Physicians make mistakes in their practice, some of which may have serious health consequences for patients. Compensation paid to people who have suffered major aftereffects due to failed procedures or treatments runs into the hundreds of millions of dollars in Canada. In 2020 alone, the Canadian Medical Protective Association (CMPA), which physicians join to defend themselves or to financially compensate victims of gross negligence or errors, paid $206 million in compensation to Canadian patients.
The CMPA is not an insurer. It is a non-profit medical liability association that follows the principles of mutuality. Founded in 1901, it grew out of an incident that occurred in 1896. A young boy in the Ottawa area fell from a tree and broke his forearm. He was treated by a doctor, but failed to follow the doctor’s instructions. This led to complications and the loss of the use of his thumb. The father sued the doctor for negligence.
The doctor won two judgments in his favour, but the case nearly bankrupted him in legal fees and he had to rely on the financial support of his colleagues in the profession to recover. In 2020, the Canadian Medical Protective Association boasted a membership of 103,075 physicians across Canada. Since its inception in 1901, it has actively supported its members in their practice, defended them in court during certain lawsuits and paid patients compensation for the medical errors it recognizes.
“Doctors, being human, may err; patients are the victims of such misfortune. When this happens it is only fair that patients receive compensation. That has been the position of the CMPA since it was founded more than 110 years ago,” the CMPA website reads.
Compensation amounts are huge: Between 2015 and 2020, the Association paid out $1.1 billion to Canadians harmed by clinical errors or negligent medical care committed by its members. This amount is broken down as follows:
How can the CMPA afford it? The Association’s 2020 annual report states that its net assets were $1,444 million, up $264 million from 2019. That money comes from membership fees, its investments and its wholly owned subsidiaries Dow's Lake Court Inc. (which operates under the name Saegis) and CMPA Investment Corporation, which holds a number of invested assets. As of December 31, 2020, the actuarial estimate of the accumulated provision for all of the Association's outstanding claims was $3,864 million, an increase of $4 million from December 31, 2019.
Financial compensation to patients on behalf of members, legal fees, expert fees, and insurance contracts made up 83 per cent of annual expenses in 2020, excluding changes in the provision for outstanding claims.
Legal actions
In 2020, the latest year for which these figures are available, medical errors in Canada resulted in 732 legal actions, 4,183 complaints to physician regulatory bodies, and 1,773 intra-hospital complaints.
Of the 732 lawsuits that made their way through the courts two years ago, only 93 were initiated in Quebec, compared with 365 in Ontario and 176 in British Columbia/Alberta. Of the $206 million the CMPA paid out in compensation in 2020, $112 million flowed to Ontario, where judgments in medical malpractice cases have historically been more generous.
To receive financial compensation from the Association, a victim of negligence or medical error must file a lawsuit. Even if the College or the hospital acknowledges that a physician committed a fault, this is not sufficient grounds for compensation by the CMPA.
Stats by region
Most cases in Canadian courts are concluded through negotiations and settlements. In 2020, 645 cases with patients were resolved: The judgment was for the plaintiff in only eight cases across Canada. In 29 of the cases, the judges ruled in favour of the physicians, 259 cases were settled with the patient, and 349 lawsuits were dismissed or abandoned.
The CMPA does not compile statistics by province, but rather by Canadian region (its own grouping). The table below shows the number of lawsuits and complaints by region in 2020 :
