In this medical malpractice case the Vancouver General Hospital appealed a decision finding them negligent in failing to assign one-on-one supervision to an elderly patient (Vancouver General Hospital v. Zheng,2024 BCCA 42). The patient subsequently fell and broke his hip. The appeal focused on whether the trial judge erred in concluding that the standard of care required one-on-one supervision based on the patient’s known risk factors. The Court of Appeal dismissed the appeal, finding that the judge’s personal injury decision was not in error.

The plaintiff was an 83-year-old patient admitted to VGH with heart problems. He exhibited signs of confusion, hallucinations, and restlessness. Nurses were informed of his risk of falling but did not reassess him regularly or implement preventative measures. The Plaintiff’s daughter left the hospital at 6 PM, and he fell unsupervised later that night.

Key Findings by the Court of Appeal

The hospital did not contest the judge’s findings regarding other breaches of the standard of care, such as failing to reassess the patient after certain points in time.

The key issue was whether the standard of care mandated one-on-one supervision given the patient’s risk factors, including confusion, hallucinations, and a potential to get out of bed. The judge relied on evidence from a nursing expert and the specific circumstances of the case to conclude that one-on-one supervision was necessary. The appeal court found that the judge’s reasoning was sound and supported by the evidence, and that they did not commit a palpable and overriding error.

No Absolute Requirement for one-on-one supervision

The court emphasized that the availability of resources for one-on-one supervision was also relevant, but the evidence did not suggest it was unavailable in this case. This case does not establish a general rule that one-on-one supervision is always required when considered as an option, but rather highlights the importance of considering all relevant factors and evidence in determining the standard of care.

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