KB v Guhle, 2025 ABKB 472: Delayed diagnosis results in infant’s quadruple amputation in one of Canada’s largest medical malpractice awards
It is well established in Canadian law that medical professionals owe various duties to their patients. Some key components of a doctor’s duty of care to a patient include the duty to diagnose, the duty to treat and the duty to consult and/or refer. These duties were recently addressed in KB v Guhle, a 2025 decision by the Court of King’s Bench of Alberta. In KB v Guhle, an 11-month-old plaintiff (referred to as K.B.), required quadruple amputations after becoming infected with a bacterial lung infection which turned into septic shock after the defendant physicians failed to properly diagnose and treat the infection in a timely manner.
Across 34 days, the court heard evidence on the issues of whether the defendant physicians breached their standard of care in diagnosing and treating the plaintiff’s condition and whether any breach of the standard of care by the defendants caused or contributed to the plaintiff’s injuries.
To establish a breach of this standard, the plaintiff was required to show, on a balance of probabilities, that the defendants departed from the normal standard of skill, judgement, or knowledge expected of a normal, prudent, and diligent doctor in the same circumstances. Justice Avril B. Inglis, speaking for the court, highlighted that doctors are not expected to be infallible. They are only expected to exercise reasonable care, skill, and judgement in making a diagnosis and treating their patients.
Ultimately, the court found that Dr. Guhle, one of the treating physicians, had breached his standard of care, and his failure to act caused the plaintiff’s injuries. He breached his standard of care by failing to act on the plaintiff’s worsening symptoms and blood test results, which indicated a bacterial infection. The evidence indicated that Dr. Guhle should have started IV antibiotics and ordered further testing at that time. His failure to act in that moment caused the Plaintiff’s bacterial infection to progress to septic shock, leading to her injuries. Further, the harm this caused was foreseeable, and earlier intervention would have prevented the outcome.
The court found that the other two defendant physicians, Dr. Belhaj and Dr. Patidar, met the standard of care, and any breaches did not cause the Plaintiff’s injuries. While Dr. Belhaj failed to document a differential diagnosis and did not consult a radiologist regarding the plaintiff’s X-ray, his treatment met the standard of care. His provisional diagnosis of bronchiolitis was reasonable based on the Plaintiff’s presentation, and antibiotics were not required at that time. Any omissions were found to not have causally contributed to the Plaintiff’s injuries. Dr. Patidar was found to have breached his standard of care by failing to directly communicate his concerns about a bacterial infection to Dr. Guhle and by not ordering IV antibiotics. However, by the time of his breach, the Plaintiff’s bacterial infection had progressed to a point where earlier intervention would not have prevented the injuries. Thus, no causation was established.
Damages were subsequently assessed in KB v Guhle, 2025 ABKB 474. There, the court recognized the catastrophic and permanent nature of the plaintiff’s pain and suffering. The court awarded the plaintiff a total of $15,671,272.40 in damages, which included non-pecuniary damages at the upper limit, tremendous future care costs, and compensation for the plaintiff’s loss of capacity to earn income. The court also awarded the minor’s mother $646,025 to compensate her for the care services she provided to the plaintiff, her loss of income, and for reimbursement of her out of pocket expenses. Additionally, the Crown was awarded $474,314.93 for the costs of health-care services that had been provided to the plaintiff. The total amount of damages awarded in this case amounted to $16,791,612.33 before adjustments.
This case raises important issues regarding the standard of care owed by physicians in an increasingly overburdened medical system, where sick patients may wait hours, days, or weeks to get the treatment they need. While understanding the nearly unmanageable difficulties placed on physicians in Canada’s struggling medical system today, this case highlights the judicial systems role in upholding ethical obligations owed by medical professionals so that Canadians continue to get the treatment they require and deserve.
Written by Kaylee Cunningham, December 4, 2025