Health Law Lawyers

At Donich Law, our team of knowledgeable and experienced lawyers provide well thought-out and strategic legal representation within the realm of health law litigation. Our team serves health professionals, institutions, and regulatory bodies across all of Ontario. Our firm offers a tailored approach to nuanced and complex legal issues within the healthcare profession. This helps ensure that our clients receive the highest level of advocacy and support.  This helps ensure that our clients receive the highest level of advocacy and support, in an effort to uphold their professional reputation that they worked hard to earn.

We have extensive experience representing clients before various regulatory tribunals. Whether you are a health professional facing disciplinary action or a dispute over registration, our team is equipped with the skills, knowledge, and expertise to safeguard your rights and interests. Moreover, our team handles civil litigation, administrative law matters, and appeals. We draw on our comprehensive understanding of the healthcare system and relevant legislation to secure positive legal and professional outcomes for our clients.

Our expertise covers a wide range of issues, including professional misconduct, negligence claims, and challenges involving the interpretation of health laws and regulations. We understand the high stakes involved in these cases, and we are committed to defending our clients’ reputations and ensuring fair and equitable treatment throughout the legal process.

Donich Law is a trusted firm for health professionals and organizations seeking effective legal solutions. Our firm is known for its meticulous preparation, strategic thinking, and steadfast commitment to achieving the best possible outcomes in all health law litigation matters.

What is the Health Professions Appeal and Review Board? (HPARB)

The Health Professions Appeal and Review Board (HPARB) is an independent adjudicative organization in Ontario that is highly important when it comes to ensuring the integrity and accountability of the healthcare profession. The Board is highly essential to ensuring that health professionals are fairly regulated, decisions are transparent, and the public is safe. HPARB serves as a key check on the decisions made by Ontario’s different health regulatory colleges, enabling health professionals and members of the public to appeal or review decisions that affect their practice or health care.

What is the HPARB’s Role and Function?

The Health Professions Appeal and Review Board (HPARB) plays an important role in Ontario’s healthcare system by providing an independent and unbiased forum for reviewing decisions made by health regulatory colleges. Its major duty is to guarantee that regulatory decisions impacting health professionals are made in a fair, transparent, and lawful manner. HPARB’s tasks include examining judgments made by a number of health regulatory institutions’ Inquiries, Complaints, and Reports Committees (ICRC) and considering appeals regarding registration decisions.

When a member of the public files a formal complaint against a health practitioner, the ICRC of the relevant college investigates and makes a particular decision. If the complainant or health professional is dissatisfied with the outcome, they may request a review by HPARB. The board then considers whether the ICRC decision was reasonable, fair, and legally sound. In the context of registration appeals, HPARB considers cases in which a health professional has been denied registration or has had conditions placed on their license. The Board assesses whether the college’s judgment was acceptable and justifiable, frequently using the records of the initial proceedings and additional representations from the interested parties.

It is not within the scope of the HPARB to undertake new investigations or re-hear cases, but rather evaluates existing records to determine the fairness and rationality of regulatory colleges’ decisions. Depending on its findings, HPARB may confirm the decision, return the matter to the College for additional review, or, in some cases, substitute its own decision. This function protects health professionals from potentially unfair or arbitrary judgments, and it strengthens public faith in the regulatory process by guaranteeing transparency and responsibility in the oversight of health practitioners.

Professional Regulation in Canada

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How can I Appeal an HPARB decision?

The Division Court of Ontario offers an avenue for judicial review when somebody does not agree with HPARB’s original decision regarding a case. This method allows the Court to determine whether the HPARB’s judgment was legal, rational, and procedurally fair. To initiate the appeal, speak with an attorney who specializes in administrative or health law, as they can evaluate the merits of your case and lead you through the complex legal process. The next stage is to file an application for judicial review with the Divisional Court, typically within 30 days of receiving the HPARB’s decision. Your application must set out the grounds for the appeal, which often might include allegations of legal errors or procedural errors.

Once the application is submitted, you must prepare and submit the record of the original proceedings, which includes all papers, evidence, and the disputed decision. Proper serving of these documents to HPARB and other relevant parties is required to ensure that they can respond to the appeal. The Court will then set up a hearing where both sides can state their positions. Your lawyer will argue that HPARB’s decision should be reversed or altered, whereas the respondents will defend it. The Divisional Court will consider the reasonableness of HPARB’s judgment as well as whether the proper legal standards were followed. Following the hearing, the court may sustain, overturn, or return the decision to HPARB for reconsideration.

Given the firm deadlines and complicated nature of these kinds of cases, legal counsel is strongly advised to guarantee the best possible outcome.

What Mechanisms are there for the HPARB ensure Fairness during the Complaint Review Process?

The Health Professions Appeal and Review Board (HPARB) plays a highly significant role when it comes to maintaining public confidence in Ontario’s health professions by providing an independent review of decisions made by the Inquiries, Complaints, and Reports Committees (ICRCs) of the different kinds of regulatory bodies for healthcare professions. HPARB is tasked with the challenging task of aiming to upholdthe public interest by ensuring that health professionals comply with the relevant standards for their professional practice. They also safeguard the rights of those professionals during the review process as a way to uphold the principle of the presumption of innocence which is key even within quasi-judicial systems.

HPARB balances these interests by closely following the key principles of administrative law, with a focus on procedural fairness and rationality. In its review of ICRC decisions, HPARB carefully considers whether the inquiry and conclusion were handled impartially and within the regulatory body’s declared scope of activity and jurisdiction. This procedure includes ensuring that the health professional had a fair opportunity to reply to the allegations and that all relevant evidence was thoroughly and appropriately assessed.

Furthermore, HPARB assesses the reasonableness of the ICRC’s decisions by determining whether they fall within an acceptable range of outcomes based on the facts supplied. The Board does not re-try the case; instead, it verifies that the decision-making process was reasonable, well-founded, and defensible. This review process is critical in ensuring that health professionals are treated fairly and that their rights are protected, all while maintaining responsibility to professional standards. As an impartial organization, HPARB plays an important role in ensuring that all parties concerned view the decisions to be fair and just.

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Relevant Cases

Dr. R.M. v. HPARB et al., 2022 ONSC 3326

In this case, the Court reviewed Dr. R.M.’s application for judicial review of decisions that were made by the College of Physicians and Surgeons of Ontario (CPSO), and later upheld by the HPARB. The ICRC had issued a formal warning to Dr. R.M. for not giving full, accurate, and relevant information to a patient, D.P., regarding cataract surgery. After the surgery, the patient D.P. filed a complaint.

Dr. R.M. argued that the hearing was not fair because he was not informed of some importance pieces of evidence (Dr. S.S.’s findings) during the investigation, which was later used against him. The Court found that although Dr. R.M. was not provided this information initially, HPARB’s review rectified any procedural unfairness that was present in the original decision.

The Court emphasized that the ICRC’s role is investigative, not adjudicative, meaning procedural requirements are less stringent. The Court ultimately dismissed Dr. R.M.’s application because they found that the ICRC’s warning was within the reasonable range of outcomes. Dr. R.M. was ordered to pay $5,000 in costs to the CPSO and was issued a public, formal warning.

A.C. v. M.M., 2020 CanLII 1 (ON HPARB)

Here, the Health Professions Appeal and Review Board (HPARB) reviewed a decision by the Inquiries, Complaints and Reports Committee (ICRC) of the College of Physicians and Surgeons of Ontario (CPSO) in regard to a complaint made by a patient, A.C., against Dr. M.M.

In this case, A.C. sustained a workplace injury, leading to a series of shoulder surgeries, with Dr. M.M. performing the second surgery in 2007. A.C. alleged that Dr. M.M. failed to provide adequate follow-up care after the surgery, potentially caused damage leading to ongoing pain and other symptoms, and inaccurately reported his condition to the Workplace Safety and Insurance Board (WSIB).

The ICRC examined the complaint and found that Dr. M.M.’s treatment was in line with expected standards. However, note that the ICRC did advise Dr. M.M. to improve his documentation of informed consent, particularly regarding the discussion of risks and benefits of surgery. The ICRC took no further action, and A.C. requested a review of this decision by the HPARB.

The HPARB reviewed the case, including additional documents provided by A.C., and concluded that the ICRC’s investigation was adequate and its decision reasonable. Moreover, the Board noted that the additional documents which served as evidence provided by A.C. did not pertain to the period relevant to Dr. M.M.’s care. Also, the Board stated that the evidence did not demonstrate a causal link between Dr. M.M.’s treatment and A.C.’s ongoing symptoms. The HPARB upheld the ICRC’s decision to issue advice to Dr. M.M. regarding consent documentation and affirmed that no further action was necessary. The decision highlights the importance of thorough documentation and the Board’s role in ensuring that investigations are adequately conducted and decisions are grounded in the evidence presented.

J. P. v C. Q.-T. L., 2020 CanLII 34723 (ON HPARB)

In this case, a dentist filed a complaint with the College of Physicians and Surgeons of Ontario (CPSO) against Dr. C.Q.-T.L., the Medical Officer of a Health Unit. The complaint come to light after the health unit conducted an investigation into J.P.’s dental clinic. This investigation resulted in an order under the Health Protection and Promotion Act (HPPA) to halt specific activities due to alleged infection control lapses. The SMDHU subsequently issued public statements and a “Lapse Report,” indicating that patients treated at J.P.’s clinic might have been exposed to improperly sterilized instruments, potentially leading to the transmission of diseases like Hepatitis B, Hepatitis C, and HIV. J.P. argued that by releasing this information to the public, his reputation was damaged.

The ICRC of the regulatory body for surgeons and physicians ultimately decided to take no further disciplinary action in regard to J.P.’s complaint, deeming it frivolous, vexatious, and an abuse of process under sections 26(4) and (5) of the Health Professions Procedural Code. The ICRC determined that the actions of Dr. C.Q.-T.L. were performed as part of his duties as a public health official, and not as a practicing physician, and that the proper forum for J.P.’s concerns was the Health Services Appeal and Review Board (HSARB), not the CPSO.

J.P. sought a review of this decision by the Health Professions Appeal and Review Board (HPARB), who ultimately upheld the ICRC’s determination. The HPARB found that the ICRC’s investigation was adequate and its decision reasonable, concluding that Dr. C.Q.-T.L.’s actions were in line with his duties and scope of powers as a public healthcare official.

About the Author

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Jordan Donich

Jordan Donich has been a Lawyer for over 10 years and is a trusted legal analyst by Canadian Media. He is as a leader in Canada’s tech sector for lawyers and developer of Law Newbie. Jordan is a Black Belt with the Japan Karate Association and trained in Krav Maga. He won a Gold Medal at 2004 Canadian National Championships and was published in the National Newspaper Awards.

Jordan has been featured in Forbes and is a member of DMZ Angels in Toronto.