Canada’s Supreme Court has clarified how factual causation and remoteness should be separated in medical-negligence cases, while leaving an anesthesiologist liable for severe and permanent brain damage suffered during an emergency caesarean delivery.
Sophia Hemmings sustained a cardiac arrest after complications from anaesthesia. Her family sued several healthcare providers, including obstetricians Lloyd Padmore and Shari O’Brien, anesthesiologist Neil Jamensky and the hospital. Liability alone went to trial because the parties had agreed the amount of damages.
The trial judge found Padmore and Jamensky liable and also held the hospital responsible for a nurse’s negligence and a failure to communicate Hemmings’ medical history. The Ontario Court of Appeal removed liability from Padmore and the hospital but upheld the finding against Jamensky. Both Hemmings’ family and Jamensky appealed.
In Hemmings v Padmore, 2026 SCC 34, the Supreme Court dismissed both appeals on October 23. Justices Rowe and O’Bonsawin, writing for the majority, treated negligence causation as two distinct inquiries. A plaintiff must first show that the breach actually caused the injury. The court must then ask whether the damage is too remote, ordinarily by considering whether the kind of injury was reasonably foreseeable.
The majority said the trial reasons did not adequately examine whether the injury would have happened without the nurse’s negligence and did not properly address whether Padmore or the nurse could reasonably have anticipated the injury. The finding against Jamensky stood because witness testimony, expert evidence and medical literature supported the conclusion that his negligence caused the cardiac arrest and resulting damage.
The court was divided in its routes to the result. Three judges would have restored liability against Padmore, while the Chief Justice would have allowed Jamensky’s appeal. The majority judgment nevertheless controls and confirms that a breach of professional duty does not itself establish liability: actual causation and legal remoteness must each be addressed.
Read the official Supreme Court of Canada decision.
