Mandatory reporting provisions typically protect the reporter from liability or retaliation for making a report in good faith. Do those immunity provisions prevent registrants from being held accountable by their regulator for making an inappropriate mandatory report?
That issue arose in Jeyaranjan v. Health Professions Appeal and Review Board, 2025 ONSC 6152 (CanLII). A physician and a patient had a significant verbal altercation. Despite never treating the patient for a mental illness or documenting any mental disorder, the physician made a mandatory report under the Highway Traffic Act (HTA) that the patient had demonstrated a violent outburst due to a psychiatric illness. The physician justified the report as protecting the public from road rage. The mandatory reporting provision in the HTA creates an immunity from actions “or other proceedings” for reporting in good faith. The physician also had three conversations with the patient’s father about the incident in which it was alleged that patient confidentiality was breached.
The Court held that the phrase “or other proceeding” in the HTA, while broad, did not apply to regulatory complaints and discipline proceedings. The Court conducted a detailed analysis of the interpretation of the legislation noting the following:
- Both the HTA and the Regulated Health Professions Act (RHPA) are intended to protect the public.
- By designating physicians as “prescribed persons” who could make reports that would result in the automatic suspension of driving licences, the HTA was trusting the regulatory regime found in the RHPA: “The Highway Traffic Act contemplates that the reporting scheme is implemented by a regulated health professional in accordance with the standards of the practitioner’s governing profession.”
- The HTA has no mechanism for addressing physicians making inappropriate reports.
- “The applicant’s interpretation would immunize the physician or other regulated health professional from professional regulation within this sphere of practice. This would convey the ironic message that this is one area of practice where the regulated health professional cannot be regulated. The legislature cannot have intended such an outcome.”
- In an analogous context related to coroners, the legislature extended the College’s jurisdiction over physician conduct in proceedings under the Coroner’s Act, suggesting that the equivalent provision under the HTA should be interpreted similarly.
The Court concluded: “The College’s jurisdiction in respect of a complaint about a [HTA] Report is therefore consistent with and essential to the reporting scheme established by the Highway Traffic Act and promotes the statutory purposes of the protection of the public that both statutes promote, from quality of care and road safety perspectives.”
The Court also said that, given this analysis, it was unnecessary for it to assess whether the complaint was made in bad faith (which would nullify the immunity provision). However, the Court found that the complaints-screening committee had an adequate basis for characterizing the report as “artificial and unsupportable”. Doing so did not amount to the screening committee making findings of contested facts or formal legal findings. The Court said:
The Committee therefore did not exceed its screening function in stating its concern the applicant had “weaponized” his authority. The Committee was explaining its basis for requiring Dr. Jeyaranjan to appear for a caution and to complete a remedial program. The Committee did not issue any declarations or orders, did not purport to make findings of professional misconduct or findings in the context of disputed facts, and did not refer this matter to a Discipline Committee. The Committee’s concern that the applicant had “weaponized” his authority was within its jurisdiction on the record before it….
According to the Court, the outcome (a requirement to complete a remedial program and attend for a caution) was reasonable, not only on the acknowledged facts, but also because the physician did not develop insight into his behaviour and because he had previously been cautioned about the preconditions for making such reports.
The Court also upheld the remedial outcome related to breaching the patient’s confidentiality in discussions with the patient’s father. While the details of what was discussed were disputed, it was clear that the physician and patient’s father discussed the incident about which the physician had reported the patient’s claimed psychiatric disorder. Also, the physician’s rationale for discussing the topic with the patient’s father did not support the possible exception to the duty of confidentiality where necessary to protect public safety.
While a regulator’s role in addressing the way registrants make mandatory reports protected by an immunity provision is complex, public protection principles are essential to the analysis.
