Report Reveals Most Common Clinical Incidents in Ireland

The State Claims Agency has published a report revealing the most common clinical incidents in Ireland and the cost of settling clinical negligence claims.

The report – National Clinical Incidents, Claims and Costs – covers the period between 2010 and 2014. Its purpose, according to lead author Dr Dubhfeasa Slattery, is to help improve patient safety by analysing national data on clinical incidents in Ireland, and studying the results in order to develop a “learning health system” that provides safer care.

More than 206,000 clinical incidents in Ireland were reported to the State Claims Agency over the five year period – not all of which were attributable to medical negligence, and therefore not all resulting in clinical negligence claims. The incidents were divided into five main categories – Medicine, Surgery, Maternity Services, Disability Services and Care of the Elderly.

In the Medicine category – the category in which most clinical incidents were reported – the most common adverse outcomes were attributable to a delay or failure to diagnose and treat (most often in the emergency room), the incorrect medicine or dosage of medicine being prescribed or administered, and serious soft tissue damage – typically caused by bed sores due to a lack of nursing care.

Among the most common surgical clinical incidents in Ireland, the delay or failure to treat was again the leading cause of adverse outcomes. However the high percentage of adverse outcomes attributable to faulty equipment and missing or misplaced clinical records was also a cause for concern – both in the Surgery category and the Maternity Services category.

The leading clinical incidents in Ireland in the Maternity Services category were post-partum haemorrhages and perineal tears, while medication issues and serious soft tissue damage dominated the clinical incidents in the Disability Services and Care of the Elderly categories. A further 66,000 medical incidents were reported to the State Claims Agency during the period being investigated that were not regarded to be of a clinical nature.

In relation to the number of clinical negligence claims made during the period and the cost of settling them, the figures quoted in the report (2,873 claims and €288 million in settlement costs) are misleading as they included claims made during the period not settled during the period, and pre-2010 claims settled between 2010 and 2014. They were also inflated during 2012 by DePuy hip replacement claims, the Lourdes Redress scheme, and by the volume of claims made for unnecessary symphysiotomy procedures.


Claim for the Failure to Treat Meningitis Resolved in Court

A young boy´s claim for the failure to treat meningitis has been resolved in court with the approval of a €3.7 million interim settlement of compensation.

Matthew McGrath was admitted to Wexford General Hospital on 27th May 2004 at the age of 17 months after it was noticed that he was uncharacteristically drowsy and vomiting fluids. Matthew was diagnosed with Haemophilus Influenza Type B – which is known to lead on to meningitis – and he should have been administered antibiotics.

Overnight, Matthew´s condition deteriorated and he was identified as being in shock. Despite medical guidelines recommending against it when a patient is in shock, Matthew underwent a lumbar puncture procedure to confirm suspected meningitis – due to which a compression of the spinal cord took place and Matthew is now permanently paralysed.

Due to the failure to administer antibiotics when Matthew was first admitted to the hospital, and the subsequent inappropriate lumbar puncture, Matthew cannot move his arms or legs and can only breathe through a ventilator. He spent the next two years of his life in hospital until his parents were eventually allowed to care for their son at home.

Through his mother – Cathy McGrath of Gorey in County Wexford – Matthew made a claim for the failure to treat meningitis against the HSE – alleging that, if he had been treated with antibiotics and given fluids at the time of his admission into Wexford General Hospital, he would not have suffered such devastating injuries.

After an investigation into the claim for the failure to treat meningitis, the HSE admitted liability and issued an apology to Matthew´s parents. An interim compensation settlement of €3.7 million was agreed, but first had to be approved by a judge before payment could be made.

Consequently, at the High Court in Dublin, the circumstances of Matthew´s devastating and unnecessary injuries were related to Mr Justice Matthew Cross. Judge Cross approved the settlement, and adjourned the claim for the failure to treat meningitis for five years in order that reports into Matthew´s future needs can be conducted.


HSE Found Liable in Hydrocephalus Brain Injury Claim

The Health Service Executive (HSE) has been found liable in a hydrocephalus brain injury claim after a hearing at the High Court.

Ava Kiernan started displaying the symptoms of hydrocephalus (“water on the brain”) when she was just a few months old. In April 2008 – when she was three months old – Ave was examined by a public health nurse, who failed to act on her mother´s concerns or arrange a follow-up examination.

Hydrocephalus is caused by spinal fluid “pooling” in the skull because it has failed to drain from the brain. It is most commonly identified in children under the age of one year by a rapid expansion of the head´s circumference or “soft spot” bulges appearing around the skull.

A follow-up examination would have identified a rapid growth in the size of Ava´s head, but her skull was not measured again until September 2008, when the measurement – which would have been conducted in time to prevent Ava from suffering brain damage – was performed incorrectly.

Due to the nurse´s failure to act and the subsequent errors in the measurement of Ava´s head, the pressure from the spinal fluid resulted in Ava suffering brain damage. She now suffers from physical and mental disabilities and, on her behalf, Ava´s mother – Ruth Kiernan from Duleek in County Meath – made a hydrocephalus brain injury claim for compensation against the HSE.

The hydrocephalus brain injury claim was contested by the HSE, and the case went to the High Court in Dublin, where it was heard by Mr Justice Kevin Cross. Judge Cross found in Ava´s favour after a hearing that lasted three weeks. He deduced that if Ava had been recalled for a second examination four weeks after the April head measurement, or the subsequent September measurement of her head in September had been performed correctly, Ava´s hydrocephalus would have been identified.

Judge Cross continued to say that Ava´s hydrocephalus could have been diagnosed and treated before it resulted in permanent brain damage where it not for the public health nurse´s failure to act on Ruth´s concerns and the medical negligence in the second measurement. The judge adjourned the hydrocephalus brain injury claim so that an assessment can be conducted to determine Ava´s future needs and an appropriate damages settlement.


Meningitis Medical Negligence Claim Resolved at Court

A County Wicklow teenager´s meningitis medical negligence claim for compensation has been resolved after a High Court hearing at which her settlement of compensation was approved.

Laura Kavanagh (18) from Newtownmountkennedy in County Wicklow had fallen ill on 29 January 1998 at the age of thirteen months with a high temperature and severe fatigue. Her mother – Simone – had telephoned the surgery of Dr Frank Malone and Dr Paul Crean in Greystones in County Wicklow to communicate her daughter´s condition and had been told to keep an eye out for a rash.

Several hours later, Laura´s condition had deteriorated and Simone Kavanagh rang the surgery again – on this occasion speaking with Dr Crean, who said he would make a house call after surgery due to Simone not having transport available.

Three and a half hours later, Dr Crean arrived at the Kavanagh´s home and diagnosed a bowel infection. He left two suppositories and told Simone to call him back in the morning if Laura´s condition had not improved. The following day, Simone called the surgery requesting a home visit, but later cancelled the call as Laura seemed to be looking better.

However, the next morning Laura once again was very ill, and Simone was able to get an on-call doctor to visit straight away. He immediately admitted Laura to hospital, where she was diagnosed with severe meningitis.

As a result of the illness, Laura lost her hearing, and through her mother she made a meningitis medical negligence claim for compensation against Drs Malone and Crean, alleging that Dr Crean had failed to diagnose meningitis and that there had been a failure to attend Laura in good time, ensure proper care or any continuity of care.

The two doctors denied Laura´s meningitis medical negligence claim, however agreed a €5 million settlement of meningitis medical negligence compensation without admission of liability.

At the High Court in Dublin, Ms Justice Mary Irvine heard that if Laura had been admitted to hospital when Dr Crean misdiagnosed her condition as a bowel infection, it was likely that Laura would not have lost her hearing.

The judge was also told that after Laura lost her hearing, she learned to communicate through sign language and lip reading – but has a moderate intellectual disability. Ms Justice Mary Irvine approved the settlement of Laura´s meningitis medical negligence claim, saying that it would never give Laura the life she was meant to have.


Family Receive Compensation for Failure to Diagnose Cancer

The family of a woman who died from an undiagnosed tumour in her abdomen is to receive €62,500 compensation for the failure to diagnose cancer.

Sharon McEneaney (31) from Carrickmacross in County Monaghan died in April 2009 from a cancerous tumour in her abdomen, eighteen months after she had first attended the emergency department of Our Lady of Lourdes Hospital in Drogheda complaining of abdominal pain.

The cancerous tumour went undiagnosed for a further nine months, and was only identified after Sharon was given a biopsy due to the intervention of former TD Dr Rory O´Hanlon in June 2008. By then the tumour had developed to such as size that it was too late for any treatment, and Sharon died the following April.

The Health Service Executive (HSE) conducted an investigation in Sharon´s death and made 38 recommendations to prevent future failures to diagnose cancer, while – in January 2012 – Dr Etop Samson Akpan was found guilty of a poor professional performance by the Medical Council of Ireland´s Fitness to Practise Committee.

At the High Court in Dublin, Margaret Swords – the General Manager of the Louth & Meath Hospital Group – read out an apology to the McEneaney family, admitting that the hospital had failed Sharon, but also stating that the hospital was making progress in making the changes required. The court heard that, five years after Sharon´s death, six of the HSE´s recommendations are still to be implemented.

The court also heard that a settlement of compensation for the failure to diagnose cancer had been agreed between the hospital and Sharon´s family, with €10,000 going towards Sharon´s funeral and other expenses connected with her death, €27,100 compensation for the failure to diagnose cancer going to Sharon´s mother Jane, and the remainder to be shared by Sharon´s four siblings.

Ms Justice Mary Irvine closed the hearing after commending Sharon´s family for their courage and tenacity, and commented “You have shown marvellous fortitude in the face of such a loss”.


Compensation for Missed Knee Fracture Approved in Court

A young woman, whose opportunity to compete in the Special Olympics was denied due to medical negligence, has had her settlement of compensation for a missed knee fracture approved in court.

In May 2009, Amy Rose McGowan (now 31) was in training for the Special Olympics World Games that were scheduled to take place in the summer of 2011 in Athens. Unfortunately, while participating in a 50 metre training race, Amy Rose fell and hurt her knee.

Amy Rose attended Our Lady´s Hospital in Navan, where – after an x-ray had been taken – she was diagnosed with a soft tissue injury and her knee was strapped for support. However, a few months later, a pain started to develop in her knee and Amy Rose saw her GP.

 On inspection of her injury, her doctor discovered that Amy Rose had suffered a depressed fracture which had been overlooked at the hospital. Unfortunately the discovery was made too late for corrective surgery, and Amy Rose had to abandon her dreams of representing Ireland in Athens.

Through her mother – Charlotte McGowan of Trim, County Meath – Amy Rose made a claim for missed knee facture compensation against the Health Service Executive (HSE), alleging that the care, diagnosis and treatment she had received in the emergency department of Our Lady’s Hospital had been negligent.

After an investigation, the HSE acknowledged that the depressed fracture had been overlooked by hospital staff and liability was admitted for Amy Roses´ knee injury. A settlement of compensation for a missed knee fracture was agreed; but, as the claim had been made on behalf of Amy Rose due to her intellectual disability, the settlement had to be approved by a judge.

Consequently, Mr Justice Michael Peart at the High Court in Dublin heard how Amy Rose had previously been a successful swimmer and athlete before her accident and had won 34 medals and 10 trophies. Approving the settlement of €142,000 the judge said it was a pity Amy Rose´s athletics career had been cut short.


Court Approves Compensation for Delayed Delivery

The High Court has approved an interim settlement of €1.5 million compensation for the delayed delivery of a young girl who now has cerebral palsy due to the hospital´s alleged negligence.

Mary Malee (14) was born on 11th October 1999 by emergency Caesarean section at the Mayo General Hospital after there had been a delay in finding a consultant gynaecologist to assist with the delivery and an alleged breakdown in communicating her foetal distress.

As a result of the hospital´s alleged negligence, Mary is confined to a wheelchair after being born with cerebral palsy and now needs full-time support from her family. Despite her handicap, Mary is a bright and popular girl, who aims to go to university.

Mary made a compensation claim for the injuries she sustained through her mother – Maura Malee of Swinford, County Mayo – alleging that there had been a failure to intervene and perform a Caesarean section delivery in a timely manner when it became apparent that the foetus was suffering distress and likely to need resuscitation.

Mayo General Hospital and the Health Service Executive (HSE) both denied their liability for Mary´s cerebral palsy; but agreed to an interim settlement of compensation for a delayed delivery amounting to €1.5 million, with a further assessment of Mary´s needs to be conducted within two years.

At the High Court, Ms Justice Mary Irvine heard that Maura Malee had attended the consultant gynaecologist who had delivered her three previous children three days before Mary was born. The gynaecologist had informed Maura that he would be unavailable for Mary´s delivery, as he was about to undergo treatment for cancer. However, he had told Maura that arrangements would be made for her to be transferred to another consultant.

Maura saw her family doctor the following day, and he told Maura to go to hospital immediately as she was showing symptoms of pre-eclampsia. Maura was admitted to Mayo General Hospital and transferred to the labour ward, where she underwent a CTG shortly before 6:00am which revealed a series of decelerations.

The first consultant that was called was unavailable to attend Mary´s birth, and second consultant arrived shortly before 7:00am. Allegedly there was a failure to communicate the severity of Maura´s condition, and the Caesarean delivery did not take place until after 7:20am.

In court, after Mary had read out a statement in which she commented “It would have been appreciated had the HSE/Mayo General Hospital said they were sorry”, Judge Irvine approved the interim settlement of compensation for a delayed delivery and adjourned the case.


Judgement Reserved in Test Result Mix-Up Claim

Ms Justice Bronagh O’Hanlon has reserved judgement in a test result mix-up claim for compensation in which a woman was incorrectly told she had the HIV virus.

Judge O´Hanlon at the High Court heard that Michelle Kenny (35) from Crumlin in Dublin had returned from a  holiday in Majorca feeling unwell and – on 17th August 2010 – attended the St James Hospital in Dublin, where she underwent an ECG and blood tests, and had an x-ray taken of her chest.

Michelle was kept in hospital for a week as doctors believed she may have a blood clot on her lung, but was discharged on August 23rd to await the result of a blood test for TB. When she returned to the Outpatients Clinic on October 6th for an assessment, Michelle also underwent a blood test for HIV.

The following week, Michelle´s doctor rang her to say that, although she was clear of TB, her HIV test result had indicated positive. Three further tests showed that a mistake had been made, and that Michelle was not at risk from the HIV virus; however, as Michelle told the court, “I was devastated. I thought I was going to die, that I had no future.”

After an investigation revealed that the doctor at St James Hospital had given her the wrong person´s results, Michelle sought legal advice and made a compensation claim for nervous shock against the hospital – alleging that the news, albeit wrong, had stopped her socializing and caused a change in her lifestyle.

St James contested the test result mix-up claim for compensation on the grounds that Michelle had not suffered any loss or damage. They argued that Michelle had been told quickly after the mistake had been identified that she did not have HIV and denied that she was entitled to any compensation for a test result mix-up.

After hearing arguments from both sides, Ms Justice Bronagh O’Hanlon said she would reserve judgement on the claim for test result mix-up compensation for a later date.


Judge Resolves Claim for Hospital´s Lack of Care after Birth

A judge has resolved a forty-year-old woman´s claim for a hospital´s lack of care after the birth of her child which resulted in a significant loss of blood due to haemorrhaging.

Honey Larkin brought her claim for a hospital´s lack of care after the birth of her child following the events of January 2008 at the Letterkenny General Hospital in County Donegal.

Honey had given birth to her final child by Caesarean section, but started haemorrhaging heavily while in recovery. Honey claimed in her action against consultant gynaecologist Eddie Aboud and the Health Service Executive (HSE) that she had a near-death experience due to the loss of blood while she was waiting for the hospital to arrange a further surgery to stop the bleeding.

Honey – who also comes from Letterkenny in County Donegal – claimed that neither the staff at the hospital nor Mr Aboud checked for indications of bleeding after the Caesarean operation; and when the cause of her distress was acknowledged the hospital failed to act appropriately within a reasonable timeframe. The result, Honey claimed, is that she now suffers from Post Traumatic Stress Disorder.

Both Mr Aboud and the HSE contested Honey´s claim for the hospital´s lack of care after the birth of her child; entering the defence that she was treated appropriately throughout and after the Caesarean procedure, and in a timely manner once staff raised the alarm about the haemorrhage. Consequently the case went to the High Court and was heard by Mr Justice Kevin Cross.

At the hearing, Judge Cross was told that no internal haemorrhaging had been apparent when Mr Aboud had finished the Caesarean operation; but, when he was called back to attend to Honey, he performed the second operation quickly and successfully. Judge Cross said he felt that Mr Aboud could not be held liable for any of Honey´s suffering and dismissed the gynaecologist from the case.

However, after considering the actions of the hospital once Honey´s condition had been identified, Judge Cross found that the Letterkenny General Hospital had failed in their duty of care towards her. He ordered the HSE to pay €25,000 compensation in resolution of Honey´s claim for the hospital´s lack of care after the birth of her child.


Settlement of Claim for Fatal Hospital Errors Approved at Court

A family from Dromahair in County Sligo have heard the settlement of their claim for fatal hospital errors approved in the High Court following the death of Dhara Kivlehan three years ago from avoidable multiple organ failure.

On 20th September 2010, Dhara (29) was admitted to Sligo General Hospital for the delivery of her first child after having experienced painless contractions for two days. Dhara was two weeks passed her due date and, on examination, was exhibiting signs of pre-eclampsia – high blood pressure and fluid retention around her ankles (also known as oedema).

Blood taken from Dhara showed that she had abnormal kidney and liver function (a further symptom of pre-eclampsia), but no action was taken due the results of the blood tests not being communicated to Dhara´s doctors for twelve hours. The morning following her admission, Dhara gave birth to her son -Dior – by Caesarean Section and was transferred to a side room off of the main Maternity Ward.

While Dhara was in the side room, her condition started to deteriorate, but it was not until 4.45pm the following day that she was transferred to the Intensive Care Unit at Sligo General Hospital. At 11.00pm that evening, Dhara´s condition became critical and she was air-lifted to the Royal Victoria Hospital in Belfast to receive specialist treatment.

Dhara died four days later due to multiple organ failure secondary to HELLP syndrome – a variant of pre-eclampsia – but, as yet, both the Belfast coroner and the Sligo coroner have declined requests to conduct a post-mortem.

Dhara´s husband – Michael – believing that the symptoms of haemolysis, elevated liver enzymes and a low latelet count were not identified and treated in time to prevent his wife´s death, made a compensation claim for fatal hospital errors against the Health Service Executive (HSE) – alleging that the Sligo general Hospital had breached its duty of care and that the care provided for Dhara once she had given birth to Dior was negligent.

The HSE denied that there had been a failure in the duty of care by Sligo General Hospital in the treatment that Dhara had received, but Michael persevered with his claim, and a court hearing was scheduled to determine whether the HSE had a case to answer.

Shortly before the claim for fatal hospital errors was due to be presented in court, the HSE acknowledged that there had been shortcomings in the care provided for Dhara both before and after the birth of her son, and an €800,000 settlement of compensation for fatal hospital errors was negotiated.

At the High Court in Dublin, the family heard a statement read out to them in which the HSE apologised unreservedly for the errors that had been made which led to Dhara´s death and offered their condolences to Michael and Dior.

Following the apology, Ms Justice Mary Irvine approved the settlement of compensation for fatal hospital errors, and also used the opportunity to criticise the HSE for “holding out until almost the bitter end” before admitting liability, and consequently causing the Kivlehan family unnecessary distress.


RCSI says Most GP Malpractice Claims are due to Misdiagnoses

A report compiled for the Royal College of Surgeons in Ireland (RCSI) indicates that the majority of GP malpractice claims for compensation are due to missed or delayed diagnoses.

The report, which was prepared by the Centre for Primary Care Research in Dublin, was undertaken to identify which areas of primary care should be focused on when planning future educational strategies and developing risk management systems for primary healthcare professionals.

It revealed that GP malpractice claims often featured missed diagnoses and medication errors, with the delayed diagnosis of breast cancer and colon cancer being responsible for more malpractice claims against GPs than any other form of medical negligence.

Lead researcher of the report – Dr Emma Wallace – acknowledged that family doctors are practicing more defensively as the number of malpractice claims in Ireland increases, and this has led to more patients being unnecessarily referred to consultants – enabling an identifiable condition to deteriorate.

In addition to the misdiagnosis of breast and colon cancer, the report identified other cancers which were often misdiagnosed or identified later than they should have been. These included cancers of the skin, female genital tract and lungs; while children with appendicitis and meningitis were most likely to be misdiagnosed.

Admitting that GP malpractice claims are “not a perfect substitute for adverse events”, Dr Wallace – who is herself a GP – said that when malpractice claims are made against GPs, the doctors facing litigation often experience higher levels of stress – reducing the level of service they are able to offer and placing more patients at risk of a missed diagnosis or medication error.

She commented “this systematic review is timely considering the increased interest in focusing on primary care as a way of improving patient care and safety” and hoped that the review provided an insight into the types and causes of adverse effects in clinical practice which would reduce the number of GP malpractice claims in Ireland.


Family Settle Compensation Claim against the HSE

The High Court has heard that a family has settled its compensation claim against the HSE, made after the death of Eileen Maloney at Mayo General Hospital in February 2009.

Eileen (69) from Pullathomas in County Mayo had been admitted to Mayo General Hospital on 1st February 2009 complaining of a severe pain in the abdomen. Because it was the weekend and no doctor was available, the family alleged that an X-ray showing an obstruction in her small intestine was not reviewed and her perforated bowel misdiagnosed.

It was not until the following Friday that Eileen was given a CT scan – which revealed a tumour had developed in her large bowel – but despite Eileen being in constant pain, surgery was not scheduled until the Thursday of the next week. The family claimed in their action against the HSE that, had this scan be reviewed properly, Eileen´s perforated bowel would have been identified and surgery brought forward.

Eileen died five days after the operation to remove the tumour, and the family alleged in their compensation claim against the HSE they were told that Eileen – who was suffering from cancer – would have survived the surgery, and would have had at least six months to live, had the correct diagnosis been made at the time of her admission and the appropriate treatment provided.

Mayo general Hospital and the HSE denied their responsibility for Eileen´s wrongful death and disputed the family´s right to claim compensation for mental anguish due to hospital negligence. However, at the High Court, Mr Justice Michael Peart was told that an agreement had been reached which would see the compensation claim against the HSE settled for €50,000 without admission of liability.

After hearing the circumstances of Eileen´s death – which Mr Justice Michael Peart described as “very, very tragic” – the judge approved the settlement of the family´s claim.


Savita´s Husband seeks Compensation for Hospital Negligence

The husband of Savita Halappanavar has announced that he is seeking compensation for hospital negligence after the HSE report was release into the circumstances of her death in October last year.

Savita died at the University Hospital in Galway one week after having attended the Accident and Emergency department complaining of acute back pain. She was found to be in the process of miscarrying her 17 week foetus and was sent home.

Savita returned to the hospital later in the day as the pain had not subsided and was admitted under the care of consultant doctor Dr Katherine Astbury. Savita´s waters broke the following morning and requested a termination, but was told to “await events” as an abortion was not possible while there was still a foetal heartbeat.

Savita´s condition continued to deteriorate – during which time she was misdiagnosed by Dr Astbury as suffering from sepsis after the consultant doctor had failed to read the patient notes made the previous evening. Dr Astbury eventually consulted with a senior colleague about a termination, but a scan later revealed that Savita´s baby was already dead.

After being moved into theatre, Savita spontaneously delivered her deceased baby and was later moved into intensive care suffering from septic shock. The following morning it was discovered that Savita had developed severe septicaemia due to E.coli ESBL, due to which she became critically ill and, on Sunday October 28th, she suffered a cardiac arrest and died of multiple organ failure.

A verdict of medical misadventure was delivered at the inquest into Savita´s death, but a subsequent Health Service Executive investigation failed to identify who was to blame for the negligent treatment Savita received or acknowledge liability for her death; prompting family and friends to describe the investigation as a “whitewash”.

In order to get answers to the questions which remain after the investigation, Savita´s husband – Praveen Halappanavar –  has made a claim for compensation for hospital negligence against the University Hospital Galway and the HSE alleging that the hospital failed to treat, failed to follow up blood tests, and failed to diagnose.

The University Hospital Galway and the HSE have not yet indicated whether they will acknowledge liability before a court date is arranged to resolve the claim for hospital negligence compensation.


Claim for Birth Injuries due to Lack of Staff Resolved in Court

The family of a girl who suffered brain damage at her birth due to hospital obstetric negligence have had their claim for birth injuries due to a lack of staff resolved at the High Court in Dublin.

Alex Butler (8) from Dunmore East, County Waterford, was born at the Waterford Regional Hospital in April 2005; however, due to the hospital´s failure to have an adequate number of properly trained competent medical staff to deal with the Alex´s delivery, and to ensure that an adequate and properly competent obstetrician was available, Alex´s delivery was delayed by twelve minutes – during which time she suffered brain damage which led to permanent tetraplegic injury.

Through her mother – Sonya – Alex made a claim for birth injuries due to a lack of staff at the hospital, alleging that her consultant obstetrician had been allowed to take leave at the same time as the hospital´s two other obstetricians and that the hospital had employed a locum obstetrician without ensuring that he competent. It was further claimed that Sonya´s pre-operative assessment was substandard and there was a failure to recognise the necessity for a Caesarean section.

The High Court heard that the Health Service Executive (HSE) admitted liability for Alex´s injuries, and the claim for birth injuries due to a lack of staff against the consultant obstetrician – John Bermingham – and locum obstetrician – Mahmud Khbuli – were dismissed. A representative from Waterford read out an apology for the mismanagement of Alex´s birth and accepted that the mistakes that were made should never have happened.

The Court also heard that an interim settlement of Alex´s claim for birth injuries due to a lack of staff amounting to €1.4 million had been agreed upon between the HSE and Alex´s parents. The compensation settlement is to be reviewed again in two years when an assessment of Alex´s care needs for the future has been made, and by which time it is hoped that the option of a structured settlement is available.


Court Approves Compensation for the Wrongful Death of a Child

The High Court has approved a settlement of compensation for the wrongful death of a child after a statement was read out in court apologising for the death of the child due to a delayed diagnosis.

Kaiden Costello was admitted to Temple Street Children´s Hospital in April 2009 when he was just six months old, as his concerned mother – Kate – had noticed her son was off his food. Kaiden was diagnosed with a failure to thrive, but two months later was re-admitted and an MRI revealed that his condition was due to a brain tumour. Kaiden underwent surgery to remove the tumour in July 2009, but he died three days later.

Kaiden´s mother made a claim for the wrongful death of a child due to a delayed diagnosis against the hospital and HSE; alleging that, had an MRI been conducted when Kaiden was first admitted to the hospital and the tumour identified sooner, her son could have received chemotherapy treatment that would have extended his life by five to ten years or undergone surgery earlier to remove the tumour.

In the High Court, Mr Justice Kevin Cross heard that liability for the failure to diagnose Kaiden had been admitted by Temple Street Children´s Hospital and a settlement of compensation for the wrongful death of a child had been agreed upon amounting to €180,000.

As part of the settlement agreement, an apology was read out by CEO of Temple Street Children´s Hospital – Mona Baker – who said that she understood that no apology or compensation arising from Kaiden´s death could negate the continuing heartache that the family must feel every day.

Judge Cross thereafter approved the settlement of compensation for the wrongful death of a child which comprised of €145,000 for Kate Costello´s nervous shock as a result of the death of her son and €35,000 relating to the wrongful death due to a delayed diagnosis.


Woman Awarded Compensation for Injuries from Symphysiotomy

A woman, who underwent a symphysiotomy procedure at Our Lady of Lourdes Hospital in 2000, has been awarded €591,297 compensation for injuries from symphysiotomy by the High Court.

Tracey Nelson (45) from Navan in County Meath underwent the procedure prior to the delivery of her second child, when medical staff at Our Lady of Lourdes Hospital in Drogheda failed to correctly diagnose the symptoms of symphysis pubis dysfunction (SPD).

After suffering for many years with the physical discomfort from the symphysiotomy, Tracey underwent surgery in 2004 to stabilise her condition and again, in 2007, had to have a spinal cord stimulator fitted – since when Tracey has been relatively free of pain.

However, as Tracey related to Mr Justice Iarfhlaith O’Neill at the High Court, she has also suffered emotionally due to the negligence of the medical staff who failed in their duty of care to manage her pregnancy.

Tracey told the court she had developed fibromyalgia – where she had constant pain in her muscles and joints – and due to the pain, started to drink alcohol heavily. This resulted in the break-up of her marriage and, in turn, to depression.

Our Lady of Lourdes Hospital denied their liability for Tracey´s injuries, but Mr Justice Iarfhlaith O’Neill ruled that he was satisfied from the medical evidence there was a failure to diagnose SPD on February 2nd when Tracey attended the hospital complaining of pain in the pelvic area.

The judge said there was no doubt that the “primary cause” of Tracey´s physical and psychological injuries was the negligence of the HSE and “terrible consequences” of it. “I am quite satisfied that the failures in this regard fell substantially below the standard of care to be expected of doctors practising obstetrics in a maternity unit such as Our Lady of Lourdes in Drogheda,” he said.

Awarding Tracey €591,297 in compensation for injuries from symphysiotomy, Mr Justice Iarfhlaith O’Neill said that he was also satisfied the doctors and midwives who attended Ms Nelson were “oblivious” to her SPD condition and consequently took no precautions to prevent the risk of avoidable injury during the course of her labour.


Claim for Death after Caesarean made against HSE

A widower, who lost his wife after she had given birth to their son via a C-section procedure, has made a claim for death after Caesarean against the Health Service Executive.

Dhara Kivlehan (29) from Dromahair, County Sligo, gave birth to her son – Dior – on 21st September 2010 at Sligo General Hospital via a Caesarean section operation but, soon after the procedure, developed multiple organ failure secondary to HELLP syndrome – a variant of pre-eclampsia. Dhara was rushed to Belfast´s Royal Victoria Hospital to receive specialist treatment, but died on September 29th.

Dhara´s husband – Kevin Kivlehan (33) – asked the Belfast Coroner John Lecky for an inquest into his wife´s death, but his request was turned down. Now he has asked the Coroner for Sligo to investigate the circumstances of his wife´s death and made a claim for death after Caesarean against the Health Service Executive (HSE).

No decision has yet been made by the Sligo Coroner, but the HSE is expected to defend themselves against the claim for death after Caesarean, and the alleged breach of duty and alleged negligence claimed by Kevin Kivlehan, after the symptoms of hemolysis, elevated liver enzymes and a low latelet count were allegedly not identified and treated in time to prevent his wife´s death.

A High Court decision on whether the HSE have a case to answer in respect of the claim for death after Caesarean is expected soon.


Delayed Diagnosis of Brain Tumour Claim Heard in Court

A former student, who suffers severe spasticity of the limbs and has eye movement problems allegedly due to the negligence of a Galway hospital, has had his delayed diagnosis of a brain tumour claim heard in court.

 Seamus Walshe Jnr (27) of Taylor´s Hill, Galway, was a 21-year-old student studying construction studies when he first started suffering problems with his eyes in 2006 whenever he looked upwards. His symptoms deteriorated to the point where upward eye movement left him feeling nauseous and he would start to vomit.

 Seamus attended Galway University Hospital with his problems, but was told after a neurological examination that there was nothing seriously wrong with him and he should get used to having problems with his eyes.

Seamus returned to Galway University Hospital later in the year when he started to develop pains in his head and underwent a scan which revealed a brain tumour. He was referred to Dublin´s Beaumont Hospital where he underwent surgery to remove the tumour in May 2007.

However, complication during the brain tumour operation resulted in severe haemorrhaging around the brain and Seamus was kept in intensive care for nine weeks following surgery. When he started to recover, he was transferred back to Galway University Hospital in November 2007.

Ms Justice Mary Irvine at the High Court heard that in September 2008 Seamus was sent to the National Rehabilitation Centre in Dún Laoghaire but, because of the alleged negligent treatment he had received, was confined to a wheelchair with spasticity of the limbs and had problems moving his eyes.

Seamus made a compensation claim for the delayed diagnosis of his brain tumour through his father, Seamus Snr, claiming that had he had a scan when he first attended the Galway University Hospital, the tumour would have been diagnosed earlier and he would have been referred to the Beaumont Hospital sooner.

A second claim was made against the Beaumont Hospital for choosing to perform brain surgery when treatment with chemotherapy and radiotherapy had resulted in long term survival rates of up to 90 percent.

Both the Health Service Executive – on behalf of Galway University Hospital – and the Beaumont Hospital denied their liability for Seamus´ injury, but Ms Justice Mary Irvine heard that a negotiated settlement of 2.5 million Euros in compensation for the delayed diagnosis of a brain tumour had been agreed without admission of liability.

The settlement of compensation is intended to provide Seamus with the care he needs for the next three years, after which time a structured periodic payment system would provide for his future care if legislation was passed by the Government in time to allow such a payment procedure.


Wrongful Death Compensation for Woman´s Loss of Inheritance

A woman, who was deprived of her inheritance due to her mother-in-law´s grief at the loss of her son, has won a High Court judgement and almost 1.6 million Euros in medical malpractice compensation against the medical practitioners responsible for his wrongful death.

Michael Davoran (47) from Ballyvaughan, County Clare, died in August 2003 from a chronic colitis condition. His widow Grace claimed in an action against the Health Service Executive (HSE), consultant gastroenterologist John Lee and consultant surgeon Oliver McAnena, that Michael continued to be treated with medication after being admitted to University College Hospital, Galway in July 2003, even though his condition was deteriorating.

Mr Justice Iarfhlaith O’Neill at Dublin High Court heard that, because of the alleged medical malpractice of the three defendants, Michael had to undergo surgery on August 21st 2003 after it had been noticed that his condition was not improving, and then again on August 29th when an emergency laparotomy was performed due to Michael´s health getting worse despite the surgery. Michael remained in the Intensive Care Unit at University College Hospital, Galway, until two days later, when he suffered a fatal cardiac arrest due to multiple organ failure.

Mr Justice Iarfhlaith O’Neill at Dublin High Court heard that, as a result of Michael´s alleged wrongful death, his mother, Maura, changed her will in her grief to disinherit Grace and her four children from the family´s 623 acre Ballyalben Farm. Maura subsequently died, leaving the family farm and its income to her daughter, while Grace and her family – who had worked Ballyalben Farm all their lives – now had to rely on the income from the adjacent, much smaller Ballycahill Farm.

The defendants did not deny liability for Michael´s death, but argued that it was a disagreement between Michael´s widow and mother which was responsible for the disinheritance. Mr Justice Iarfhlaith O’Neill rejected the argument, stating that even if this was the case, it could be attributed to the mother´s distressed state of mind after her son´s death. Furthermore, he stated, he was satisfied that had it not been for his wrongful death, Michael´s dependents would have inherited the Ballyalben Farm.

Finding in favour of Grace´s claim for medical malpractice compensation, the judge awarded her 1,312,275 Euros for the loss of inheritance of Ballyalben Farm, 184,271 Euros in loss of income from farming the estate and 50,436 Euros to represent half the estimated loss that Michael´s dependants incurred from rental income – assuming that they would have moved out of the Ballycahill Farm after Maura´s death and rented it.


Compensation for Late Diagnosis Settled Out-of-Court

A woman who had to have both legs amputated due to alleged medical negligence has settled her failure to diagnose compensation claim against the doctor she accused of malpractice.

Catherine Blake (62) of Clonmel, County Tipperary, had alleged negligence and a breach in the doctor´s duty of care following an accident she had been involved in 1998. Two crates she had been seated on tipped over and Catherine had sustained injuries to her head and back.

She had attended Dr Gerard Sullivan at the Mary Street Medical Centre in Clonmel, County Tipperary in July 2000 complaining of pains in her legs and difficulty walking. It was claimed in Catherine´s compensation claim for late diagnosis that Dr Sullivan had ignored her complaints of symptoms which might have led the doctor to diagnose deep-vein thrombosis.

In September 2000, Dr Sullivan diagnosed that Catherine was suffering from thrombophlebitis, a vein inflammation due to a blood clot, but it was alleged in the failure to diagnose compensation claim that he failed to follow up his diagnosis with adequate treatment and continued to rule out the possibility of deep vein thrombosis. Catherine´s condition continued to deteriorate and she eventually had to have both legs amputated – allegedly due to Dr Sullivan´s failure to diagnose.

Dr Sullivan denied the claims but shortly before the trial was due to begin the High Court in Dublin heard that a settlement had been reached without admission of liability. No details were provided to the court about how much compensation Catherine was to receive.


125,000 Euros Out of Court Settlement in Doctor Negligence Claim

The parents of a young woman who died after her doctor failed to recognise the symptoms of deep vein thrombosis have agreed to a 125,000 Euros settlement in their doctor negligence claim.

Ray and Angela Hennessy of Douglas, County Cork, had brought the action against Dr Hassan Al Bayyari of Castlenock, Dublin, following the death of their daughter Julie in March 2007. It was claimed in the case against Dr Bayyari that Julie had twice visited him in earlier in the month to complain of pains in her leg which she believed were due to a skiing accident four weeks previously.

Despite Julie raising the possibility of deep vein thrombosis, Dr Bayyari failed to prescribe any medication for the Hennessy´s daughter or refer her to the hospital for further tests. Two days after Julie´s second visit to Dr Bayyari´s surgery she was dead in her home in Blanchardstown. A post-mortem into Julie´s death revealed that Julie had died from deep vein thrombosis/pulmonary embolism, exacerbated by the oral contraceptive prescribed for her by Dr Bayyari.

After seeking legal advice, the Hennessy´s brought a doctor negligence claim against Dr Bayyari which was due to be heard in the High Court. However, shortly before the trial was due to commence, Mr Justice John Quirke was told that the two parties had agreed to the out-of-court settlement and that the matter was now resolved.


Ectopic Pregnancy Negligence Claim Resolved

A woman, who was transferred between hospitals while in severe and continuous pain from her ectopic pregnancy, has been awarded 75,000 Euros in personal injury compensation at the High Court.

Anne English (47) from Clonmel, County Tipperary, had attended the St Joseph’s Hospital, Clonmel, in 1996, with a suspected molar pregnancy – an unusual condition in which abnormal growth occurs instead of foetal tissue.

Anne was examined by consultant obstetrician and gynaecologist, Dr. Raymond Howard, who dismissed the molar pregnancy and suggested that Anne was suffering from a condition known as acute retrocecal appendicitis. Dr Howard then organised for Anne to be transferred to Our Lady’s Hospital, Cashel, for a surgical opinion.

However, as Mr Justice Sean Ryan at the High Court heard, Dr. Howard had overlooked Anne´s true condition which was a ectopic pregnancy – one in which the embryo implants outside of the womb – and, when the pregnancy finally ruptured while Anne was at Our Lady’s Hospital, she was returned to St Joseph´s Hospital by hospital despite bleeding heavily and being in a critical condition.

On Anne´s return, Dr Howard immediately transferred her to the operating theatre, where anaesthetic measures had to be taken to resuscitate her and three litres of blood were removed from her peritoneal cavity. Despite making a physical recovery from the incident, Anne claimed she had been severely psychologically damaged by the incident and continued to suffer from it.

Finding the Dr. Howard 40 per cent liable for the injury due to his oversight, and the Health Service Executive 60 per cent liable for the injuries suffered by Anne, Mr Justice Sean Ryan announced a personal injury compensation award of 75,000 Euros should be paid to Anne stating “The decision to transfer her from the Cashel Hospital to Clonmel in this state amounted to gross negligence”.


Breast Cancer Misdiagnosis Compensation Approved in Court

A man, whose wife died from breast cancer after being misdiagnosed as all clear, has had a 110,000 Euro settlement approved in the High Court.

Ann Moriaty was just 51 years of age when initially diagnosed with breast cancer in April 2005. She underwent a mastectomy operation the following month, followed by chemotherapy and radiotherapy at St. James´s Hospital in Dublin. Thereafter she attended six-monthly reviews at St. James´s, where she was considered to be doing well and in remission from the cancer.

In June 2007, Ann started to suffer from weight loss and nausea. She attended, and was admitted to, the Mid-Western Regional Hospital in Ennis, County Clare, on June 11th, where a diagnosis of a urinary tract infection was made and Ann was discharged on June 15 with a course of antibiotics. A chest X-ray was taken at the time which was reviewed and considered to be normal.

Ann once again attended the Mid-Western Regional Hospital on August 11th suffering from the same symptoms and unable to eat or drink. An out-patient appointment was arranged for August 13, where she was prescribed an anti-emetic and discharged. However, an X-ray taken on August 9th at the hospital had shown, it was claimed, a local bulge opacity and vague shadowing in the mid-left zone.

Although the family were relieved that there had been no re-occurrence of the cancer, Ann´s GP was still concerned about her health. On August 14th, she was referred to the Galway emergency clinic where she was immediately admitted and a series of tests carried out. On August 16th, Ann and her family were advised that the cancer had recurred and that it was at an advanced stage.

The distressed family sought verification of the later diagnosis at St. James´s Hospital, where it was confirmed that Ann indeed had extensive breast cancer with liver, brain and lung involvement. The hospital advised the family that the extent of cancer meant Ann´s illness was terminal and, despite undergoing further radiotherapy, Ann died in April 2008.

Alleging that had his wife´s condition been diagnosed sooner, she would have survived longer with fewer symptoms, Ann´s husband – Karl Henry of Ennis, County Clare – and son Ciarán sued the Health Service Executive (HSE) for damages for personal injuries, mental distress, loss, damage and loss of dependency. Karl claimed that Ann´s death had a devastating effect on both him and their son and that the consequent HSE public investigation had also caused significant distress.

The HSE denied the claims, but Mr Justice John Quirke at the High Court heard that they were willing to make an offer of 110,000 Euros in compensation without admission of liability. Counsel for the bereaved family said that they were willing to accept the offer and, stating that this was a “very sad case”, it was approved by the judge.


Multi-Million Euro Settlement in Parrot Infection Case

A 22 year old woman, who contracted a rare disease while working in a Limerick pet shop, has been awarded what is believed to be the highest ever structured compensation settlement in a High Court personal injuries action.

Patricia Ingle from Weston, County Limerick, worked throughout 2007 and 2008 at the Petmania Pet Store in the Jetlands Retail Park, County Limerick. In August 2008, she fell ill with violent headaches and vomiting, was attended by a doctor and sent to the Mid-Western Regional Hospital in Dooradoyle.

Doctors at the hospital treated Patricia and sent her home, but a few weeks later the symptoms returned and she was again sent to hospital by her GP. Within two days, Patricia´s condition had deteriorated to such an extent that she was technically voiceless, had difficulty swallowing, suffered from blurred vision and could not move.

Patricia had suffered irreversible brain damage and can now only breathe through a ventilator, has to be fed via a tube and can only communicate by using a voice-box. She is confined to a wheelchair and is an inpatient each night at the Mid-Western Regional Hospital.

Claiming that she had contracted the chlamydia psittacosis infection from a cockatiel parrot purchased by the pet store, Patricia sued Petmania and their parent company O’Keeffes of Kilkenny Limited, Springhill, County Kilkenny. She also alleged that her condition had been mismanaged by the hospital, and claimed that, had doctors recognised that she needed an examination by a neurologist, she could have been transferred to Cork Hospital earlier for specialist treatment.

Mr Justice Iarfhlaith O’Neill at the High Court heard how chlamydia psittacosis can be passed from parrots to humans through inhalation of airborne dried faeces dust, and that Patricia had never received any health and safety training throughout her employment at Petmania.

He also heard expert testimony to state that the single most significant risk of working in a pet store was the risk of contracting an infectious disease, yet because of the animals´ low value, pets at Petmania were never screened or treated against the potentially fatal diseases.

In respect of the action against the Health Service Executive (HSE), the court heard that doctors at the Mid-Western Regional Hospital had watched Patricia´s condition deteriorate for 58 hours before transferring her to Cork Hospital, even though they were aware that she worked in a pet shop due to a previous hospital attendance when she was bitten by a rat.

It was claimed that had there been a proper recognition of her symptoms, some, if not all of her current condition would have been avoided.

Although the case was anticipated to last for several weeks, protracted talks on the fourth day of court proceedings resulted in the HSE agreeing to settle the claim, and pursuing Patricia´s claims against the other defendants.

The settlement package consists of 3 million Euros to be paid to Patricia immediately in respect of her injuries, with further lifetime payments to be considered in two years time once new legislation is in place to facilitate structured payments.

The health Service Executive have estimated that it currently costs around 500,000 Euros to provide Patricia with the treatment she needs, so the total compensation package is likely to exceed the record High Court award of 7.5 million Euros paid to a child who sustained cerebral palsy at birth.


4.5 Million Euros Brain Damage Settlement for “Child in a Man´s Body”

A Galway man, who suffered severe brain damage after his viral encephalitis illness was allegedly misdiagnosed as eczema, has had a 4.5 million Euro settlement approved in the High Court.
Martin O’Brien (45) from Newcastle, County Galway, developed a rash with itchy sores in January 1996. He was referred to University College Hospital, County Galway by his doctor, who believed he had scabies and who prescribed benzyl benzoate as a temporary measure.
At University College Hospital, Martin was diagnosed as having eczema and, when his case was reviewed in February, it was claimed in court that he was advised to continue using the treatment prescribed for him in January.
However, by the end of March, Martin was complaining of aches, pains, fevers, sweating and memory loss and, after attending the Merlin Park Regional Hospital, County Galway on March 31st, Martin collapsed and was admitted to the hospital under the care of Dr. Brendan S Duffy.
Mr Justice John Quirke heard at the High Court that following his collapse, Martin had complained of having a blackout, amnesia, headaches, a stiff neck, a loss of power in his lower limbs and abnormal rolling of his eyes.
By the evening of the 31st March Martin was unable to recognise his wife and, it was claimed, that tests taken after his admission indicated encephalitis and possibly herpes simplex. However, no treatment against the virus was prescribed until April 4th, when Zovirax was prescribed, and on April 5th when Acyclovir was added to the treatment. Martin remained in hospital until August 1996.
In the subsequent case brought against Dr Duffy and the Health Service Executive, it was alleged that Martin suffered severe brain damage as a result of the delay and was described in court as a “child in a man´s body”. Martin can no longer work and has relied for the past fifteen years on care provided by his family.
A settlement of 4.5 million Euros without admission of liability was negotiated between legal representatives of Martin´s family and insurers for Dr Duffy. Approving the settlement, Mr Justice John Quirke paid tribute to Martin´s wife, Anna Marie, describing her as “a wonderful lady” and directed that part of the award should immediately be paid to the family for the care they had provided.
The Health Service Executive has also urged the family to place Martin into a home.