Alexandria Ruigrok unpacks how Ontario’s proposed reforms may tilt the med mal landscape
While the proposed changes to the Rules of Civil Procedure are not yet law, plaintiff-side medical malpractice lawyers are already preparing for what could be a significant shift. For Alexandria Ruigrok, associate at Bogoroch & Associates LLP, the question is less about whether the proposed reforms are good or bad, and more about how they will be interpreted and applied in practice.
“We will need to find new ways to level the playing field for our clients,” Ruigrok says. “The real impact on medical malpractice litigation will depend on how timelines are enforced, how the rules of evidence are applied, and how well plaintiffs’ counsel can adapt to a new system.”
A fundamental shift in how cases are built
The proposed reforms emerging from the Civil Rules Review would move Ontario toward an up-front evidence model, requiring parties to disclose key information, documents and witness statements much earlier in the litigation process. For personal injury and medical malpractice lawyers, this represents a fundamental departure from the way cases are currently developed.
“Parties would be expected to put their cards on the table from the outset, sharing everything they plan to rely on at trial,” Ruigrok explains. “The idea is that everyone understands the strengths and weaknesses of the case early on, which could encourage faster resolutions.”
The proposal also introduces a court-driven approach to case management. Once pleadings close, parties will have one year to build their case, conduct limited oral examinations, and exchange any remaining information they intend to rely on at trial.
In theory, Ruigrok acknowledges, earlier transparency could be beneficial. In practice, however, she cautions that medical malpractice cases are defined by a significant imbalance of power and access to information.
Compressed timelines and information gaps
One of the most immediate concerns for plaintiffs under the proposed changes involves access to medical records. Although patients have a right to their records, getting them can take months. On the other side of the table, medical malpractice defendants like physicians, hospitals, midwives, or dentists may already have access to the records, along with the ability to consult with colleagues and rely on protected internal review processes.
“That disparity exists from day one,” Ruigrok notes. “In some cases, plaintiffs may not have even been conscious when the alleged malpractice occurred. You can imagine how this might pose issues for gathering evidence on an accelerated timeline.”
Another major change is how examinations for discovery would work under the proposed system. Right now, it’s not uncommon to spend a full day obtaining evidence from one defendant in complex medical malpractice cases. The Working Group has recommended significant limits for the use of oral examinations, including restricting their use to high-value cases, and cutting down substantially on their length.
“Under the new model, we would have 90 minutes to examine all of the defendants, regardless of how many defendants there are,” Ruigrok says, noting that while feedback from groups like the Ontario Trial Lawyers Association helped steer the Working Group away from eliminating discoveries entirely, the practical effect will still be profound. “It will change how we practice, and it will make things more challenging for plaintiffs.”
Expert evidence and financial realities
A further area of concern, Ruigrok notes, is the early exchange of expert reports. Plaintiffs are typically in a very different financial position from the defendants. “On one side, you have large institutions or physicians who are members of the CMPA, and on the other side you have folks from all walks of life who are often injured. Requiring plaintiffs to commit significant resources before litigation has fully matured is going to place a greater burden on plaintiffs than it will on defendants in these cases.”
The cumulative effect, she adds, is a system that may force plaintiffs to lock in a theory of the case before all of the relevant facts are available – a risk heightened by compressed timelines and reduced oral examinations.
Overall, Ruigrok anticipates significant training and education for everyone in the civil justice system if these reforms go ahead. “It will be more important than ever for plaintiff’s counsel to develop strong advocacy skills, to make sure our clients’ interests are protected,” she notes. “All stakeholders will need to retrain if these push through.”
How Bogoroch & Associates is preparing for what comes next
As the bar waits to see whether the proposed reforms will become law – and what the final version looks like – Bogoroch & Associates is already laying the groundwork. Lawyers at the firm have attended professional development sessions, and Zoom presentations from the Civil Rules Review Working Group to understand the proposals and their potential impact on medical malpractice cases. They are now carefully reviewing the Final Policy Proposal and discussing what the reforms could mean for their practice, even as they recognize it could take years for the government to draft and implement new rules.
The Working Group has already signalled that if the reforms are implemented, there will need to be extensive education to ensure everyone is playing by the same rulebook: judges, court staff, plaintiff-side counsel, and defence counsel will need to learn how to interpret and apply them. Ruigrok notes that there are lawyers at the firm who have used the existing rules for over three decades, while she’s just beginning her legal practice. Her entire career could be under the new rules, a possibility she calls intriguing.
“Whatever comes next, it’s comforting to know that everyone is along for the same ride,” she says. “It’s an exciting time to practice law.”
Despite the challenges inherent in a new regime rollout, Bogoroch & Associates is keen on calling out the opportunities. The firm has long prioritized moving cases efficiently, recognizing that delay does not serve clients’ interests. Ruigrok believes if the proposed twoyear track is implemented fairly, it could be a considerable improvement in the timeline to resolution compared to the four, six, or even eightyear journeys that are common today.
“As always, we’re keeping a close eye on developments in the law,” Ruigrok says. “I’m very confident that whatever changes the Working Group’s proposal may bring, we will tackle them head on and use them to advocate effectively for our clients. The goal remains the same: moving cases forward and securing compensation for those who need it.”
This article was produced in partnership with Bogoroch & Associates LLP
