Injury Compensation News

The Clinical Indemnity Scheme has been criticized in The Irish Times today for granting anonymity to medical professionals. The State Claims Agency has operated the Clinical Indemnity Scheme since 2002 for all medical malpractice cases taken against hospitals and doctors. The State Claims Agency ‘assumes responsibility for the vicarious negligence by act or omission on the part of doctors, nurses, midwives and allied healthcare professionals”

The State Claims Agency has advised solicitors that it is ‘neither necessary nor appropriate” to include the names of doctors in medical malpractice documentation.

This means that negligent doctors are effectively protected from public record unless the lawsuit is heard in the High Court.  The vast majority of medical malpractice cases, like most other types of personal injury cases, are settled prior to going to court .

This effectively means that medical professions are granted anonymity for their negligent actions.

A former director the Mid-Staffordshire Health Service in the UK has warned that fatality rates in Irish hospitals will rise unless there is some easing of budget cuts.

Mike Gill was speaking from experience when he addressed the Irish Nurses and Midwives Organisation (INMO) at a conference in Croke Park, Dublin – during his tenure at the Mid Staffordshire NHS Foundation Trust, an enquiry concluded that between 2005 and 2008 up to 1,200 patients had died unnecessarily due to the management´s prioritising of finances over patient care.

Mr Gill also stressed the importance in his speech of Irish nurses and midwives speaking out about the issues they encounter at the frontline of the health service. Condemning what he referred to as the “culture of non-reporting” he encountered while at the head of the Mid Staffordshire NHS Foundation Trust, Mr Gill insisted that “the patient must always be the priority”.

His sentiments were echoed by the union’s general secretary Liam Doran who stated that “Mid Staffordshire has said that nurses and midwives cannot be silent. They cannot be silenced by the system, they cannot be emasculated by the system, they have to have the courage, when they believe care is being compromised, to speak up and speak out.”

He continued, “When that doesn’t happen, patient care and mortality rates actually increase and we have to listen and learn. We can’t pretend that we are not going to make the same mistakes as other health systems have when finance has been given priority.”

Before the start of the conference INMO had released a statement saying that the Irish Health Service was under unbearable pressure and Mr Doran had words to add to this also. “At the moment I don’t see any floor for the Irish health service, we still have the moratorium in place, we still have beds closed on an increasing basis, we still have community services being cut back and now we are told X hundreds of millions more has to come out for the fourth year in a row.

The conference also heard how the closure of 2,317 beds and loss of almost 3,000 nurses meant that union members had “never been more frustrated” at the failings of the system to listen to and act upon what they were saying. The union warned of increased mortality rates and wrongful deaths in Irish hospitals unless the Government reverses its policy of prioritising budget cuts over patient care.

Current proposals for health service funding could see a further 500 million Euros cut from the existing budget, following a 1 billion Euros reduction in 2011.

The High Court in Dublin has heard that a claim for wrongful death compensation has now been settled for an undisclosed sum by the Health Service Executive in the case of David O´Leary.

David of Ballinascarthy, County Cork, was 12 years old when he died of acute myocarditis in February 2007, after having been diagnosed with a winter vomiting bug by doctors at the Cork University Hospital.

David´s parents alleged in their action against the hospital and the Health Service Executive that David had tried to explain to doctors how ill he was and that he had difficulty breathing. They claimed that, had the doctor´s listened to what their son was trying to tell them, his condition would have been diagnosed and David would still be alive today.

The Health Service Executive denied the allegations, but had expressed in a letter to the parents its sincere regret for any deficiencies or inattention in the care of their son. The letter, which was read out to Mr Justice John Quirke at the High Court also stated that the family could take comfort from the “lessons that have been learned by all concerned with David´s care”.

Mr Justice John Quirke heard that the medical negligence claim against the Health Service Executive had been settled for an undisclosed sum without admission of liability, and had included the maximum amount payable of 33,000 Euros for the nervous shock and mental distress of the parents as a result of David´s death.

A huge increase in the number of patients left overnight on Emergency Department trolleys could escalate hospital negligence claims made against the Health Service Executive (HSE).

According to the Irish Nurses and Midwives Organisation’s “trolley watch”, 6,624 patients were left overnight on trolleys in August due to a lack of beds, with 401 patients bed-less on August 31st alone. The figures indicate a 35 per cent rise on those from last year and are attributed, according to the Irish Nurses and Midwives Organisation General Secretary, Liam Doran, on the rising rate of bed closures due to the pruning of funds by the government and HSE.

“A Serious Negative Impact upon Patient Care”

Selecting Limerick as an example of how the situation has got out of control, Mr Doran noted that despite assurances in 2009 from the HSE that any reconfiguration of services “would not require any additional beds”, 50 acute beds were closed at Ennis General and Nenagh Hospitals, followed by 25 further bed closures at St. John´s Hospital in Limerick and – in the middle of the August crisis – the HSE closed 25 acute beds at Limerick Regional Hospital. This has had, according to Mr Doran, “a serious negative impact upon patient care”.

“An Unsafe Situation”

The Irish Nurses and Midwives Organisation’s claims that HSE cuts were resulting in “an unsafe situation” were echoed by Mr Fergal Hickey, President of the Irish Association for Emergency Medicine. Mr Hickey, quoting research conducted in Australia which was supported in the British Medical Journal, stated that Emergency Department overcrowding could be responsible for as many as 350 unnecessary deaths in Irish hospitals each year. He added that, for the first time ever, children admitted through the Emergency Department procedure were also facing delays in treatment due to the overcrowding situation.

“The Solution is Complex”

In response to the claims, Minister for Health James Reilly – who promised after his appointment in March that there would never again be 569 on trolleys in hospitals as there were earlier in the year -stated that “the solution is complex and will require an enhanced capacity by hospitals to deal with the inter-related issues involved”. Nonetheless, staff working in the country´s Emergency Departments are deeply concerned about the forthcoming months.

The Situation May Get Worse Before it Gets Better

The Irish Nurses and Midwives Organisation is concerned that the increase in bed shortages and subsequent high numbers of patients being left on hospital trolleys is occurring at the height of the summer – traditionally a “quiet” time of year – and has called on statutory bodies such as the Health Information and Quality Body (HIQA), An Bord Altranais and the Medical Council, to inspect all affected hospitals.

However, it is already known that HIQA has been unable to carry out independent hygiene inspections of hospitals throughout 2011 due to a lack of resources. This raises the fears for MRSA and other hospital infections being acquired by patients waiting in hospital corridors for a bed to become available. Furthermore, according to the HSE’s own performance system, five out of the six main Dublin hospitals are ranked as “unsatisfactory” in terms of the performance of their emergency departments.

The Health Service Executive (HSE) has apologised to a family for the death of their young son from meningitis at Our Lady of Lourdes Hospital, Drogheda, County Louth, and resolved a claim for wrongful death compensation in an undisclosed out of court settlement.

The family of four month old Dean Patrick Kenny from Drogheda, County Louth, brought an action for wrongful death against the hospital and HSE, claiming that the hospital staff had failed to diagnose their son’s condition and discharged him when it was unsafe to do so.

The family alleged in their claim that Dean had been referred to the hospital with suspected meningitis by the family GP early in the morning of July 1st 2002. Dean was examined and discharged, and the family went home where Dean’s condition continued to deteriorate.

After a later visit to their GP – where meningitis was confirmed – they returned to the hospital, but it was too late to save little Dean, who died that night.

In their defence, the hospital and HSE denied negligence, and pleaded it had complied with general approved medical practices. They claimed that Dean did not show clinical features of bacterial meningitis and was feeding well.

However, shortly before High Court proceedings were about to commence, Mr Justice John Quirke was informed that the HSE had made an undisclosed offer of settlement, which was accepted by the family, and the case was to be struck out.

The mother of a two year old girl, who died after contracting meningitis, has been awarded more than 170,000 Euros after the hospital in which the little girl died admitted errors in the way they handled her condition. Natalie Courtney (28) of Drimnagh, County Dublin, had taken her daughter, Aisling, to Our Lady’s Hospital, Crumlin, Dublin on February 19 2006, after Aisling had started suffering from hallucinations and a sore neck. The doctor who examined Aisling diagnosed her as having a 24-hour viral gastric bug and being dehydrated. Natalie requested that Aisling be kept in overnight for observation and stayed with her daughter throughout.
After the initial examination, a rash developed on Aisling’s back and, early in the morning of February 19, Aisling was placed on a drip. She subsequently developed purple spots on her skin, and Natalie was informed that Aisling was being treated for meningitis.
Aisling’s condition deteriorated and she was moved into the hospital’s intensive care unit. But, at 10.25am, Aisling died of a heart attack. The shock was overwhelming for Natalie who, Mr Justice Iarfhlaith O’Neil heard at the High Court, became socially withdrawn and developed feelings of guilt due to her own failure to intervene in Aisling’s treatment and demand more appropriate action. After seeking legal advice, Natalie sued the hospital for nervous shock arising from Aisling’s death, claiming that she had suffered depressive injuries as a result of the manner in which she had witnessed her child’s death.
Our Lady’s hospital conceded liability late last year – extending and aggravating Natalie’s feelings – and Mr Justice Iarfhlaith O’Neil accounted for this lack of admission when awarding Natalie 150,000 Euros plus an amount to cover the costs associated with legal representation at the inquest into Aisling’s death.

A member of a High Court working group, commissioned to investigate provision for the victims of catastrophic injury and chaired by Mr Justice John Quirke, has announced that the working group is considering the introduction of pre-action protocols to reduce the financial burden to the State of clinical negligence compensation claims.
Mr Michael Boylan was speaking in Dublin at a conference on catastrophic birth and child injuries organised by the charity “Action Against Medical Accidents”. He said that a legal “duty of candour” should be introduced to require medical practitioners to advise a patient as soon as they are aware that a clinical error as occurred.
Quoting from a Health Service Executive report, Mr Boylan stated that there was evidence to suggest that patients often forgave the clinical error when it is disclosed promptly, fully and compassionately, and not only would this action reduce the trauma and distress of patients and their families upon discovery, but also reduce the amount of legal costs arising from contested medical negligence actions.
The first proposal from the working group was contained in a report published in November 2010. The report recommended that people who sustain catastrophic injuries would benefit more from periodic compensation payments than one lump sum. Mr Boylan hoped that the report would be acted upon and legislation introduced, although he acknowledged that the overall cost to the State could be greater and feared that this might prevent it from being adopted into law.

The family of a woman who died from internal bleeding, shortly after giving birth at the National Maternity Hospital, has been awarded almost 2.5 million Euros in a High Court settlement.
Taz Kenefick (36), a dentist from Bray in County Wicklow, had been admitted to the Holles Street National Maternity Hospital in Dublin to give birth to her second son in November 2004.
The birth was complicated as Mrs Kenefick developed an infection during her labour and had a condition in which the placenta was very deeply attached to her womb.
Following the birth of her son, Mrs Kenefick bled very heavily and, despite the attention of her obstetric consultant, died on the operating table.
Her husband, Kevin, sued the consultant and the hospital for clinical neglect, and Mr Justice Iarfhlaith O’Neill at the High Court heard that the hospital admitted liability just two weeks ago.
Awarding almost 2.5 million Euros to Mr Kenefick and his two children, Mr Justice Iarfhlaith O’Neil announced that the action against the consultant was no longer going to be pursued.

The family of a man who died following an accidental piercing of his heart at a Dublin hospital, spoke of how they were pleased the case had finally been resolved. Avril Ridge of Mohill, County Leitrim, and daughter of the deceased, was speaking after Mr Justice John Quirke had approved a 385,000 Euros settlement against surgical registrar Dr. Ramy Alnahhal of the Blackrock Clinic in Dublin.
The judge had heard how Mr. Art Ridge (62) had undergone successful cardiac surgery in November 2005 to replace a valve in his heart. However, a few days later it had been decided to insert a chest drain to aid Mr. Ridge´s recovery, and it was during this surgical process that Dr. Alnahhal had pierced the patient´s heart by using excessive force on the forceps. His error caused massive internal bleeding and despite emergency surgery, Mr. Ridge never recovered.
An action initially brought against consultant Michael Tolin and the Blackrock Clinic by the victim´s wife, Mrs Maura Ridge, was struck out with no liability admitted but, while approving the settlement against Dr Alnahhal, Mr Justice John Quirke expressed his sympathy to the family and declared that Mr Ridge had passed away in the court’s view at “a very young age” and “for no good reason”.

A new superbug called CRE (Carbapenem Resistant Enterobacteriaceae) has been discovered in Irish hospitals for the first time. The new superbug is potentially fatal and can cause kidney infection and pneumonia. Four cases have been discovered so far in Ireland, causing concern with medical professionals because it is difficult to eliminate once it takes hold in a country’s medical system (which has already occurred in Greece and parts of the United States).

One of the problems with treating the superbug is that the general population is less responsive to treatments for CRE because of the widespread using of board spectrum antibiotics.

If CRE spreads in Irish hospitals, it it likely to be for the same reasons as the recent MRSA outbreak – contaminated surfaces, especially medical equipment.