Executive Summary: Key Legal and Evidentiary Issues

• Dr. Marcel Caron, a retired obstetrician-gynecologist, sued his former department head, Dr. Sophie Desindes, and Santé Québec, alleging that her interventions in his hospital practice were unlawful, caused him pecuniary losses, harmed his professional reputation, and warranted punitive damages.
• Central to the dispute was whether removing Dr. Caron from the on-call list and suspending his clinical teaching activities constituted a modification of his hospital privileges or, rather, a reduction of his obligations — a distinction with fundamental consequences for civil liability.
• The court examined the scope of a department head's authority under the Loi sur les services de santé et les services sociaux (LSSSS) and the department's internal regulations to determine whether Dr. Desindes acted within her jurisdiction.
• Expert evidence submitted by the defence — on obstetrical practice and colposcopy — went unchallenged by the plaintiff, and the court found that several of Dr. Caron's clinical acts were contrary to recognized standards of care.
• The claim for reputational damages was found to be prescribed, as it was filed more than one year after Dr. Caron's awareness of the alleged harm stemming from the October 1, 2018 meeting.
• Punitive damages were refused because no intentional infringement of a protected right was established, no applicable statutory provision authorized their award, and the defence evidence demonstrated that Dr. Desindes acted in good faith throughout.

Facts of the case

Dr. Marcel Caron practiced obstetrics, gynecology, and colposcopy at the Centre hospitalier universitaire de Sherbrooke (CHUS), a facility within the Santé Québec network, from September 1978 until his retirement on June 30, 2019 — a career spanning more than 40 years. During that time, he assisted at the births of more than 8,000 children in the Estrie region and held the status of membre actif of the obstetrics-gynecology department, with privileges including admission, consultation, treatment, and colposcopy. At the age of 73, and following the renewal of his privileges by the board of directors on May 10, 2018, Dr. Caron was authorized to continue practicing at the CHUS until December 10, 2019.

In the spring of 2018, Dr. Sophie Desindes was appointed head of the obstetrics-gynecology department, replacing the outgoing head, Dr. Waddell, who had led the department since 2009. Dr. Desindes assumed her functions at the beginning of August 2018. She had previously been a resident under Dr. Caron's supervision in the early 2000s, and had once sent him a note commending his calm demeanor.

During the on-call weekend of September 23 and 24, 2018, two senior residents, Dr. Camille Deshaies and Dr. Maude Doucet, reported to Dr. Desindes that Dr. Caron's clinical decisions during that shift were unsafe and inconsistent with recognized departmental standards. On September 28, 2018, before even receiving Dr. Caron's response, Dr. Desindes also received a complaint from a third colleague, Dr. Anne Méziat-Burdin, regarding a patient of Dr. Caron who had not been operated on during his call, and from Dr. Annie Ouellet the following day, who wrote of her "great anger" over what she described as a catastrophic decision by Dr. Caron involving a twin pregnancy. On October 1, 2018, a fourth complaint arrived from Dr. Évelyne Raîche regarding a patient treated for an ectopic pregnancy.

After consulting with Dr. Waddell, Dr. Desindes convened Dr. Caron to a meeting on October 1, 2018, at 7:00 a.m. During that meeting, she informed him of the complaints she had received and, invoking patient safety, immediately removed his name from the evening and overnight on-call roster and suspended his clinical supervision of students and residents. Dr. Caron was taken aback and rejected the characterization of his conduct, stating he would act in the same way if the situations arose again.

Policy terms and contractual clauses at issue

The resolution of the CHUS board of directors dated May 10, 2018 (Exhibit D-10) was central to the legal analysis. It confirmed Dr. Caron's status as membre actif and listed his privileges — admission, consultation, treatment, colposcopy, and echography — without including on-call duties among them. The resolution also enumerated Dr. Caron's obligations, which expressly included: (v) respecting the scheduling and coordination of activities as established by the department head, and (vi) participating in on-call service according to the assignment of the department head or service head. Clinical teaching was similarly listed as an obligation under the same resolution.

The departmental regulations (Articles 2.2.1, 5.3.7, 7.2, and 8), adopted December 4, 2012, further confirmed that the department head was responsible for preparing and managing the on-call list in accordance with the CMDP rules, taking into account the competencies of the members, and could evaluate and exempt a member from on-call duties in exceptional circumstances. Article 8 confirmed that academic activities fell under the coordination authority of the department head.

Under Articles 188, 189, and 190 of the LSSSS, the department head is charged with coordinating professional activities, managing the on-call list, and overseeing the practice of medicine within the department. The court also referenced Article 251 of the LSSSS, which permits emergency suspension of privileges by certain administrators, and Article 252, which provides physicians with the right to contest decisions before the Tribunal administratif du Québec within 60 days.

Reasoning and analysis

The court's analysis proceeded along two axes: first, whether the measures imposed on Dr. Caron affected his privileges or merely modified his obligations; and second, whether Dr. Desindes acted reasonably and within the scope of her authority.

On the first question, the court concluded unequivocally that on-call participation and clinical teaching were obligations, not privileges. Since the board's resolution of May 10, 2018 expressly listed them under obligations and not under the privileges column, removing Dr. Caron from the on-call list and suspending his teaching duties did not amount to a modification of his privileges. The court cited Khalifa-Boctor c. Centre de santé et de services sociaux d'Antoine-Labelle, 2008 QCCS 4308, and the doctrine of Patrick Molinari to confirm that the management of the on-call list falls within a department head's discretion, and that a physician's removal from that list does not constitute a modification of privileges.

On the second question, the court held that Dr. Desindes acted within her jurisdiction under the LSSSS and the departmental regulations. The information she received — multiple complaints from colleagues about patient safety incidents occurring within a single on-call period — gave her reasonable grounds to act swiftly. The court acknowledged that her approach at the October 1, 2018 meeting was imperfect: Dr. Caron was summoned by a late-evening email on a Thursday, was not given advance notice of the subjects to be discussed, and was not informed that Dr. Waddell would be present. However, imperfection is not equivalent to fault. The court found that Dr. Desindes subsequently corrected her approach: she provided advance notice and case lists before the January 21, 2019 meeting, permitted Dr. Caron to bring a colleague, produced and circulated written summaries of each meeting, and formally apologized for the communications shortcomings at the February 1, 2019 meeting.

The claim for pecuniary damages was dismissed on two independent grounds: first, no fault was established against Dr. Desindes; and second, even assuming fault, the evidentiary record was insufficient to establish a direct causal link between the suspension of on-call duties and the alleged income loss of $143,173.37, as the billing documents submitted were incomplete, unexplained, and commingled with private practice revenues and cabinet management costs.

The claim for reputational damages of $25,000 was dismissed as prescribed. The one-year prescription period (Article 2929 C.c.Q.) had begun to run from October 1, 2018, the date of the first alleged harm, yet the action was not filed until July 8, 2020 — more than a year after that date and even more than a year after the last day of practice, June 30, 2019. The court found no legal basis to suspend the prescriptive period.

The claim for moral damages of $50,000 was also dismissed. While the court accepted that Dr. Caron genuinely suffered distress, it found no fault in the conduct of Dr. Desindes, and under the civil liability regime, damages must flow from a proven fault. The court also noted that Dr. Caron's own conduct — remaining at work, participating in further meetings, accepting modified colposcopy conditions, and ultimately acquiescing to the mentorship arrangement — was inconsistent with someone who had been gravely humiliated in the legal sense. Notably, the defence presented two uncontradicted medical expert reports — from Dr. André Masse on forceps practices and Dr. Céline Bouchard on colposcopy — which led the court to conclude that several of Dr. Caron's clinical acts were indeed contrary to recognized standards, a finding the absence of a counter-expertise left unrebutted.

Ruling and overall outcome

The court dismissed all claims brought by Dr. Marcel Caron in their entirety. No fault was established against Dr. Desindes or Santé Québec, no amount was awarded in favor of the plaintiff, and the defendants were awarded all costs, including expert fees both for the preparation of expert reports and for attendance at court. The defendants — Dr. Sophie Desindes and Santé Québec — were the successful parties. The exact total of costs awarded was not specified in the judgment, though the court expressly refused to reduce the expert fees and directed that full judicial costs were payable by the plaintiff.