegic, paraplegic, severe brain damage and similar injuries).

Even when plaintiff’s receive damage awards that seem large, they often never see the full amount decided by the judge or jury. Many awards are drastically reduced on appeal. These reduced or vacated judgments are seldom reported by the media.

If you are considering a claim for compensation for pain and suffering it is important to have an experienced Nova Scotia personal injury lawyer assisting you to ensure that you provide all of the relevant information that the courts will consider when assessing your non-pecuniary damages claim for pain and suffering.

Continue reading "Nova Scotia Personal Injury Claims: How Much Is My “Pain and Suffering” Worth?" »

New Guidelines to Diagnose Mild Brain Injury

The American College of Emergency Physicians has established new guidelines to be used in diagnosing mild traumatic brain injury.

Serious but Undiagnosed Injury

Mild traumatic brain injury has to be one of the most serious, yet undiagnosed health problems in Canada. Unfortunately, the general public has little understanding of what mild traumatic brain injury is and the problem is compounded by a poor understanding by some health professional about the criteria for what constitutes a brain injury.

Each year approximately 700 Nova Scotians suffer a traumatic brain injury. There are up to 5,000 - 6,000 serious car accidents in Nova Scotia and P.E.I. each year. Given the violent nature of car crashes, many of these people will suffer a mild traumatic brain injury, although they may never be diagnosed by a health professional.

No One Knows the Real Numbers!

In their release announcing the new guidelines, the College of Emergency Physicians states:

“The real incidents of traumatic brain injury are unknown since many patients who sustain an injury never seek medical care.”

I fully support any initiative that makes it easier for health professionals to determine when a patient has suffered a brain injury. But more effort needs to be placed on educating the public about the causes, and symptoms, of mild traumatic brain injury.

Thanks to Bruce Stern at the Traumatic Brain Injury Law Blog for bringing the guidelines to my attention.

Related Posts:

Ban Fighting in Hockey to Prevent Brain Injuries – Deaths: Expert Panel

NHL Hockey Stars - Doctors team up to study concussion/brain injuries

Traumatic Brain Injury: Myth # 1 - You have to be knocked out to suffer a brain injury

Traumatic Brain Injury Claims: Myth #2 You Have to Hit Your head to Suffer a Brain Injury

What is a Mild Traumatic Brain Injury?

Continue reading "Brain Injury Claims: New Guidelines to Diagnose Mild Traumatic Brain Injury" »

We have been investigating potential personal injury claims against Bayer Inc. the manufacturer of the drug Trasylol (Aprotinin) for almost a year now.

In January 2006, the New England Journal of Medicine reported that of the 4,400 heart surgery patients who received Trasylol:

1. Trasylol increased the risk of stroke by 181%;

2. Trasylol increased the risk of heart attack by 48%; and

3. Trasylol increased the risk of heart failure by 109%.

Furthermore, in a Canadian Research Study referred to as the BART Study, Trasylol was compared to alternative health surgery drugs. The BART Study found that 1 in 50 patients who received Trasylol died from complications related to the drug.

Some patients at the cardiac unit of the Queen Elizabeth II Health Sciences Centre in Halifax Nova Scotia received Trasylol as part of the hospital’s pre-operative procedures. There are no public statistics about how many patients from the Queen Elizabeth II Health Sciences Centre received Trasylol or how many of those patients who received Trasylol developed debilitating or fatal complications.

If you or a family member had heart surgery at the Queen Elizabeth II Health Sciences Centre and suffered stroke, heart attack, heart failure or kidney damage after your surgery, you may have a potential claim for compensation.

Continue reading "Trasylol (Aprotinin) May Cause Fatal Side Effects: Information for patients" »

A “multi-million dollar” class action law suit has been filed against drug manufacturer Bayer Inc. for injuries allegedly caused by the drug Trasylol (also known as Aprotinin)

CTV News has reported that a number of class action lawsuits have been filed in the United States. Now patients in Canada have filed a similar lawsuit.

Bayer Inc. withdrew Trasylol from the market after medical research studies showed that patients treated with the drug were more likely to die than patients treated with other medication.

We have been investigating potential Trasylol claims for almost a year.

In May of this year I posted about a Canadian study called the “BART Trial” which found that patients who received Trasylol were 53% more likely to die than people who received other common anti-bleeding agents like Aminocaproic Acid.

You can read the post here: Trasylol (Aprotinin) Anti-Bleeding Drug Raises Death Risk: Canadian Study.

Almost a year ago a documentary on CBS’s 60 Minutes discussed the risks posed by the drug and suggested that the manufacturer, Bayer, hid evidence that Trasylol was dangerous. The documentary pointed out that as far back as January 2006 the New England Journal of Medicine published a study reporting that Trasylol was connected with kidney failure, cardiac arrest and stroke in patients undergoing coronary artery surgery.

You can watch the whole 60 Minutes story here.

You can also take a look at my earlier post: Is Trasylol (Aprotinin) the Next Vioxx? Manufacturer Hid Evidence Drug was Dangerous.

Trasylol (Aprotinin) has been used by the cardiac surgery unit of the Queen Elizabeth II Health Sciences Centre for many years. If you or a family member suffered kidney failure, cardiac arrest or stroke after having heart surgery, you may have a potential claim.

For more information you can contact me at www.apmlawyers.com or toll free 1-877-423-2050 or through this blog.

Here we go again. Prince Edward Island’s Department of Health has been investigating a radiologist (currently on leave) because of what the Department describes as an “unacceptably high” error rate.

However, despite the fact that the radiologist’s mistakes may have an impact on the health and safety of patients in Prince Edward Island, the Department has refused to make the report public.

CBC has reported that Dr. Karunamoy Das has been on leave since an independent audit of his work showed that his interpretation of CT scans, MRI images, x-rays, and ultrasound images had an error rate of 12%. The Department of Health ordered a complete review of all 5,700 diagnostic images that Dr. Das reviewed.

Deputy Health Minister Keith Dewar has said that patients whose records were reviewed have been told of their own results.

The report is just the latest in a string of media reports about problems with medical test results in the various Atlantic Provinces which have included faulty pathology test results in New Brunswick and problems with breast cancer screening test results in Newfoundland and Labrador.

Unfortunately, I think we are seeing just the tip of the iceberg. Most health care professionals are capable and hardworking individuals. However, they are working under crushing work loads and severe underfunding of our health care system.

In the short term, the funding crisis is only going to get worse as the global financial crisis impacts Provincial health care budgets. In the long term, the demands on our medical system are going to increase exponentially as the baby boom generation ages and their health problems become more complicated.

Here we go again. Prince Edward Island’s Department of Health has been investigating a radiologist (currently on leave) because of what the Department describes as an “unacceptably high” error rate.

However, despite the fact that the radiologist’s mistakes may have an impact on the health and safety of patients in Prince Edward Island, the Department has refused to make the report public.

CBC has reported that Dr. Karunamoy Das has been on leave since an independent audit of his work showed that his interpretation of CT scans, MRI images, x-rays, and ultrasound images had an error rate of 12%. The Department of Health ordered a complete review of all 5,700 diagnostic images that Dr. Das reviewed.

Deputy Health Minister Keith Dewar has said that patients whose records were reviewed have been told of their own results.

The report is just the latest in a string of media reports about problems with medical test results in the various Atlantic Provinces which have included faulty pathology test results in New Brunswick and problems with breast cancer screening test results in Newfoundland and Labrador.

Unfortunately, I think we are seeing just the tip of the iceberg. Most health care professionals are capable and hardworking individuals. However, they are working under crushing work loads and severe underfunding of our health care system.

In the short term, the funding crisis is only going to get worse as the global financial crisis impacts Provincial health care budgets. In the long term, the demands on our medical system are going to increase exponentially as the baby boom generation ages and their health problems become more complicated.

For years insurance companies and their lawyers have been telling chronic pain victims: "...it's all in your head!"

Defendants Claim Chronic Pain Isn't Real

Insurance companies hire psychiatrists to produce reports claiming that the chronic pain victim's pain is the result of a psychiatric illness, accuse the victim of malingering or come up with a bogus diagnosis like compensation neurosis.

New Medical Evidence

Well this weeks issue of the medical journal Neuron has proved that the insurance companies are right, the pain is in their head. But not in the way they think.

CBC has reported on a new study that used functional magnetic resonance imaging to study differences in the brains of normal subjects and the brains of subjects with complex regional pain syndrome.

Chronic Pain Rewires the Brain

The brains of chronic pain patients showed physical changes in the brain's white matter, the cable-like "wiring" of fibres that deliver messages between neurons.

The study's lead investigator, Vania Apkarian, a professor of physiology at Northwestern University's Feinberg School of Medicine in Chicago had this to say:

"This is the first evidence of brain abnormality in these patients...People didn't believe these patients. This is the first proof that there is a biological underpinning for the condition."

Another Tool for Victims Advocates

This study is going to be a great tool for those of us that represent injured victims!

Continue reading "Chronic Pain Rewires the Brain: Insurance Companies Take Note!" »

A number of Canadian hospitals are reusing "single-use" medical devices (SUDs) that are supposed to be disposed of after being used. Worse yet, the vast majority of hopitals that are reusing the medical devices are sterilizing the devices in-house. Infection control experts have criticised the practice as being "fraught with risk", according to a story by the Canadian Press.

...tragedies like the tainted blood scandal and cases of variant Creutzfeldt-Jacob disease -- the human form of mad cow disease -- linked to reuse of tools used in brain surgery have deepened the understanding of infection risks and raised the bar for infection control in hospitals.

No Regulations:

The story reports that while there appears to be consensus among health care professionals that a national policy is needed and that the practice of in-house reprocessing ought to be banned, a regulatory void means that in many parts of the country hospitals can do as they wish when it comes to reuse of single-use medical devices.

Saving Money vs. Patient Safety:

The cost of health care has become so astronomical that hospitals have been forced to find any way they can to save money. Some would say by cutting corners at the expense of patient safety.

The Canadian Agency for Drugs and Technologies in Health (CADTH) is a national body that provides Canada’s federal, provincial and territorial health care decision makers with impartial advice and evidence-based information about the effectiveness and efficiency of drugs and other health technologies.

Reuse Poses Legal Liability Issues:

CADTH has produced a series of reports on reprocessing of SUDs that address concerns about possible risks to patients of infection or other complications, legal liability issues, and uncertainties regarding cost-effectiveness.

CADTH concluded that there is:

"Insufficient evidence to establish safety and effectiveness "of reusing SUDs.

Reuse Endangers Patient Safety: United States:

Almost three years ago the Washington Post published a story about the dangers of reusing SUDs. The report documented dozens of cases of patient injuries and device malfunctions after single-use devices were reused.

Government Investigates Health Risks:

The practice has become so widespread that the United States Government Accountability Office prepared a report on the issue. The title of the report concludes that FDA has increased its regulation of the reprocessing of SUMDs and "available information does not indicate that use presents an elevated health risk".

But on the very first page of the report the authors state:

Neither existing FDA data nor studies performed by others are sufficient to draw definitive conclusions about the safety of reprocessed SUDs compared to similar original devices.

How comforting.

Dangerous drivers suffering from alcohol abuse, cardiac disease and neurologic disorders are not being reported by their doctors; and doctors may be committing medical malpractice for failing to comply with provincial laws.

A recent report in the medical journal Open Medicine found that between 1996 and 2001 37% of drivers admitted to a trauma unit with injuries from car accidents had a reportable medical condition that made them unfit to drive.

Most of the patients (85%) had seen a doctor in the year before the crash, and 14 per cent had even seen a doctor a week before their crash. But only three per cent of these had been reported to the Ontario Ministry of Transportation.

The author of the report Dr. Donald Redelmeier of Toronto's Sunnybrook Health Sciences Centre, was quoted by CTV as saying:

"There's sort of a historical tradition where a lot of physicians didn't believe road safety was a part of public health...Globally, motor vehicle crashes account for almost 1 million fatalities, far eclipsing malaria for the first time in the history of the planet."

All Canadian provinces and territories have enacted some form of legislation requiring doctors to report patients who are believed to be unfit to drive a motor vehicle. In some jurisdictions, the duty is mandatory; in others, it is discretionary. In either case, the duty to report is an exception to the normal rules in respect of doctor-patient confidentiality.

The authors suggest a number of reasons why doctors may not be following the law requiring them to report unfit drivers:

Uncertainty as to whether a patients impairment is serious enough to report;

Concerns over how their patients will react;

Being too busy;

Lack of training; and

The view that road safety isn't a medical problem.

Based on their findings, the authors conclude that mandatory reporting in Ontario "does not achieve its stated purpose."

Innocent victims of car accident have filed personal injury claims against doctors for failing to report unfit drivers who subsequently caused car accidents. See for example Toms v. Foster

Whatever the reason, a doctors failure to report can have serious consequences, not only for the innocent victims of car accidents caused by unfit drivers, but to the doctors who fail to report them.