Law360 Canada ( February 19, 2026, 9:33 AM EST) -- Appeal by Dr. Vasiliou from trial judge’s causation finding. Gumbley experienced an acute asthmatic attack on Oct. 9, 2014. She was taken by ambulance to Toronto East General Hospital, where her symptoms worsened. That evening she was intubated and ventilated. On Oct. 16, 2014, Gumbley began exhibiting signs of a neurological injury. It was eventually determined that she suffered brain damage that rendered her an incomplete quadriplegic, unable to walk, and incontinent, with limited ability to see or to speak. Dr. Vasiliou became the most responsible physician for Gumbley’s treatment and care when she admitted her to the intensive care unit at about 7 p.m. on Oct. 9, and she retained that responsibility until about 1:50 a.m. on Oct. 10, when Dr. Warner, who was the on-call intensive care specialist, took over responsibility for Gumbley’s care. The trial judge found Dr. Vasiliou was negligent in Gumbley’s care and held that her breaches of the standard of care more likely than not caused Gumbley’s brain damage. On appeal from that finding, the essential factual issue in the causation analysis was whether Gumbley’s injury occurred on Oct. 9, while she was under Dr. Vasiliou’s care, or whether it occurred later. Dr. Vasiliou argued that, in making that finding, the trial judge improperly relied on the hearsay content and opinions expressed in a critical care note dictated by Dr. Warner....