A ruling by Superior Court of Ontario Justice Grant Dow in the long-running case Stirrett v. Cheema ‘sheds light on the complexities involved in framing doctor-patient relationships in medical malpractice suits,’ according to Law Times’ Anita Balakrishnan. The decision, which may be appealed, offers guidance to medical malpractice lawyers and lawyers representing healthcare providers in disputes involving research studies.

The case arose from a 2004 incident in a Toronto hospital. David Stirrett, the husband of the plaintiff, visited the hospital for an angiogram – a dye test to detect heart problems – after being warned by a cardiologist that an artery was 90 per cent blocked. Prior to the procedure, a nurse recruited Stirrett for a study led by Dr. Bradley Strauss. The study trained one group of participants to self-inject insulin and another group to follow dietary and exercise instructions. After six months, the participants would be asked to undergo a second angiogram and the two groups’ results would be compared.

Stirrett was warned that the second angiogram was not medically necessary – it was for the purposes of the study only. He was also warned of a 1-in-1,000 risk of complications like heart attack or stroke. He nonetheless agreed to participate in the study.

Stirrett’s second angiogram was performed by Drs. Asim Nazir Cheema and Tej Narendra Sheth, neither of whom were connected to the study. During the procedure, the inner and middle layers of the artery walls separated, and Mr. Stirrett died days later.

Both Cheema and Sheth were cleared of all wrongdoing in Justice Dow’s decision, but Dr. Strauss was found to have breached his fiduciary duty by not disclosing minor changes to the study. The consent form Stirrett signed in 2004 noted a participation of rate of 240 patients, and the nurse who recruited him mentioned that the study was funded by the Heart and Stroke Foundation of Canada. In reality, Heart and Stroke had cut off funding the previous year, and the number of participants had fallen to 100.

“While the changes made in the STREAM study from when the consent form was drafted may not have been significant or changed the risk of harm to David Stirrett, it was not something for Dr. Strauss to decide,” wrote Justice Dow. “His obligation, or duty, was to pass on these changes to David Stirrett.”

It’s possible that the minor changes would have discouraged Stirrett from participating in the study and undergoing the fatal second angiogram. Funding from the Heart and Stroke Foundation implies reputability, and the larger number of participants may have provided a sense of security.

Stirrett v. Cheema is a fascinating case that underscores the legal complexities faced by medical malpractice lawyers daily. If the defense for Dr. Strauss decides to appeal Justice Dow’s decision, the already long-running case could be extended by several more years.

If you or someone you know has been injured as a result of a medical procedure, contact the medical malpractice lawyers at Neinstein Personal Injury Lawyers today. Our experienced team can help you access the compensation you deserve.

Greg Neinstein