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Pacific Medical Law Supports the 2017 Janna Epp Bursary

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Pacific Medical Law has established a bursary in honour of Janna Epp, a beautiful, determined young girl with cerebral palsy who faced challenges that few of us could imagine. Sadly on October 11, 2012, Janna passed away.

In memory of Janna, Pacific Medical Law donates $5,000 to a child living with cerebral palsy in BC every year, to assist with that child’s care, therapy, equipment or recreation.

If you have a child with cerebral palsy who could benefit from these funds, please send in your application. The recipient of the bursary will be selected by Janna’s mother.

Applications are due July 1, 2017

Contact Pacific Medical Law for application details:

604-685-2361 or toll free 604-685-2361

[email protected]

Susanne Raab is Selected to become a Fellow in the Litigation Counsel of America

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Susanne Raab is honored to have been invited to become a Fellow in the Litigation Counsel of America (the “LCA”).The LCA is a trial lawyer honorary society composed of less than one-half of one percent of lawyers in North America.

Fellowship in the LCA is highly selective and by invitation only. Fellows are selected based upon excellence and accomplishment in litigation, both at the trial and appellate levels, and superior ethical reputation. The LCA is aggressively diverse in its composition. Established as a trial and appellate lawyer honorary society reflecting the American bar in the twenty-first century, the LCA represents the best in law among its membership. The number of Fellowships has been kept at an exclusive limit by design, allowing qualifications, diversity and inclusion to align effectively, with recognition of excellence in litigation across all segments of the bar. Fellows are generally at the partner or shareholder level, or are independent practitioners with recognized experience and accomplishment. In addition, the LCA is dedicated to promoting superior advocacy, professionalism and ethical standards among its Fellows

Bursary for Children Living with Cerebral Palsy

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Pacific Medical Law has established a bursary fund in honor of Janna Epp, a beautiful, determined young girl with cerebral palsy, who faced challenges that few of us could imagine. Sadly, on October 11, 2012 Janna passed away.

In memory of Janna, Pacific Medical Law will donate $5,000 to a child living with cerebral palsy every year, to assist with that child’s care, therapy or recreation. The recipient of the bursary is selected by Janna’s mother.

Last year Pacific Medical Law provided the $5,000 bursary to a little girl named Leila. Leila is an extraordinary child with cerebral palsy who is amazingly strong and has a true zest for life. Leila works hard with her therapies and wanted the opportunity to try Feldenkrais therapy and therapeutic horseback riding to improve her muscle tone and decrease stiffness. She also wanted a Squiggles postural support system to keep her safe and comfortable when she is out exploring the world. Pacific Medical Law was pleased to support Leila and her mother, in this small way, to help Leila reach her full potential in life.

This year the bursary recipient will be selected on July 30, 2015. Applications are due July 15, 2015. For more information, please click; Janna Epp Bursary Application Form 2015, or go to https://www.pacificmedicallaw.ca/jannaeppbursary.shtml

Paul McGivern spoke at the Birth Trauma Conference – June 7, 2013

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Paul McGivern  was an invited speaker and a panelist at the Birth Trauma Conference organized by CanLNC and held at the Vancouver Pan Pacific hotel on June 7, 2013. Susanne Raab and Natalia Ivolgina also participated in the conference. The conference featured top lawyers in the province practicing in birth trauma litigation and covered topics such as causes of cerebral palsy, standards of fetal monitoring, challenges in proving causation, and recent developments in the Supreme Court of Canada. Paul shared his knowledge in such areas as the use of experts in medical malpractice cases and recent pronouncements from the Supreme Court.

Paul highlighted the fact that birth trauma lawsuits are highly expert opinion driven which translates into enormous financial stakes for both the family and the law firm involved. Paul shared that in his practice, to minimize the risks he always investigates the case with the experts even before the lawsuit is commenced. Paul also discussed the types of experts usually required to build a winning case and how to work with the experts to ensure that their opinion is unbiased and that they would present as credible witnesses at trial.

Paul discussed the legal significance of Ediger and Cojocaru cases that he had recently won at the Supreme Court of Canada. In both of these cases the Court was critical of the physicians’ failure to properly inform the mothers of the risks involved in the treatment they recommended when obtaining their patients’ consent to the procedures. The Court essentially stated that it is not enough to simply inform the patients of the risks associated with a proposed treatment; it must be explained what these risks mean in terms of real-life consequences should they materialize.

In other words, it is not enough to simply say, “There is a risk of bradycardia” in the context of the facts in Ediger, for instance, where the physician decided to use a mid-level forceps procedure during the delivery. Instead, it must be explained that “there is a small risk of cord compression if I attempt this procedure. Cord compression may deprive your baby of oxygen. We would monitor for potential asphyxiation by paying attention to any signs of fetal bradycardia. However, in the event that cord compression occurs, I may not have enough time to organize an OR room and deliver the baby in time before a permanent brain injury occurs”. In Ediger, the physician did not warn the mother of any risks, and was found liable on the basis of failing to ensure that the emergency back-up was immediately available by calling the operating room before attempting the mid-forceps procedure which happened to be occupied with another surgery.

Similarly, in Cojocaru, the physician was found liable solely on the basis of her failure to bring the significance of the risks home to the mother when she recommended that she attempts vaginal delivery after having had a Cesarean section previously (commonly referred to as VBAC). The physician in Cojocaru only told the mother that there is a 1 in 200 risk of uterine rupture associated with a VBAC; she did not tell the mother that if this risk materializes there is a significant chance of her baby suffering permanent damage because there likely would not be enough time to recognize the signs of uterine rupture, arrange for an emergency Cesarean section and deliver the baby before a permanent brain injury is sustained.

Find full details of the conference here

Find full decision of Cojocaru v. British Columbia Women’s Hospital and Health Centre, 2013 SCC 30 here

Find full decision of Ediger v. Johnston, 2013 SCC 18 here

Paul McGivern Interviewed by Lawyers Weekly

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Paul McGivern  was interviewed by Lawyers Weekly on the significance of the recent decision of the Supreme Court of Canada in the case that he argued. The decision was important in two respects: it clarified the threshold for rebutting the presumption of judicial integrity and impartiality and raised the bar for physicians in terms of explaining the risks of the proposed procedure when obtaining informed consent from patients.

The Supreme Court of Canada essentially confirmed, in Paul’s words, “that trial judges are entitled to rely on the lawyers that appear before them, and are entitled to rely on the written submissions that counsel make. They’re entitled to copy from those submissions, and put them into their judgments. But the more complex the case, the more the judge is encouraged to put the reasons into their own words”.

On the issue of informed consent, the decision, according to Paul, “emphasizes the need for physicians to explain to their patients exactly what they’re going to be doing, what the risks are, and most importantly what the potential consequences are if the risk that the procedure entails actually materializes. In other words it isn’t enough to say ‘there might be a uterine rupture.’ You actually have to explain to the patient what that means, in real terms, for the patient. And in this case, what it meant, was it would be unlikely at best that they could rescue the child before brain damage set in.”

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