This was a decision of the Health Professions Appeal and Review (HPARB), affirming the decision of the College of Physicians and Surgeons of Ontario (CPSO), finding that three neurologists at North York General Hospital fell below the standard of care in their management of Mr. Vinzenzo Costantini. Mr. Costantini was taken to hospital after falling off a ladder and hitting his head. Brain imaging revealed multiple brain bleeds, and a neurosurgeon at Toronto Western Hospital was consulted by telephone. The neurosurgeon advised that Mr. Costantini should be monitored at North York General but that if his condition worsened, to call back so that Mr. Costantini could be sent for neurosurgical assessment at Toronto Western Hospital. Mr. Costantini then came under the care of the three neurologists, Dr. Daniel Chet-Ti Wong, Dr. Kevin Sanders and Dr. Donna McRitchie. Over the course of 10 days in the hospital, Mr. Costantini’s condition deteriorated. He became incontinent, could not recognize family members and could not swallow food. A repeat CT scan demonstrated an objectively worsening brain bleed. Despite this, none of the neurologists took any steps to transfer Mr. Costantini to a neurosurgical hospital, despite repeated requests from his family members. Finally, Mr. Costantini was sent to Toronto Western Hospital where he died during surgery to relieve the pressure in his brain. The CPSO found that Dr. Wong, Dr. Sanders and Dr. McRitchie all fell below the standard of care. The doctors appealed this finding and the HPARB affirmed the CPSO decision, after hearing submissions from Mr. Mladenovic on behalf of the family and from counsel for the three doctors.

Costantini v. Wong, Sanders, McRitchie_13-CRV-0305 – Decision and Reasons

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