What are the factors used in determining whether there is gross negligence in a medical malpractice case?

In addition, in DeCosta v. R.,[8] Bowman J. went on to summarize the factors as follows: In drawing the line between “ordinary” negligence or neglect and “gross” negligence a number of factors have to be considered. One of course is the magnitude of the omission in relation to the income declared. Another is the opportunity the taxpayer had to detect the error. Another is the taxpayer’s education and apparent intelligence. No single factor predominates. Each must be assigned its proper weight in the context of the overall picture that emerges from the evidence.