Can a Plaintiff's Treating Doctor Give Expert Opinion Evidence for the Defence in an Injury Claim?

Reasons for judgement were released today by the BC Supreme Court dealing with this interesting issue.
In today’s case (MacEachern v. Rennie) the Plaintiff ‘suffered traumatic brain injury when her head came into contact with a tractor trailer while she was walking or riding her bicycle along King George Highway in Surrey, BC
In the years before the collision the Plaintiff was treated by a physician, Dr. Dowey, who apparently “prescribed methadone (to the plaintiff) as part of her treatment for heroin addiction“.
In the months leading up to the trial the Defence lawyers had a pre-trial interview with the doctor which was not consented to by the Plaintiff’s lawyers.  After speaking with this doctor the defendants decided to rely on him as a witness in their case.
The Defendants called the doctor to give evidence and sought to have the doctor qualified as an expert to give medical opinions about the Plaintiff’s pre-accident condition and prognosis.  The Plaintiff opposed this for several reasons and argued that “it was improper for Dr. Dowey to have pre-trial meetings with counsel for the defendants in the absence of plaintiff’s counsel“.
In permitting the doctor to testify as an expert witness for the defence Mr. Justice Ehrcke of the BC Supreme Court summarized and applied the law as follows:
[22] Plaintiff’s counsel submits that as a treating physician, Dr. Dowey owed the plaintiff a duty of confidentiality not to divulge her personal information without her consent, and that Dr. Dowey breached his duty of confidence when he spoke with counsel for the CN Defendants in the their absence. The submission is that as a result, the CN Defendants should not be permitted to lead evidence of Dr. Dowey’s expert opinions….

[29]         The only question before me, then, is whether Dr. Dowey should be prohibited from giving opinion evidence. He has been subpoenaed by the CN Defendants. As a witness under subpoena, he must answer the questions asked of him unless there is a basis in law for excluding his evidence. The plaintiff does not make a claim of privilege, but rather submits that to permit Dr. Dowey to give expert opinion evidence would conflict with his duty of confidentiality.

[30]         The plaintiff relies on a decision of the Ontario Superior Court of Justice, Burgess v. Wu (2003), 68 O.R. (3d) 710 (Sup. Ct. of Justice). In that case, Ferguson J. emphasized the distinction between pre-trial disclosure and the admissibility of evidence at trial, as well as the distinction between a claim of privilege and the duty of confidentiality. He wrote at para. 55-57:

[55]      It is important at the outset to distinguish between access at trial and access before trial. Once a physician takes the witness stand, and regardless of whether he or she is called by the patient or subpoenaed by the defence, the physician must answer all relevant questions subject to a ruling in unusual circumstances that some subjects are privileged (see the discussion below re M. (A.) v. Ryan, infra). It is irrelevant whether or not the patient consents. The physician cannot refuse to answer on the ground of a duty of confidentiality:  Metropolitan Life Insurance Co. v. Frenette, [1992] 1 S.C.R. 647, 89 D.L.R. (4th) 653, at p. 687 S.C.R., p. 681 D.L.R., per L’Heureux-Dubé J.

[56]      This rule is consistent with the rules of ethics promulgated by the profession and by regulation which specifically state that the duty does not apply to situations where disclosure is “required by law”.

[57]      The issue of concern in the present case is access before trial. The general question is:  what is required by law outside the witness stand? In this context the primary restraint is the duty and right of confidentiality, and not the evidentiary issue of legal privilege.

[31]         Counsel for the plaintiff points out that Ferguson J. went on to hold that the doctor who had treated the plaintiff in that case would be prohibited from testifying as an expert for the defence. Counsel urges me to make a similar ruling here.

[32]         There are, however, two important distinctions between that case and this. First, Ferguson J. made a finding that there had been improper pre-trial contact between the witness and counsel for the defence, and that finding was instrumental in his decision that the witness should not be permitted to testify as an expert for the defence. He wrote at para. 134: “The party at fault should not benefit from the fruits of the impropriety.”  On the facts of the present case, I have found that there was no impropriety in the meeting between Dr. Dowey and counsel for the CN Defendants.

[33]         The second distinction is in the nature of the opinion evidence that is being sought. In Burgess v. Wu, the tenor of the opinion sought was expressed in a letter quoted at para. 21:

We are interested in your views, as a forensic psychiatrist, as to the likelihood that Mr. Burgess would have committed suicide (regardless of the prescription of Seconal), his prognosis otherwise, and the probability of him returning to a functioning lifestyle.

[34]         That is, the opinion sought in Wu related to the patient’s prognosis after the period of time when the witness had treated him. In the present case, counsel for the CN Defendants have stated that they do not seek any opinion from Dr. Dowey about Ms. MacEachern’s prognosis after the last date he saw her, November 29, 2004. More specifically, they do not seek from him an opinion about whether she likely would have continued using drugs after September 2005 had it not been for the accident. They might attempt to elicit such an opinion from another expert who did not treat the plaintiff, but they will not seek such an opinion from her treating physicians.

[35]         Counsel for the plaintiff has referred to the Personal Information Protection Act, S.B.C. 2003, c. 63, but its provisions do not support the plaintiff’s position since s. 3(4) of thatAct provides:

3(4) This Act does not limit the information available by law to a party in a proceeding.

[36]         In the circumstances of this case, I do not find that the duty of confidentiality would prevent Dr. Dowey from giving relevant opinion evidence as a medical doctor in relation to the period of time that she was his patient.

bc personal injury claims, Civil Procedure, expert evidence, MacEachern v. Rennie, Plaintiff doctors testifying for the defence

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ERIK
MAGRAKEN

Personal Injury Lawyer

When not writing the BC Injury Law Blog, Erik is the managing partner at MacIsaac & Company, based in Victoria, B.C. He is also involved with combative sports regulatory issues and authors the Combat Sports Law Blog.

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