Lawsuit reveals bitter, 14-year rivalry between infectious disease specialists

Prominent University Health Network expert seeks millions from employer, high-profile colleague who she accuses of attacking her reputation

A sign for the University Health Network Toronto General Hospital in Toronto, Ontario, Canada, on Monday, Dec. 14, 2020. Photo by Cole Burston /Bloomberg

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As Canadians come to grips with a series of infectious disease threats, two of the country’s highest profile experts in the field are squaring off in a multimillion-dollar court battle.

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In a claim filed with the Ontario Superior Court of Justice in late 2024, Andrea Boggild, medical director of the University Health Network’s Tropical Disease Unit, seeks more than $4 million from her employers, alleging that the hospital system broke a promise to make her the new “clinical face” of the TDU, following the retirement of its legendary founder Jay Keystone.

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“In trying to secure the position that was promised to her, Dr. Boggild has endured over a decade of further broken representations, harassment, and sex-based discrimination from the Institutional Defendants,” she alleges in the document.

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Boggild is also seeking more than $2 million in damages from her UHN colleague and fellow tropical medicine expert Isaac Bogoch, who she accuses of attacking her reputation with colleagues and peers “with the goal of installing himself as Dr. Keystone’s appointed successor, and de facto Director of the TDU.”

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Keystone, who founded the TDU in the mid-1970s and was awarded the Order of Canada for his services to the field, left big shoes to fill.

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He was supposed to be winding down his practice when Boggild, an up-and-coming infectious disease expert, was hired to replace him in 2012.

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But Boggild says she was left as Keystone’s successor in name only, as the veteran specialist prolonged his career and handed key roles to his new protege, Bogoch – a frequent media commentator who subsequently rose to prominence during the Covid-19 pandemic, when his Twitter (now-X) account became a go-to source for public health information.

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After clashing over patients and clinic time, Boggild and Bogoch’s feud intensified after Keystone’s 2019 death, leading to a series of workplace complaints and investigations. Both physicians remain employed with the UHN, although their workspaces do not overlap, with Bogoch accepting tropical disease patients via his own infectious diseases clinic outside Boggild’s TDU.

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The litigation is currently in the discovery phase and none of the allegations have been proven in court.

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In his statement of defence, Bogoch denies all of Boggild’s allegations.

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“Dr. Bogoch specifically denies that he made any of the statements alleged in the Statement of Claim and puts the Plaintiff to the strict proof thereof. Dr. Bogoch pleads that the alleged statements as outlined in the Statement of Claim are the product of fabrication, hearsay, misinterpretation, miscommunication or the like,” Bogoch’s statement of defence reads.

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His lawyers Wade Poziomka and Taran Hoogsteen also provided an emailed statement to the National Post: “This matter involves a long-running professional difference between my client and a senior colleague. Dr. Bogoch maintains that each of these allegations are false. Those who know my client personally or professionally would recognize this,” the statement reads. “While it is unfortunate to see these issues escalated to litigation, we are confident that this process will provide my client with the opportunity to put these matters behind him with some finality.”

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In its own statement, provided by UHN spokesperson Ana Fernandes, the institution said it would refrain from commenting while the matter is before the courts.

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“With that said, UHN is vigorously defending against the allegations,” the statement continued.

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Boggild started at the TDU in a temporary role in 2008, initially filling in for Keystone while he was off on a medical leave.

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Keystone, the TDU’s founding medical director when it was established in 1976, no longer had that title by the time Boggild arrived, but remained a leading presence in the unit, running clinics and handling its lively “Friday Rounds” – a weekly education session for trainees, fellows and others to discuss interesting cases and topics in the area. He was eventually awarded the Order of Canada in 2016 for four decades of service to the field of tropical medicine.

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The seeds of Boggild’s legal claim were planted in 2011 when she transitioned from her temporary role to a full-time post as staff physician with UHN, which also came with an appointment to the University of Toronto’s Faculty of Medicine.

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According to Boggild’s claim, her letter of recruitment said that her appointment specifically identified her as Keystone’s TDU replacement, with a promise of three or four tropical medicine clinics per week and responsibility for the Friday Rounds and other tropical medicine educational sessions. Boggild alleges that she was told separately that Keystone would be finishing up at UHN some time around 2012.

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In court documents, UHN acknowledges discussing with Boggild the possibility of her replacing Keystone, but says that any clinical or teaching objectives it promised were never meant to kick in before his retirement.

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“The date of Dr. Keystone’s retirement was never guaranteed, nor could it be,” UHN’s statement of defence continues.

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In fact, that date never really did arrive: Keystone worked right up until his death in September 2019.

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Instead, Boggild alleges that she was relegated to just one or two sessions per week as Keystone held on to the vast majority of TDU clinics, forcing her to take work outside UHN in order to hit her billings target.

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Things escalated in 2012 when Boggild returned from maternity leave, to find that Keystone had hired two new clinical assistants to help with his TDU load, including Bogoch.

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With the new hires continuing to attend clinics and Keystone rebuffing her inquiries about the matter, Boggild says in her statement of claim that she took her concerns over Keystone’s head to management at UHN’s Division of Infectious Diseases in early 2013.

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According to UHN’s account of events in its statement of defence, the result was that Boggild and Keystone were given priority for TDU clinic days, with Bogoch and others providing TDU coverage only as needed.

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However, around the same time, Keystone did enlist Bogoch to help with the organization of his Friday Rounds.

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Bogoch, a frequent media commentator on infectious disease issues, sees tropical disease patients in his own UHN clinic, which Boggild’s claim characterizes as a “parallel tropical medicine service” that “draws referrals away” from herself and the TDU.

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However, UHN says that it has no requirement for tropical disease cases to flow through the TDU, explaining that Bogoch, just like any of its physicians with expertise and qualifications in the area, is entitled to treat and assess patients with these issues.

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“Any media opportunities for Dr. Bogoch were developed and managed by Dr. Bogoch himself, and not UHN,” the institution’s statement of defence adds, rejecting Boggild’s allegation that it had positioned Bogoch for tropical medicine media appearances.

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After Bogoch got his own full-time appointment with the Division of Infectious Diseases in 2014, UHN says Keystone supported his bid for regular TDU clinics. However, division management deferred to Boggild – by now the TDU medical director – who continued to offer Bogoch clinic days on an ad hoc basis only, as a back-up to cover staff absences or high patient volume.

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Bogoch also went to UHN’s unofficial ombudsman about his quest for TDU clinic time, where Boggild’s claim says Bogoch accused her of blocking his advancement – an allegation denied by Bogoch.

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In the following years, Boggild claims that she withdrew from the Friday Rounds altogether as a result of her deteriorating relationship with Keystone, who she alleges would target her with “offensive jokes and remarks in front of staff and trainees.”

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“At times she attempted to re-engage in rounds, Dr. Boggild was made to feel unwelcome and met with Dr. Keystone’s public derision and mocking of her, with comments focusing on her professionalism, appearance, and gait,” she alleges in her statement of claim.

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In its response, UHN acknowledges that “despite his unquestioned expertise in tropical disease medicine, Dr. Keystone had something of a reputation for being politically incorrect.” Still, the institution says it never received a specific complaint from Boggild about his behaviour.

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Another flashpoint came in July 2019, when Keystone, by then in the last weeks of his life, was unable to host the Friday Rounds. With Bogoch also absent, Boggild stepped in and moved the event to a new location that allowed for virtual presentations and attendances.

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According to UHN, “Bogoch took issue with this action, believing that, at least in part, Dr. Boggild was attempting to subvert his work in tropical disease medicine.” In her claim, Boggild says her colleague accused her of “hijacking” the rounds, labelling his subsequent complaint an “attempt to discredit her and bring her reputation into disrepute.”

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UHN says Keystone also initiated his own complaint about Boggild around this time, alleging that she “engaged in inappropriate behaviour and sought to undermine Dr. Bogoch,” but his death in September 2019 came before anyone from the hospital could meet him.

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In the aftermath, UHN management recommended that Boggild receive leadership coaching as part of a plan to tackle the dysfunctional communications and lack of transparency that had marred the interpersonal relationship between her and Bogoch. Boggild says in court documents that she agreed to work with the leadership coach, granted Bogoch one day a week in the TDU clinic and suggested another UHN physician to co-lead the Friday Rounds with Bogoch to minimize her own contact with him.

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The onset of the COVID-19 pandemic removed some of the TDU workplace issues from the table, with pandemic response taking priority and the Friday Rounds cancelled for the foreseeable future.

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However, by December 2020, the UHN defence says “there continued to be a lack of trust and collegiality between Drs. Boggild and Bogoch that was undermining the workplace environment in the TDU.”

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The hospital network says Boggild’s leadership coach concluded that an impasse had been reached, with reconciliation unlikely.

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“Both Boggild and Bogoch maintained that the other was obstructive in their participation or management of the TDU, and both claimed a pattern of unprovoked incivility and harassment by the other,” UHN says in its statement of defence.

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Around this time, an internal review of the TDU leadership yielded mixed results, before UHN called in an independent third-party investigator in response to fresh competing harassment complaints by Bogoch and Boggild in May 2021.

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According to UHN, the investigator came down on Boggild’s side, concluding that her allegations against Bogoch were supported, with aspects of his behaviour found to be “unprofessional, harassing, and inappropriate,” amounting to “incivility under UHN’s Physician Code, and harassment under UHN’s Fostering Respect in the Workplace Policy.”

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On the other hand, the report concluded that Bogoch’s allegations against Boggild were not supported, that she had not breached either of the UHN policies and that her conduct did not amount to workplace harassment, inappropriate treatment or incivility.

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Bogoch objected to the investigator’s findings and continues to dispute them.

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Meanwhile, the manner in which Boggild was treated by management at UHN’s Division of Infectious Diseases constituted a violation of her rights under the Ontario Human Rights Code, the third-party investigator concluded.

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Following its receipt of the report, UHN says it developed a series of remediation measures, including “establishing healthy workplace boundaries between Dr. Boggild and Dr. Bogoch; and directions regarding appropriate and professional workplace communications.”

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In its statement of defence, the institution claims that Boggild’s claim should be dismissed as statute-barred, alleging that it is based almost entirely on events prior to July 2022 – more than two years before it was filed.

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In any case, UHN denies that it has not breached its contract with Boggild, claiming that she had hit the minimum clinic load of three per week by 2017, when Keystone’s health issues necessitated a drop in his workload.

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“To the extent that Dr. Boggild claims that it was represented to her that she would become the ‘clinical face’ of the TDU, UHN denies any misrepresentation. Dr. Boggild became the Medical Director of the TDU in 2013, and continues in that role to this date,” the statement of defence continues. “The fact is that Dr. Boggild became, and remains, the ‘clinical face’ of the TDU.”

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Despite their differences, Boggild and UHN are on the same page when it comes to the institution’s role in fighting the spread of infectious diseases at a time of heightened public concern around outbreaks of hantavirus, measles and Ebola, among others, as well as the increased international travel associated with events like the FIFA World Cup.

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“Torontonians should rest assured that UHN is a world leader in research and treatment of tropical and infectious diseases, which are unaffected by the issues raised in my claim,” Boggild said in a statement to the National Post.

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In its own statement to the newspaper, UHN said that the systems and teams in place at its Division of Infectious Diseases “ensure consistency, collaboration and a strong state of readiness to respond to emerging infectious diseases and maintain the highest standards of care at all times.”

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“There has been no impact to the delivery of patient care or the ongoing operations of the Division, which continue to function as usual under established clinical and operational protocols,” the statement continues.

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