Patient had adverse inflammatory response, ‘frozen shoulder’ after vaccination
The Ontario Court of Appeal has upheld a Superior Court judge’s findings that a doctor was negligent in administering a tetanus vaccine and that his negligence caused the patient’s damages, including income and pension loss.
The case was Bradley v. Wang, 2026 ONCA 570. On Dec. 1, 2015, the respondent patient visited her family doctor’s office for a tetanus vaccination. The appellant, a first-year family medicine resident supervised by the family doctor, administered the vaccine.
According to the patient, she felt severe pain in the area of the injection. As an emergency department nurse who had herself administered many vaccines and knew the correct location for an injection, she believed the needle was too high and too far toward the front of her arm.
Patient’s injuries
Following the injection, the patient experienced debilitating and unremitting pain in her arm and shoulder, as well as restricted movement. She stopped working over a week after the vaccination and has not resumed any employment since.
According to specialists who assessed the patient, she had an adverse inflammatory response to the vaccination and developed adhesive capsulitis, also known as a frozen shoulder.
Ontario Superior Court finds doctor negligent
In an action against the appellant doctor, the patient alleged negligence in his administration of the vaccine.
At trial, the parties agreed that the doctor’s breach of the standard of care would depend on the court’s acceptance of the patient’s evidence about the location of the injection. In his defence, the doctor challenged the patient’s credibility and reliability.
On Apr. 29, 2025, Justice Mary E. Vallee of the Ontario Superior Court of Justice determined that the doctor’s negligence resulted in the patient’s damages.
Ontario Court of Appeal denies doctor’s appeal
On appeal, the doctor alleged errors in the trial judge’s analysis of the standard of care and causation and in her assessment of damages.
The Ontario Court of Appeal dismissed the appeal. The appeal court awarded the patient all-inclusive costs of $50,000, as agreed.
Standard of care analysis upheld
Regarding the trial judge’s standard of care analysis, the Ontario Court of Appeal saw no reason to interfere with the judge’s decision to believe the patient’s testimony.
The appeal court ruled that the judge:
- understood the importance of the issue of the patient’s credibility and reliability
- carefully considered the appellant doctor’s challenges to the patient’s testimony before rejecting them
- reasonably preferred the patient’s direct eye-witness evidence over the doctor’s evidence of his usual practice
Causation analysis affirmed
The Ontario Court of Appeal found no reviewable error in the trial judge’s common-sense conclusion that the patient likely would not have sustained her injuries, but for the improper administration of the vaccine.
The appeal court explained that the judge relied on the evidence of the patient’s expert, who opined that adverse reactions to vaccinations were rare and that experiencing the respondent patient’s symptoms after a properly administered vaccine would be extremely unlikely and inconsistent with those associated with a patient experiencing an abnormal immune response.
The appeal court added that the patient had previously received tetanus vaccinations without any problems.
Damages assessment confirmed
The Ontario Court of Appeal acknowledged that it would have been preferable if the trial judge had used the word “mitigation” in her reasons.
However, the appeal court deferred to the judge’s findings, which addressed the appellant doctor’s argument that the patient failed to mitigate her damages. The appeal court held that the doctor failed to prove mitigation was possible by showing suitable jobs for the patient in her area of residence.
Prior disciplinary cases at Ontario Court of Appeal
Here are some other recent decisions from the Court of Appeal for Ontario arising from disciplinary matters involving medical professionals in the province.
In a medical malpractice proceeding involving a septic pregnancy loss, the Ontario Court of Appeal issued an Aug. 7 decision finding no reversible error in the trial judge’s conclusion that the patient’s catastrophic injuries would not have occurred but for the appellant doctor’s negligence.
In a medical malpractice action regarding a brain aneurysm, the Ontario Court of Appeal made a May 1 decision quashing an appeal against an order adding defendants upon determining that the appeal lay to the Divisional Court with leave because the order was interlocutory.
In proceedings arising from a medical malpractice settlement, the Ontario Court of Appeal issued a Mar. 25 order for a law firm to pay the injured party and his mother costs of $37,000 after confirming on Jan. 8 that a contingency fee agreement was unfair and unreasonable.
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