HSE Settles Cerebral Palsy Legal Action for €1.9m with Woman (20)

A woman, aged 20, who suffers from cerebral palsy who sued the HSE to relation to the treatment administered to her during her delivery has settled her cerebral palsy action with an interim payout of €1.95m at the High Court.

Despite being born just 40 minutes after her healthy twin sister in Wexford General Hospital, the High Court was told that Shauni Breen has cerebral palsy, spastic diplegia and is restricted to a wheelchair. There was an alleged failure to recognise it was a high-risk labour at the time.

Currently living in Meadowbrook, Riverstown, Glanmire, Co Cork, Ms Breen had  taken the legal action against the HSE in relation to the events that occurred at the time of her delivery on December 30, 1997. Before the delivery, when the twins were just 33 weeks and three days, their mother Marie Foley was taken to Wexford General Hospital at 5am in the morning.  Just after this Ms Breen’s twin sister Nicole was born healthy at 6.10am. Following this, it claimed that the labour for Shauni lasted approximately 40 minutes and was handled in a negligent manner. Ms Breen’s legal representative claimed there was no anaesthetist present nor a full supporting present and prepared for every possible outcome.

The HSE denied these claims in the High Court and argued that management of the birth complied with standard best practice and was consistent with normal procedures in Irish maternity units at the time of the birth in 1997.

It was argued by Ms Breen’s legal team Counsel that she (Ms Breen) displayed an abnormal presentation and, due to this. should have been delivered by caesarean section within 15 minutes of the birth of her sister. However, due to complications experienced Ms Breen had to be resuscitated and was transferred to a different hospital.

Judge Kevin Cross approved the 1.9m cerebral palsy compensation settlement and it as stated that Ms Breen will return court in five years’ time when her future care needs will be assessed.

Ms Breen’s Legal team told the Hight Court that the care by her mother to Ms Breen throughout her life had been extraordinary and Counsel said the young woman was currently doing well.


Claims for Birth Defects due to taking Epilim

Claims for birth defects due to taking Epilim while pregnant have been made in France on behalf of up to 4,100 children with foetal valproate syndrome.

Epilim is the trade name of an anti-epilepsy drug that uses the active ingredient sodium valproate to control electrical activity in the brain. Introduced in France in 1967, Epilim was passed for use in Ireland in 1983, and is now also often prescribed to treat bipolar disorder, migraine and chronic pain.

At the time it was introduced into Ireland, claims for birth defects due to taking Epilim while pregnant were being investigated in France. It was alleged that the sodium valproate entered the bloodstream as valproic acid, which caused foetal congenital and development issues.

The evidence of birth defects due to taking Epilim was considered inconclusive, and the drug continued to be prescribed to pregnant mothers. It was only in 2006 that the manufacturers of the drug – Sanofi – warned that sodium valproate may have adverse effects and advised the medical profession to advise pregnant mothers of the potential risks.

Research conducted several years later by France´s social affairs inspectorate – IGAS – found the majority of doctors and pharmacists were unaware of the risks associated with Epilim. The research prompted the inspectorate to conduct a small scale study in the Rhone-Alpes region last year, where a much higher than expected rate of birth defects due to taking Epilim while pregnant was discovered.

France’s National Agency for the Safety of Medicines (ANSM) looked deeper into the issue and researched the health of 8,701 children born between 2007 and 2014 whose mothers were known to have taken Epilim during their pregnancies. ANSM identified up to 4,100 children suffering from foetal valproate syndrome and discovered hundreds of Epilim-related stillbirths.

ANSM´s study has resulted in the families of those affected by the adverse effects of sodium valproate to form a class action in order to jointly make claims for birth defects due to taking Epilim. The families claim that Sanofi did not do enough to adequately inform the medical profession of the risks associate with the drug. It also claims the drug manufacturer failed to put adequate warning on its packaging.

In Ireland, the Disability Federation has called on the government to conduct an audit of children diagnose with foetal valproate syndrome. The organisation claims the scale of the problem in Ireland should be identified in order that adequate support measures are provided for families. If a member of your family has been affected by foetal valproate syndrome, and you would like to know more about claims for birth defects due to taking Epilim while pregnant, you should speak with a solicitor.


Guidelines Could Prevent More Syntocinon Birth Injury Claims

The State Claims Agency has said that a consistent set of guidelines should be compiled for birth-inducing drugs to prevent more Syntocinon birth injury claims.

Syntocinon is the brand name in Ireland of oxytocin – a synthetic drug that is frequently used in maternity wards to induce labour and accelerate contractions. The benefits of Syntocinon are that the drug reduces the time spent in labour, prevents excessive bleeding and helps the womb to contract after childbirth.

However, when Syntocinon is administered, both mother and child need careful monitoring to observe any signs of an adverse reaction or foetal distress. Oxytocin is one of the top ten “high-alert medications” in hospitals, and the death of four babies at the Portlaoise Hospital has been attributed to the lack of adequate monitoring.

Children who survive the accelerated contractions have been known to suffer brain damage, and among a series of recent Syntocinon birth injury claims was one in February this year, in which an interim settlement of birth injury compensation amounting to €2.32 million was approved by the High Court.

The State Claims Agency – the authority that pays out when Syntocinon birth injury claims are resolved – recently conducted a study into the use of oxytocin in Irish hospitals, which showed that there is a lack of consistency in how the drug is administered and how the health of mothers and their babies is monitored.

The report revealed that staff at one maternity unit had no guidance on the drug´s use and that at another staff had to refer to a checklist. Thirteen hospitals had similar guidelines – although not entirely consistent, five hospitals had introduced protocols, three had introduced procedures and six relied on policies. Two of the hospitals provided no guidance at all on the monitoring of mothers and babies, and one failed to advise nursing staff on the dosage of oxytocin that should be administered.

Mary Godfrey – the clinical risk advisor at the State Claims Agency – said that the results of the survey were alarming and called for a consistent set of guidelines to be compiled for all birth-inducing drugs to improve outcomes for mothers and babies, and to prevent more Syntocinon birth injury claims being made against the state.

However Ms Godfrey failed to comment on an important area of the report which revealed “No service obtains explicit written consent from women prior to starting them on the drug.” Informed consent is a vital issue for the State Claims Agency to address if it genuinely wishes to prevent more Syntocinon birth injury claims.


IHCA Warns of Hospital Mortality Rate Increase

Dr Gerard Crotty has warned of an impending increase in the hospital mortality rate during a speech to delegates at the Irish Hospital Consultants Association annual conference.

Dr Crotty – president of the Irish Hospital Consultants Association (IHCA) – commented during his keynote speech in Cork that patients are almost certainly dying unnecessarily while waiting for a hospital bed, and he referred his audience to international studies which show a 30 percent increase in the hospital mortality rate when patients are left on trolleys after the decision has been made to admit them.

Blaming an under-funding for creating the problem, Dr Crotty said that the health service was showing the strain after years of “easy cost-saving measures” and that a significant fall in day case patients was attributable to the inadequate stock of beds available to cater for the increased number of emergency cases. “I fear for what will happen as we enter the winter” the Doctor said, noting an increase of patients waiting in hospital emergency departments during one of the best summers for years.

Dr Crotty referred to the health service in Ireland as being in “intensive care” and he called upon the Government to significantly increase funding for frontline health services to avert a patient safety crisis. He said that patients deserve a better health service than currently exists and that a realistic budget is required to deliver safe, high quality care to patients without unacceptable delays which could ultimately result in their death.

In the same speech, Dr Crotty welcomed the acknowledgement by Health Minister Leo Varadkar that the 30 percent pay decrease for new entrant consultants had been a mistake and that it had undoubtedly worsened the crisis in the health service by reducing the attractiveness of senior medical positions. The President of the IHCA called for a complete reversal of the 30 percent pay cut to prevent newly graduating doctors from seeking positions overseas.

Also at the conference, Martin Varley – the Secretary General of the IHCA – said that a number of consultants who had signed work contracts in 2008 with the promise of increased salaries were taking legal action due to their pay increases failing to materialise. Under the agreements, consultants were due pay rises from €175,000 to €240,000 in 2009, but the pay rises were withheld when the economic crisis developed and the Department of Health reallocated the finance for other priorities.


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”.


Family Hears Apology for Hospital Death due to Dehydration

A family attending a High Court hearing have heard a statement read to them apologising for their mother´s hospital death due to dehydration.

The family of Eileen Brady were in court to hear the apology as closure to their compensation claim for a hospital death due to dehydration following the tragic loss of their mother at the Cavan General Hospital in January 2010.

Eileen (65) had been referred to the Cavan General Hospital by her GP after she had been diagnosed with a poor fluid intake which was manifesting in mouth ulcers. Eileen was admitted to the hospital on 5th January, but died the following day due to multiple organ failure.

An investigation into her death revealed that the dehydration treatment Eileen had been admitted for had been ineffective, as her veins had collapsed due to the chemotherapy treatment she was undergoing in a Dublin hospital to treat her stomach cancer.

The investigation also revealed that Eileen´s hospital death due to dehydration could have been prevented if her medical charts had been examined more closely, if senior physicians had been consulted as Eileen´s condition deteriorated or if the Cavan General Hospital had liaised with the Dublin hospital at which Eileen was receiving her treatment for cancer.

Eileen´s son – Martin Brady from Crosskeys in County Cavan – sued the Cavan General Hospital and Health Service Executive (HSE) on behalf of the family, claiming that Eileen´s avoidable hospital death due to dehydration had caused the family mental distress. The HSE admitted liability and a compensation settlement was agreed out of court, subject to the family receiving a public apology.

At the High Court, the HSE´s legal representative read out a statement in which the hospital and the HSE apologised for the negligent care which resulted in Eileen´s death, and the subsequent grief and stress that had been suffered by her family and friends.

Responding on behalf of the family, Aidan Brady said he hoped that both Cavan General Hospital and the HSE had learned from “the grave mistakes” made in the care of his mother “and that no other family would have to go through the trauma and distress that we have suffered”.

Ms Justice Mary Irvine closed the hearing after extending her personal sympathy to Eileen´s family.


Perinatal Death Due to Negligence Exposed by RTE Program

An RTE Prime Time program has exposed four cases of perinatal death due to negligence at the Midland Regional Hospital in Portlaoise.

The program “Fatal Failures” featured the tale of Roisin and Mark Molloy from Tullamore in County Offaly, whose son Mark died soon after his delivery January 24th 2012. The couple fought a four-month battle to have an investigation launched into their son´s death – during which time they were fed misinformation into the circumstances of his delivery.

When an independent clinical review was subsequently concluded, it reported that “failures in the standard of care provided were casually linked to the foetal hypoxia damage that occurred [and the death of baby Mark]” – effectively that Mark had suffered an avoidable perinatal death due to negligence.

The Midland Regional Hospital issued the Molloy´s with an apology and told the couple that neonatal deaths at the hospital were extremely rare. However, by chance, Roisin Molloy heard a radio interview in which a Shauna Keyes was retelling the story of how she had lost her child at the Midland General Hospital in similar circumstances, and the two women got in touch with each other.

However, as the RTE Investigation Unit discovered, there were at least two further incidents of perinatal death due to negligence, which had been investigated internally at the hospital, but the grieving parents never been advised of the outcome. The RTE investigators also found that none of the measures that had been recommended following Mark Molloy´s death had been implemented.

Appearing in the program, Dr Philip Crowley – the National Director of Quality & Patient Safety at the Health Service Executive (HSE) – said that the delays in investigating Mark Molloy´s death and implementing procedures that would avoid perinatal death due to negligence were “lamentable” and he apologised on behalf of the HSE for the trauma the families had been through.

The Minister for Health – Dr James Reilly – also commented on the findings of the RTE investigators. Speaking on the Today radio program he said he had asked the Chief Medical Officer to conduct a further investigation into the failings of care at the hospital and described the four cases of perinatal death due to negligence as “utterly unacceptable”.


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.


Family Claim for Hospital Death due to Lack of Care

An Australian family has indicated they will be making a claim for a hospital death due to a lack of care following a hearing into the fatal accident in which a 26 year-old drowned while taking a bath.

The report followed the death of Amy Hauserman in March 2008, who had voluntarily been admitted to the Frankston Hospital in Melbourne after doctors feared she was showing signs of schizophrenia which had resulted in Amy previously suffering with anorexia.

Two days after her admission, Amy died from “a hypoxic brain injury in a setting of immersion” which Coroner Peter White attributed to either Amy lapsing into an unconscious state during the bath or slipping and falling as she tried to get out of it.

The Coroner noted that no risk assessment had been conducted as to whether it was safe for her to take a bath unsupervised and that Amy´s consultant had not been consulted beforehand. He also said at the inquest hearing that the absence of supervision was a primary feature of Amy´s death as it would have been avoided had a nurse been present in the bathroom.

One of the nurses involved in Amy´s care gave evidence at the inquest that she was unaware there was a protocol for patients taking baths, but her testimony was contradicted by the Hospital´s Head of Nursing who said that all psychiatric ward patients should only be allowed to take a bath unsupervised after a risk assessment had been conducted.

After the Coroner´s verdict had been delivered, Amy´s father made a statement in which he confirmed that the family would be making a claim for a hospital death due to a lack of care on the grounds that had staff at the Frankston Hospital “showed her the due and proper care she deserved, she would still be us now”.

The Mornington Peninsula Health Service – against who the compensation claim for a hospital death due to a lack of care has been made – failed to comment on Mr Hauserman´s allegations; however a court date in May 2014 has now been set for the claim to be heard.


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.


Compensation for a Casualty Department Misdiagnosis Approved

A grieving family have had a settlement of compensation for a casualty department misdiagnosis approved after hearing a statement read out in court apologising for the healthcare that resulted in death of their son.   

The parents of eight-year-old Richard de Souza made their claim for compensation for a casualty department misdiagnosis following the events of February 2011, when Ralmon and Flavia de Souza attended the A&E department of the Midland Regional Hospital in Portlaoise with their son who was suffering from chicken pox.

The two parents were concerned about a large swelling under Richard´s left arm that was hot to touch and were told by a doctor at the hospital that Richard had developed an infection. The doctor prescribed a three-day supply of antibiotics and sent the family home.

However, later that evening, Richard developed a great thirst and became delirious. The following morning he complained of feeling the need to vomit before passing out at the family home in Athy, County Kildare. An ambulance was called, but Richard was in a state of cardiac arrest when paramedics arrived and he was declared dead on arrival at the Midland Regional Hospital.

At the High Court in Dublin, Ms Justice Mary Irvine heard that Richard´s cause of death was a streptococcal infection which led to toxic shock syndrome. She was told that a patient displaying a high temperature and high pulse and heart rate would normally be admitted to hospital straight away and that had Richard been administered intravenous antibiotics at the time it would have saved his life.

The judge also heard that Ralmon de Souza had to be hospitalised due to the severity of the nervous shock he sustained on hearing about his son´s death and, because of Ralmon´s grief, eight-month pregnant Flavia de Souza had to attend her son´s funeral alone. Both parents were diagnosed with Post Traumatic Stress Disorder following Richard´s death.

As part of the €160,000 settlement of the de Souza´s claim for a casualty department misdiagnosis, an apology was read out in court apologising for the mistakes which led to Richard de Souza´s death. After hearing the apology, Ms Justice Mary Irvine approved the settlement of compensation for a casualty department misdiagnosis.


High Court Awards Compensation for a Failed Sterilisation

The High Court has awarded a mother €100,000 compensation for a failed sterilisation after the son she was never supposed to give birth to died after only six months of life.

Karen Hurley-Ahern (41) from Newcastlewest, County Limerick, underwent the sterilisation procedure in February 2001 after discovering from her GP that she had a rare blood-clotting disorder that would pose a risk to herself and her unborn child if ever she were to fall pregnant again.

The operation was performed by gynaecologist Dr Victor Moore at the Tralee General Hospital in County Kerry, but in April 2002 Karen fell pregnant again and, after a difficult pregnancy, gave birth to baby Samuel on 10th October 2002 – six weeks early and by emergency Caesarean section.

Samuel suffered from severe abnormalities which were unrelated to Karen´s sterilisation procedure, and remained in hospital for six months – kept alive by a series of life -support machines. In April 2003, Samuel suffered a severe heart attack and Karen and her partner – Garrett Ahern – made the painful decision to switch off the life-support machines.

After seeking legal advice, Karen and Garrett made a claim for failed sterilisation compensation against Dr Moore and the Southern Health Board (now the Health Service Executive), for the suffering and trauma the couple had been through due to the unsuccessful procedure.

Dr Moore and the HSE denied liability – claiming that the procedure had been performed correctly and the couple had been warned that there was a risk of failure. However, in the High Court in Dublin, Mr Justice Sean Ryan found in favour of the now-separated claimants – acknowledging that Samuel´s disability was not a consequence of the failed sterilisation procedure, but stating that Karen had suffered to a significant extent due to the defendant´s negligence.

Awarding Karen €100,000 compensation for a failed sterilisation, Mr Justice Sean Ryan said that the award of compensation was in respect of the worry she had experienced when she discovered she was pregnant, the pain of childbirth, the distress of Samuel´s condition and distress after his death. However, no award was made to Garrett as – according to Mt Justice Sean Ryan – while he had undoubtedly endured emotional anguish, there was no proof Garrett had suffered a defined psychiatric injury.


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.


Woman Awarded €170,000 Stillborn Child Compensation

A woman, who child was delivered stillborn due to the necessary blood not being available on an ambulance, has been awarded €170,000 stillborn child compensation in the High Court.

Fiona Ni Chonchubhair (36) from Killarney, County Kerry, was thirty-one weeks pregnant when she attended the Tralee Hospital in May 2009 suffering from internal bleeding. An ambulance was arranged to transfer her to Cork University Hospital – some 71 miles away – but the ambulance was not equipped with blood transfusion equipment.

A further delay of 20 minutes, when the ambulance crew could not locate the accident and emergency unit, led to Fiona losing a substantial amount of blood and despite being immediately operated on and given six units of blood on her arrival at Cork University Hospital, the treatment came too late to save her baby, who was delivered stillborn by Caesarean section.

Fiona and her husband – Stephen Cotter – made a claim for stillborn child compensation against the Health Service Executive (HSE) alleging that, had she received a transfusion en route to Cork University Hospital, Fiona would have suffered a less severe level of hypovolaemic shock, which would have provided sufficient oxygen to her child to ensure its survival.

The couple´s claim included compensation for the post-traumatic stress, severe bereavement disorder and adjustment disorder that Fiona had suffered, and also for the cost of renting a home in Cork during a later pregnancy so that Fiona would be closer to the hospital. After an investigation into the stillborn child claim for compensation, the HSE admitted liability and issued and apologised to Fiona and Stephen.

At the High Court in Dublin, Mr Justice Sean Ryan said that the HSE had demonstrated “extraordinary ineptitude” and that it was “scarcely credible” in this day and age an ambulance would be arranged for a patient suffering from internal bleed without someone thinking of having the necessary cross-matched blood for transfusion.

Hearing that the claim for stillborn child compensation was before him for the assessment of damages only, Mr Justice Sean Ryan told Fiona that he could only determine compensation for a stillborn child on the basis of legal principles and not based on his sense of indignation, and awarded the couple €170,000 in stillborn child compensation.


Compensation for Medical Misadventure Awarded Against HSE

The family of a woman who died giving birth to her second child has been awarded 850,000 Euros in compensation for medical misadventure following a High Court hearing.

Evelyn Flanagan (38) from Castlebar in County Mayo died at Mayo General Hospital on October 19, 2007, following the birth of her daughter Niamh as a result of serious complications. An initial post-mortem suggested that Evelyn´s death was attributable to an amniotic fluid embolism; however Evelyn´s family contested the findings – claiming that the deterioration in her condition was due to a postpartum haemorrhage which could have been prevented with greater care.

Inquest proceedings in 2008 and 2009 resulted in a verdict of death by medical adventure, following which Evelyn´s husband – Padraic Flanagan – made a claim for medical misadventure compensation against the Health Service Executive and consultant obstetrician, Dr Murtada Mohamed. It was alleged in the action that Evelyn suffered a postpartum haemorrhage as a result of a rupture of her uterus which was not detected or adequately dealt with.

Mayo General Hospital initially denied that negligence had occurred but, as Mr Justice Michael Peart heard at the High Court, an acknowledgement of liability had been made during mediation prior to court proceedings. The judge awarded the family 850,000 Euros in compensation for medical misadventure to include the maximum allowable 25,395 Euros for mental distress and payments for each of Evelyn´s two children as they grow older.


Wrongful Death Claim Admitted By Hospital

The family of a man who died in hospital due to “an unjustifiable delay” in his treatment have received an apology from the hospital in question and 500,000 Euros compensation in settlement of their wrongful death claim.

Barry Murphy (38) from Carrigaline, County Cork, was known to suffer from Crohn´s Disease – but was generally in good health – when he was admitted to the South Infirmary–Victoria University Hospital on the morning of 24th April 2008 complaining of abdominal pains. Barry was diagnosed with a perforated bowl but, by the time the hospital operated on him, parts of his body had already shut down due to septic shock and he died at 11.15pm the same evening.

Barry´s widow, Mary, claimed that the hospital had not cared for her husband by failing to operate on him in time, and that they were guilty of medical negligence in the avoidable and wrongful death of her husband. The South Infirmary–Victoria University Hospital initially denied the claims, but in front of Mr Justice John Quirke at the Dublin High Court apologised to the family and admitted that the level of care that was provided for Barry fell short of an acceptable standard.

The apology and admission of liability for Mary Murphy´s wrongful death claim was accompanied with an offer of compensation for delayed treatment amounting to 500,000 Euros. Mr Justice John Quirke approved the settlement, once he had Mary Murphy´s agreement that it was acceptable, and extended his sympathies to Mary and her two daughters – commenting that what had happened to Barry was “unthinkable” and “tragic”.


Clinical Indemnity Scheme Criticised for Granting Anonymity

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.


Wrongful Deaths Likely to Increase in Irish Hospitals, Warns Expert

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.


Court Hears of Settlement in HSE Wrongful Death Claim

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.


Hospital Negligence Claims Likely to Rise Due to Bed Shortages

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.


Undisclosed Compensation Settlement for Baby´s Wrongful Death

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.


Meningitis Compensation of 170,000 Euros Awarded

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.


“Duty of Candour” May Force Clinical Error Admissions

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.


High Court Settlement For Maternity Errors That Cost Mother Her Life

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.


New Superbug Hits Irish Hospitals

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.


Huge Increase in Hospital Negligence Compensation in 2010

The State Claims Agency has already paid out 20% more in compensation in the first eight months of the year compared with the whole of the 2009. The State Claims Agency had already paid compensation of €59.9 million up to August 2010, compared with total compensation payments of €48 million in 2009.  At the current rate,  the Agency will make compensation payments of nearly €90 million in 2010.  This represents an increase in compensation of nearly 50% in 2010 compared with 2009.

The Minister for Health, Mary Harney, has announced some measures to improve patient safety.  The most significant are draft healthcare standards developed by the Health Information and Quality Authority (Hiqa), which has now entered into a public consultation phase.

Minster Harney has said that about 10% of people admitted to hospital experienced an ‘adverse event’, and about 1% of the adverse events would result in injury or death.  Speaking about the adverse events, the minister said “Many of them are systemic failings and many of them are avoidable”.

It should also be pointed out that although the rate of adverse events in HSE run hospitals is particularly high, the HSE is not always responsible, such as the recent DePuy recall.


Jury Returns Verdict of Medical Accident

A jury at the coroner’s court returned a verdict of death by “medical accident” in the case of Louise Butler at the Mid Western Regional Hospital in Limerick on November 16th, 2006 from a large subarachnoid haemorrhage, one month after she was mistakenly diagnosed with a migraine.

The wrong diagnosis occurred despite the family of the 21-year-old victim repeatedly requesting a brain scan.

The Jury has recommended that patients who present at hospitals with persistent and severe headaches should receive Cat scans  as soon as possible.

The Health and Safety Executive had already apologised in the High Court in July during proceedings and also made  a compensation payment to the family of Louise Butler.


New HSE CEO Can Reduce Medical Malpractice Claims

There has been much commentary in the media about the new Health Services Executive (HSE) chief executive Cathal Magee facing a difficult first year implementing significant budget cuts. However, he also has a significant challenge changing the internal staff culture of the HSE, which was most recently criticised by the Ombudsman for its “rotten culture of secrecy” when dealing with medical malpractice.

Cathal Magree should start by reading the paper in August 17th issue of the Annals of Internal Medicine about a program launched by the University of Michigan Health System that encouraged health workers to report medical mistakes. The program included a procedure for telling victims about errors, who exactly made the error, what steps were made to prevent similar mistakes in the future, and mostly importantly, making a sincere apology to the patient or family. The procedure also included a process for offering fair compensation.

Reporting and explaining errors honestly to patients obviously leads to faster resolution of disputes, but also reduced the number of lawsuits by 36%.


Family Awarded 40,000 Euro for Hospital Negligence

A High Court settlement of €40,000 was approved by Mr Justice Michael Peart as compensation for  the distressed family of Ms Louise Butler, aged 21, of Cappa Lodge, Sixmilebridge, County Clare.  Louse Bulter died at Limerick Regional Hospital on November 16, 2006.

The settlement and apology followed a hospital negligence claim, which the HSE had initially denied. The claim was brought against the Health Service Executive (HSE) by Ms Butler’s brother James Butler, on behalf of his family, who insisted that Ms Butler would have lived if she had received proper medical care at Limerick Regional Hospital,

Between October 6-12, 2006, Ms Butler sought help at the hospital for an unbearable headache. Her family and doctor strongly urged the hospital to provide her with a CT cat scan prior to her leaving the hospital. Ms Butler was discharged on October 12 without having received a CT cat scan.  The hospital eventually did provide a CT cat scan for Ms Butler on October 13 that  showed massive bleeding in her brain. The family claimed that this came too later because Ms Butler collapsed and died before receiving the results.

Medical experts testified that if the scan would have shown the need for immediate treatment if it had been provided earlier.

The HSE apologised to the Butler family and admitted medical failures and deficiencies had contributed to Louise Butler’s tragic death.