Birth Injury Claims

An 18-month-old girl who sustained significant brain injuries after, it was claimed, she was allowed to leave hospital without the correct post-surgery antibiotics has had an interim settlement of €3m approved in the High Court. Now 14-years of age, Knocknacarra Co Galway native Chloe Flaherty experienced seizures ollowing cranial surgery, just days after she was sent home from hospital in 2009. Senior Counsel Des O’Neill, representing Chloe in court, stated that the young girl she had been prescribed with a course of antibiotics as she was experiencing high temperatures in the time leading up to her discharge from Children’s University Hospital Temple Street in April 2009. However, when she was allowed to leave she was not provided with adequate antibiotics or a prescription. As they were seeking advice on what they should do about their daughter’s condition, Chloe’s parents twice contacted the hospital in the days after her discharge looking for advice. The advice given to them was that they should keep giving Chloe Calpol as she was experiencing typical recovery side effects that were not unusual. Sadly, just one week later the young girl suffered seizures for a period of more than one hour who resulted in her sustaining a catastrophic brain injury. Mr O’Neill informed the Judge that, following this incident, Chloe was kept in hospital for two years until her parents successfully applied to have her released to their care. Since that time that have provided all care for her their daughter at all time. He added that, prior to undergoing the cranial surgery, Chloe was a cheerful, happy young girl who had met all her milestones. After she was born at at Galway University Hospital in October 2007, Chloe was referred to Temple Street where she was diagnosed with unicoronal synostosis in March 2008. A srugical procedure was recommended to remedy this. Chloe’s parent were informed that this would be a simple procedure and rarely leads to any complications. However, when the surgery was carried out in April 2009 by by a plastic surgeon and a paediatric neurosurgeon, Chloe suffered significant blood loss during the surgery and in the days afterwards was given antibiotics. Th elegal action alleged that there was a failure to properly advise Chloe’s parents in relation to the possibility of infection or brain damage being experienced. Additionally it was claimed that and that the defendants were negligent in discharging hallowing her to leave the hospital without antibiotics. The defendants refuted these claims, and the court was told that if the case had gone to a full hearing, the defence would argue that the seizures could have been caused by a genetic condition. The approval given was for n interim settlement of €3m for the next four years, at which time it the case will return to court for a further assessment to ascertain if all the young girl’s needs are being met. The settlement was agreed with no admission of liability. Solicitor for the Flaherty family, Ciaran Tansey told the Judge that they predicted that the settlement agreed in four years’ time could be one of largest approved by the Irish courts as it will cover 100% of the girl’s needs for the remainder of Chloe’s life. Presiding Judge Justice Paul Coffey gave his approval for the proposed settlement and wish the Flaherty family well for the future. Speaking on behalf of Chloe’s parents, Patrick and Samantha outside of court, Mr Tansey stated that this approval brings to an end a ten-year legal battle which was settled “at the 11th hour” and while the settlement “will never offer adequate recompense for what has happened to Chloe or Samantha and Patrick” he said that they accept their child will be looked after financially.  

The Coombe Hospital has a history of settling compensation for birth injuries and death compensation over the years. These include a 2013 settlement after it was ruled that dyskinetic cerebral palsy was caused to a baby being dealt with negligently during delivery, birth injuries compensation of €15m for a Donegal boy who sustained birth injures due to being deprived of oxygen during his birth and €65,000 hospital negligence compensation settlement in November 2009 due to a facial cut at birth  for another infant. Now the unfortunate death of an infant i 2015 just hours after his birth as a result of medical negligence had lead to a the family being awarded compensation for birth death negligence against the Coombe Women and Infants University Hospital at the High Court. The boys parents, Assumpta Sweeney and Jason Butler, along with his brothers and sisters were awarded €35,000 in the legal action that was heard at the High Court. Sadly, their son Rory Jason Sweeney Butler passed away shortly after his delivery on November 19 2015 at the Coombe Women and Infants University Hospital. it was claimed by the plaintiff’s that compensation was appropriate due to the negligence that led to the baby’s wrongful death. They told the court that they experienced nervous shock and trauma as a result of their little boy’s death. Legally representing the family, Richard Kean SC, made it known to the Judge that the parents had to deal with a huge amount of suffering and in the aftermath of the “very tragic” death of their infant son Rory as a result of alleged hospital negligence. An admission of liability was agreed by the defendant in the personal injury compensation claim. Judge Justice Eager approved the statutory compensation award for medical negligence. The overall amount of compensation will be handed over to the immediate family of the young boy who now reside in Dublin 12.  

Toxic chemical personal injury claims have been made against the defence forces as a result of exposure to toxic chemicals at one of their airfields. In early 2017, a document in which a worker employed by the Defence Forces claimed to have proof of the “the untimely deaths of at least 20 adults…of which I believe died of illness related to unprotected chemical exposure” was made public. The whistleblower was stationed at the Baldonnel Airfield. The document included evidence that children of the Air Corps workers at the site also died due to their parents toxic chemical injury. The file mentioned specifically the death of a newborn girl due to ventricular septal defect (heart defect), a five year old boy died while having surgery to address a ‘malrotated intestine’ and a girl aged 15 died after contracting Ewing’s sarcoma, a form of cancer. The latter girl’s father is suffering from leukaemia at present. The wives of members of the defence forces have been making claims the effects of chemical exposure for some time. A mechanic, who previously worked with the Air Corps, noticed that a number of these women had experienced more than one miscarriages and in one particular case, a woman had eight consecutive miscarriages. This suspicious trend was brought to the attention of the authorities, and an independent third party, former civil servant Christopher O’Toole, was appointed by the Minister for Defence in 2016, to investigate the allegations Leader of Fianna Fáil Mr Micheál Martin said he believes a Commission of Investigation is now necessary. He stated “The situation is far from satisfactory because with his opening comments the report’s author is essentially saying he cannot fulfill the terms of reference. From the Government’s point of view they established this review, they must have known the terms of reference could not be fulfilled. It’s farcical.” Although the Health and Safety Authority (HSA) have advised that procedures into risk assessment need to be reviewed, a whistleblower has said that these steps are “too little, too late”, especially in the case of those who have lost family members or who have developed life-changing illnesses and injuries. Allegations have been made stating that these deaths are due to organizational failure on the part of the Defence Forces which meant that Air Corps personnel were exposed to toxic chemicals. The Defence Forces are now facing Toxic Chemical Personal Injuries compensation actions by some former employees. The Defence Forces have released a statement stating, “Given these matters are subject to litigation, it would be inappropriate to comment further.”

A judge has approved an interim cerebral palsy settlement for a six-year-old boy and complimented the Health Service Executive for its cooperation. The six-year-old boy from Ballaghaderreen in County Roscommon was born at Sligo General Hospital in May 2010 after his birth had been avoidably delayed. According to the details of the case told to the High Court, a CTG trace at 5:30pm on the evening of the boy´s birth indicated that he was suffering foetal distress and should be delivered at the first possible opportunity. However, rather than perform an emergency C-Section procedure within an appropriate period of time, the boy´s delivery took place more than two hours later. Due to the avoidable delay, the boy was starved of oxygen in the womb and was born with cerebral palsy. He now has a weakness on the right side of his body, although this does not appear to have prevented him from becoming a sociable child. On the boy´s behalf, his mother made a claim for cerebral palsy compensation against the Health Service Executive (HSE). The HSE was quick to acknowledge liability and, as talks began with the boy´s parents to agree a cerebral palsy settlement, senior HSE personnel apologised for the mistake that had led to their son´s birth injuries and explained how it had happened. The boy´s parents and the HSE agreed to an interim cerebral palsy settlement of €740,000 which will cover the family´s costs for the next five years – the extended period of time being due to the family having moved to Canada. As the claim had been made on behalf of a child, the interim cerebral palsy settlement had to be approved by a judge to ensure it was in the boy´s best interests. At the approval hearing – and after hearing details of the case – Mr Justice Kevin Cross complimented the HSE for its attitude, and said that an apology and an explanation was “absolutely something to be encouraged”. Approving the interim cerebral palsy settlement, Judge Cross said he was delighted with the progress the little boy had made, and he wished him well for the future.

An interim settlement of compensation for birth injuries due to medical negligence at the Midwestern Regional Maternity Hospital has been approved in court. On 19 August 2013, Catriona Enright was admitted to the Midwestern Regional Maternity Hospital in Limerick, thirty-seven weeks into her pregnancy with son Charlie. After tests were conducted, the decision was made to induce labour and Catriona was administered Syntocinon. Despite hyper-stimulation being a known side effect of Syntocinon, Catriona´s condition was not adequately monitored. A subsequent misinterpretation of the CTG tracing and a belated recognition of foetal distress led to Charlie being born “flat” the following day, unable to breathe independently. Charlie was transferred to Cork University Hospital, where he was diagnosed as having suffered an intra-cranial haemorrhage and treated with therapeutic hypothermia (“head cooling”). However, due to the brain damage Charlie suffered prior to his birth, he is severely and permanently disabled. On her son´s behalf, Catriona claimed compensation for birth injuries due to medical negligence against the Midwestern Regional Maternity Hospital and the Health Service Executive (HSE). Liability was admitted for Charlie´s birth injuries and an interim settlement of €1.75 million agreed while a report is prepared into Charlie´s future needs. As the claim for compensation for birth injuries due to medical negligence was made on behalf of a child, the interim settlement had to be approved by a judge to ensure it was in Charlie´s best interests. Consequently, at the High Court, Mr Justice Anthony Barr was told the circumstances leading up to Charlie´s birth. Judge Barr approved the interim settlement, saying it was a very good one that should take care of the boy´s needs for the next two years. After two years, the family will have to return to court for the approval of a subsequent interim settlement of compensation for birth injuries due to medical negligence or the approval of a lump sum payment, assuming that no system of periodic payments is introduced in the meantime.

A final payment of delayed delivery cerebral palsy compensation has been approved in the High Court in favour of sixteen year old girl described as “heroic”. Sixteen-year-old student Mary Malee was born on 11th October 1999 by emergency Caesarean section at Mayo General Hospital after an alleged delay in locating a paediatrician. Due to the alleged delay and a miscommunication when the paediatrician arrived, Mary´s delivery was delayed by eighty minutes – during which time her brain was starved of oxygen and she suffered cerebral palsy. On Mary´s behalf, her mother – Maura Malee from Swinford, County Mayo – claimed delayed delivery cerebral palsy compensation from the Health Service Executive, alleging that there had been a failure to ensure the presence of a paediatrician when it was known that Mary was in distress in the womb, and that the hospital´s medical negligence led to the failure to conduct Mary´s birth in a timely manner. An interim settlement of delayed delivery cerebral palsy compensation was approved in March 2014 and Mary´s case was adjourned for two years in anticipation of laws allowing for the introduction of phased payments of compensation for catastrophically injured claimants. As structured settlements are still not available, Mary and her parents returned to the High Court last week to have a €5.56 million final payment of delayed delivery cerebral palsy compensation approved. At the hearing, Mary explained to Mr Justice Peter Kelly that “the stress of ongoing engagement with the HSE and the courts is not what I want”. The judge also heard that Mary has ambitions to become an advocate for people with disabilities, and describing Mary´s achievements to date as “heroic”, Judge Kelly approved the final payment of delayed delivery cerebral palsy compensation. Also at the hearing an apology from the Mayo General Hospital was read to Mary, expressing the hospital´s deep regret for “the many challenges that you have faced as a result of the treatment provided to your mother Maura at the time of your birth”. Mary subsequently gave a statement to the press in which she said: “Cerebral palsy won’t kill me but I have to learn to live with it … it’s for life. This shouldn’t have happened to me and others like me. Justice has been done and I’m bringing closure to this, we can move on with our lives”.

An interim settlement of compensation for the delayed delivery of a child, who consequently sustained brain damage, has been approved in the High Court. Mohammad Daud Assad (now aged eleven years) was born at the Rotunda Hospital in Dublin on February 20th 2004 by emergency Caesarean Section after becoming distressed in his mother´s womb. Mohammad was born in a poor condition and needed resuscitating after the delivery. Due to being deprived of oxygen immediately before his birth, Mohammad suffered severe brain damage. He now suffers from cerebral palsy and has both mental and physical disabilities. Unable to speak, Mohammad will need full-time care and support for the rest of his life. Through his mother – Alia Muryem Assad of Ballyfermot in Dublin – Mohammed claimed compensation for the late delivery of a child against the Rotunda Hospital. It was alleged that his mother arrived at the hospital at 9:00am on the morning of his birth – ten days overdue – but that he not delivered until 10:30pm. In excessively delaying Mohammad´s birth, it was claimed, there was a failure to properly assess his mother and consider a failing of the placental function – particularly after a reduction of the foetal heart rate was recorded several hours before his birth. At the High Court, Mr Justice Kevin Cross heard that Mohammad attends mainstream school and enjoys music. He was also told that the Rotunda Hospital had only acknowledged liability for Mohammad´s birth injuries within the last two weeks, and that an interim settlement of €3 million compensation for the delayed delivery of a child had been agreed. The judge approved the interim settlement of compensation for the delayed delivery of a child and commented that the way in which the family had rallied round to help Mohammad´s parents “restored one´s faith in humanity”. The case was then adjourned until 2022, when Mohammad´s future needs will be assessed and a full settlement of his claim resolved.

A claim for a retained swab during childbirth has been resolved at the High Court with the award of €117,000 compensation to the injured mother. On 22nd April 2013, Sarah Daly (38) from Rathfarnham in Dublin gave birth to a healthy child at the Mount Carmel Hospital. Three days later, Sarah was taken back to the hospital by her husband in extreme pain. No internal examination was conducted for a further three days, when a swab “the size of a plum” was discovered and removed. However, as the swab was removed without any antibiotics being prescribed, Sarah developed a significant infection which caused her further pain and discomfort. Sarah made a claim for a retained swab during childbirth against consultant Valerie Donnelly and Charles Julian Dockeray – who had managed the delivery and was standing in for Ms Donnelly – alleging that the swab was wrongfully inserted, that the presence of the swab was not identified for three days after she presented at hospital, and that she was discharged without antibiotics, resulting in an infection. Liability was admitted by the medical professionals and the claim for a retained swab during childbirth went to the High Court for the assessment of damages. At the High Court, Mr Justice Kevin Cross said what ought to have been a very joyous occasion for Sarah had become something that will live with her for the rest of her life. The judge awarded Sarah €117,000 in settlement of her claim, commenting that the award was “fair and reasonable”. The judge added that the size of the award represented the hospital´s negligence in failing to conduct an internal examination when Sarah first complained three days after the birth of her child. Had the swab been detected immediately, Sarah would not have developed the subsequent infection. Note: Normally a claim for a retained swab during childbirth would not warrant this level of compensation. As Mr Justice Kevin Cross noted, Sarah sustained a series of avoidable injuries and the amount of the compensation awarded to Sarah reflects the injuries she sustained, rather than the level of negligence demonstrated by the hospital´s medical professionals.

Leading barrister Doireann O’Mahony has called for a legal duty of candour in Ireland to prevent unnecessary delays resolving medical negligence claims. Writing in the Irish Examiner, Ms O´Mahony claims that the practice of keeping quiet when mistakes have been made has become a culture within the Health Service, and that this culture has resulted in the failure of the Health Service to admit when it was wrong and learn from its mistakes. According to Ms O´Mahony, the culture has developed despite a national policy on open disclosure being launched by the Health Service Executive and State Claims Agency two years ago. Unfortunately, the barrister alleges, the policy is not working and what is needed is a legal duty of candour in Ireland. Ms O´Mahony continues by explaining that a legal candour of duty was introduced in England and Wales last year which makes it a criminal offence not to advise a patient when – for example – a procedure has gone wrong or a medication has caused an adverse effect. She also repeats comments made by health minister Leo Varadkar last year that it was the equivalent of a motoring hit and run for doctors and healthcare professionals to fail to make such disclosures and to live up to their duty of candour. With a legal duty of candour in Ireland – and proper risk management thereafter – Ms O´Mahony suggests that lessons would be learned when mistakes are made so that they will not be repeated over and over again. She highlights recent scandals in Portlaoise, in Cavan and in Portiuncula as examples of when lessons should have been learned, but weren´t. The barrister explains that, in many cases, the motive behind a claim for medical negligence compensation in Ireland is for patients and their families to get an explanation of what went wrong. Only when long-term care for a child has to be paid for is the amount of any compensation settlement of significance. A legal duty of candour in Ireland, Ms O´Mahony claims, would prevent the need for victims of medical negligence and their families to endure protracted and often hostile litigation just to receive an apology they are entitled to. When mistakes are admitted and properly assessed afterwards, patients would not need assurances that “lessons have been learned” and “changes have been made” so that what happened to them will not happen to anybody else. Litigation can be a force for good and provide the impetus for improvement – Ms O´Mahony claims in the conclusion of her article – provided there is a proper risk management feedback loop. She hopes that, through the introduction of long-overdue procedural reform in medical negligence cases and a legal duty of candour in Ireland, a culture of more openness and honesty will develop.

The Director General of the Health Service Executive – Tony O´Brien – has criticised the State Claims Agency for forcing medical negligence litigation. The head of the HSE was addressing the Oireachtas health committee when he commented that the State Claims Agency contests too many claims for medical negligence compensation and forces plaintiffs to take their claims to court. Mr O´Brien criticised the adversarial framework used by the Agency, and said that medical negligence litigation delayed compensation to families to whom it was rightfully due for up to a decade. “These cases go on for up to 10 years and the State loses 99 per cent of them,” he said, “so why all that trauma for people to get what they need.” The Director General added that medical negligence litigation was also damaging to the healthcare professionals involved in each hearing. He said that, although the healthcare professionals were not on trial, they faced cameras at the entrance to “show trials” when the outcome of the hearings was likely to be in the plaintiff´s favour. Mr O´Brien is keen to promote accountability and said that the State Claims Agency had an “unrealistic” view about risk and safety in healthcare. His solution to excessive medical negligence litigation, Mr O´Brien told the Oireachtas health committee, would be the creation of a compensation fund to support a different system of resolving cases involving cerebral palsy and other avoidable birth injuries. In response to Mr O´Brien´s criticisms, the State Claims Agency issued a statement saying that 97 percent of cases are resolved without medical negligence litigation; and, in cases where liability is contested, courts find in the Agency´s favour 75 percent of the time. In October the State Claims Agency published a review of maternity and gynaecology services in Ireland in which it was revealed that total expenditure on cerebral palsy compensation claims had increased from €27 million in 2010 to €47 million in 2014. The increase was partly attributed to more cerebral palsy compensation claims being resolved with a lump sum payment than an interim payment due to the failure to introduce a system of periodic payment orders.

The settlement of a medical negligence claim for a mismanaged birth has been approved at the High Court in favour of a couple who lost their two-day old son. On 20th November 2012, Fiona Watters was admitted into the Cavan General Hospital in the later stages of a pregnancy. Fiona´s waters were broken at 10:30am on the morning of 22nd November by consultant obstetrician Dr Salah Aziz, and she was administered Prostiglandin – a synthetic drug similar to Syntocinon – to accelerate her labour. During the course of the day, the levels of Prostiglandin were increased. By 9:30pm that evening, Fiona´s contractions were so close together that a natural birth was attempted. However, after an hour the midwife rang Dr Aziz to inform him that the child´s head was still not visible and the indications were that the child was suffering foetal distress. On his arrival at the Labour Ward, Dr Aziz learned that another C-section procedure was occupying the theatre. He attempted a forceps delivery which failed and a vacuum delivery – both of which failed. When the theatre became available, Fiona underwent an emergency C-section, but her son – Jamie – was born in a very poor condition. He was transferred to special care baby unit at the Rotunda Hospital, where he tragically died in his mother´s arms two days later. An initial investigation into the cause of baby Jamie´s death was quashed by the High Court in August 2013 after Dr Aziz asserted that the correct procedures had not been followed by HSE investigators. However, having received an advanced copy of the report, Fiona and her partner – Francis Flynn – made a medical negligence claim for a mismanaged birth against Cavan General Hospital and the HSE. The HSE failed to acknowledge liability for Jamie´s death until July 2014, and subsequently commissioned a second investigation into his death – this time to be conducted by an independent review team following two further newborn deaths at the Cavan General Hospital. An inquest in December 2014 attributed Jamie´s death to a medical misadventure – citing the increase in the administration of Prostiglandin, Dr Aziz´s negligence in not informing the registrar that the drug had been administered, and the lack of a second out-of-hours theatre at the hospital being causative events leading up to Jamie´s death. Following the verdict, the solicitor representing Fiona and Francis started negotiations with the State Claims Agency to settle the medical negligence claim for a mismanaged birth. Due to the traumatic circumstances of Jamie´s birth and the protracted nature of the investigations into Jamie´s death, a settlement of €70,000 was agreed to account for the long-lasting grief and distress that had been suffered by Jamie´s parents. Earlier this week, details of the medical negligence claim for a mismanaged birth were related to Mr Justice Richard Humphreys at the High Court. Judge Humphreys approved the settlement, stipulating that €5,000 of the compensation should be paid into court funds for the benefit of Fiona and Francis´ daughter.

The HSE has indicated that it will take a High Court cerebral palsy award to the Supreme Court after losing an appeal against the original settlement. On 12th July 2006, Gill Russell was born at the Erinville Hospital in Cork suffering from dyskinetic cerebral palsy. The cause of his injury was described as a “prolonged and totally chaotic” delivery by his legal representatives after his mother – Karen Russell from Aghada in County Cork – had undergone a symphysiotomy to assist with the birth. On her son´s behalf, Karen Russell made a claim for compensation against the Health Service Executive (HSE). Liability was admitted and, in 2012, Gill received an interim High Court cerebral palsy award of €1.4 million. This was followed two years later with a further High Court cerebral palsy award of €13.5 million – the highest settlement ever awarded by the High Court for cerebral palsy. The HSE and State Claims Agency appealed the level of the High Court cerebral palsy award – arguing that Mr Justice Kevin Cross had based the award on a much lower rate of interest than was traditionally used in Irish courts to calculate the future value of the settlement. The two agencies warned that it was a dangerous precedent that could cost the state and the insurance industry up to €100 million per year. However, earlier this week, a three-judge panel at the Appeals Court upheld the original settlement – stating that, using the previous formula, a catastrophically injured person would have to take “unjust and unacceptable” investment risks to ensure their financial security. The judges ruled that it was not the courts´ function to inquire what a claimant was likely to do with their award for the purposes of determining its value. Handing down the verdict of the Appeals Court, Ms Justice Mary Irvine said that a seriously injured child should not be compared with an investor for the purposes of deciding what should be a prudent investment. Furthermore, she added, the HSE and State Claims Agency would not be in this predicament had the government not failed over decades to enact laws that would allow a structured compensation payment system. Unfortunately for Gill and Karen Russell, the battle to settle the claim for compensation is not yet finished. The HSE has indicated that it will take the High Court cerebral palsy award to the Supreme Court, where its case will be heard by a seven-judge panel. The date of the hearing is not yet known.

The Medical Injuries Alliance has called on politicians to fix a “glaringly obvious” problem that would help to improve patient safety in hospitals. The Medical Injuries Alliance is an organisation that helps patients who have suffered injuries due to mistakes in hospitals get answers about how the mistakes were made. Among the Alliance´s objectives is the promotion of studies into why mistakes occur, so that the results can be used to improve patient safety in hospitals. In order to meet this objective, the Alliance has frequently called on politicians to introduce laws that would force healthcare professionals to admit when mistakes have been made, to explain how they happened, and to issue an apology immediately. The “Duty of Candour” – the Alliance claims – would also accelerate the settlement of hospital negligence compensation claims. The Alliance has a statement on its website that reads “the duty of candour in hospitals and doctors should be placed on a statutory footing, entitling injured patients to an accurate account of how they came to suffer medical injury in Irish hospitals” and, to force the issue of patient safety in hospitals, the Alliance has now written a letter to the Irish Times. The letter was prompted by an article that appeared in the Irish Times that commented on a nine-year delay in the settlement of a cerebral palsy compensation claim. The paper wrote that the delay was due to alleged “stonewalling” by the Health Service Executive (HSE), pointed out that duty of candour laws were implemented in the UK last year, and that similar legislation is clearly needed in Ireland. The response by the Medical Injuries Alliance was much in agreement with the sentiments of the article and highlighted the necessity to improve patient safety in hospitals. Joice McCarthy – the Secretary of the Medical Injuries Alliance – wrote that many hospital negligence victims are forced to take legal action to get answers that healthcare professionals are reluctant to give. Ms McCarthy added that injured patients who have been through the legal process often found it to be a stressful and protracted experience; and she alluded to the recent “shabby episode” disagreement between the HSE and the State Claims Agency, in which both blamed the other for a six-year delay in settling a hospital negligence claim. Ms McCarthy concluded her letter: “Instead of blaming any particular State organisation, or indeed having different State organisations blame one another for the current difficulties, it is high time politicians simply acted to introduce a legal duty of candour in order to fix what seems to be a glaringly obvious problem”.

A couple from Limerick has rejected an HSE apology for the death of their newborn child, saying that the Health Service Executive´s apology is six years too late. On 11th February 2009, baby Caoimhe was born to Joan and John Mulcair from Corbally in Limerick after the couple had tried for many years to have a child. Tragically, Caoimhe died 39 minutes later in her mother´s arms. At last week´s inquest into Caoimhe´s death, the jury heard that a lack of blood and oxygen supply to the baby´s brain had been identified and, that during Joan´s labour, a deceleration of the foetal heartbeat had been recorded. In line with the coroner´s recommendations, the jury returned a verdict of death by medical misadventure – prior to which the court had heard an HSE apology for the death of the newborn child read out by Collette Cowan, the chief executive of the Midland Regional Hospital in Limerick where Caoimhe was born. However, Caoimhe´s parents rejected the HSE apology for the death of a newborn child, saying that it had come six years too late. Speaking outside the Limerick courthouse, an emotional John said that it was a disgrace that the HSE had put “an ordinary decent family through the pain and torment we had to endure for over six years”. John explained to reporters that the HSE had denied that there had been any failure to provide an acceptable standard to Caoimhe before, during or after her birth – until liability for her death was admitted last December, and a settlement of the family´s compensation claim was agreed. In response, the HSE said it had no control over cases involving medical negligence, which are handled by the State Claims Agency. However, the passing of the buck was described as a “shabby episode” by a columnist in the Irish Times, who wrote: “A common interest links the HSE and the claims agency and there has been a persistent pattern of denial, prevarication and years of unnecessary delay in dealing with medical claims. The public and aggrieved patients deserve better. So do the vast majority of medical professionals.”

A High Court judge has approved a €1.75 million settlement of birth injury brain damage compensation in favour of an eighteen year old man from County Sligo. Thomas O´Connor was delivered by emergency Caesarean Section on September 6th 1996 at Sligo General Hospital, showing no signs of life due to being deprived of oxygen prior to his birth. He was resuscitated and taken to the hospital´s Intensive Care Unit, but on the way suffered a heart attack and had to be resuscitated once again. Because of twice being deprived of oxygen, Thomas suffered terrible brain damage. He is spastic quadriplegic, blind, fed through a tube and cared for full-time at a residential home close to his family´s home in Collooney in County Sligo. Through his mother, Ann, Thomas made a claim for birth injury brain damage against the Sligo General Hospital and the Health Service Executive – alleging that his mother received a poor standard of care prior to his birth, and that his heart attack was due to the tube used to ventilate him being too deeply inserted. Sligo General Hospital and the Health Service Executive denied liability for Thomas´ brain injury, and contested the claim for birth injury brain damage compensation. Consequently, the case proceeded to the High Court in Dublin, where it was heard by Mr Justice Kevin Cross. At the hearing, Judge Cross was told by expert witnesses that a CTG trace monitoring the foetal heartrate had been discontinued in the morning of Thomas´ birth. This was despite there being clear evidence of foetal distress. Thomas´ birth was avoidably delayed by up to four hours the judge heard. The judge was also told that the tube used to ventilate Thomas had been inserted at a depth of 14cms into Thomas´ lungs. The usual depth of insertion is between 9cms and 10cms, and the consequence of this alleged error was that Thomas was not ventilated effectively, causing him to suffer a heart attack which exacerbated the level of brain damage he suffered. Over the course of the four-week hearing, the Health Service Executive agreed to a €1.75 million settlement of birth injury brain damage compensation. After hearing that the €1.75 million settlement will pay for Thomas´ continued care at the residential home in Collooney, Judge Cross approved the settlement – adding that he was delighted the legal ordeal had come to an end for the O´Connor family.

A woman has been awarded compensation for negligent post-natal care after she was prescribed antibiotics to deal with a vaginal swab left inside of her. Claire Lalor (30) from Swords in County Dublin gave birth at the National Maternity Hospital on 24th December 2012 after a difficult labour and was discharged three days later. On January 2nd and January 9th Claire returned to the hospital on the advice of public health nurses over concerns about pain and a smell from her lower body. On neither occasion was Claire examined internally and, on her second return visit to the National Maternity Hospital, she was prescribed antibiotics. It was only on a third visit the following week that Claire was examined internally – by which time the smell had worsened – and on this occasion it was discovered that a vaginal swab had been left inside of her from the delivery of her child. On January 18th – two days after the swab had been removed – Claire returned to the National Maternity Hospital once again, this time suffering from severe physical pain, sweating, chills fever and diarrhoea. She was admitted into the hospital, but told that she was suffering from post-natal depression and later discharged. Unable to keep food down once she returned home, Claire was taken to the Beaumont Hospital. There she was diagnosed with C.difficile – a consequence of the unnecessary antibiotics she had been prescribed on her second return visit to the National Maternity Hospital. Once she had recovered, Claire sought legal advice and claimed compensation for negligent post-natal care. After an investigation into Claire´s allegations, the National Maternity Hospital admitted liability for the pain she had suffered as a result of the swab being left inside of her, the discomfort she had experienced from the “disgusting” and “horrible” smell that had developed as a result of the hospital´s error, and for the C.difficle infection she had contracted as a result of the antibiotics she had mistakenly been prescibed. However, the hospital contested the extent of Claire´s psychological trauma, and argued that her emotional upset was attributable to her post-natal depression rather than any depression or adjustment disorder caused by the events associated with the swab. Unable to reach an acceptable settlement of compensation for negligent post-natal care, the case went to the High Court for an assessment of damages. At the High Court, Mr Justice Kevin Cross accepted that the traumatic birth of Claire´s child made her more likely to suffer from post-natal depression, and that her continuing symptoms of psychological trauma have some origin in her underlying disposition. However, the judge ruled that were it not for the admitted negligence of the National Maternity Hospital, Claire would have recovered from any post birth upset in a shorter period of time and would not have the level of psychological injury that she has now. Judge Cross added that Claire was a truthful witness in her evidence and that she was “entirely appropriately extremely distressed” by the episode. Commenting that her fear and distrust of the medical professional was not unreasonable in the circumstances, the judge awarded Claire €140,000 compensation for negligent post-natal care.

A High Court judge has approved an interim settlement of compensation for injuries due to birth complications in favour of a ten year old boy. Luke Beirne from Mullingar in County Westmeath was born at the Midlands Regional Hospital on 30th September 2004, eleven days past his due date. Due to alleged circumstances surrounding his birth, Luke was starved of oxygen in the womb and now suffers from cerebral palsy. His mother – Margaret – alleged that midwives were “chatting in the corridor” rather than monitoring her condition, and that a locked theatre room delayed Luke´s delivery – causing further birth complications. Due to the birth complications, Luke also suffers from asthma and will require surgery as he grows older and his muscles tighten. On her son´s behalf, Margaret claimed compensation for injuries due to birth complications against the HSE, and also her consultant obstetrician – David Mortell – for allegedly neglecting to discuss the risks associated with a vaginal birth when her first child had to be delivered by Caesarean Section in 2001. The HSE and the consultant obstetrician denied the allegations, but issued a statement expressing their regret that Luke had suffered such devastating birth injuries. On weighing up the facts supporting the denial of liability, Margaret´s solicitors recommended that she accept an interim offer of compensation for injuries due to birth complications without an admission of liability. Although not happy with the outcome, Margaret agreed to her solicitor´s recommendation and, when the subsequent court hearing was convened to approve the interim offer of compensation, Margaret told Mr Justice Michael Moriarty that she entrusted the court to make the right decision for Luke and his future. Judge Moriarty heard that the family were concerned that the €800,000 offer of interim compensation for injuries due to birth complications was not realistic and would not be sufficient to pay for Luke´s future care needs. However, he was also told that, if the case went to trial, the HSE and consultant obstetrician would testify that everything that could have been done in the circumstances was done. Mr Justice Michael Moriarty said that he believed Margaret´s solicitors had engaged in some “very hard bargaining” to obtain the offer of settlement, and ruled that it was in Luke´s best interests given the possibility that a full trial may have resulted in a successful defence. He approved the interim settlement of compensation for injuries due to birth complications, and adjourned the case for eight years when Luke´s future needs will be reassessed.

The number of medical negligence claims against the HSE has almost doubled over the past five years according to figures released by the State Claims Agency. According to recently released data, 936 new medical negligence claims against the HSE were lodged with the High Court last year – almost double the number reported in 2010. In addition to these new cases, and 218 already lodged in 2015, the State Claims Agency is already dealing with more than 3,000 historical medical negligence claims against the HSE dating back to 2013 or earlier. The true number of medical negligence claims against the HSE is likely to be much higher than that reported by the State Claims Agency, as it fails to take into account proceedings issued in lower courts, public liability claims for accidents in hospitals and employer liability claims when medical staff are injured while working in Irish Hospitals. Issues with maternity services have recently come under the spotlight following the publication of the Hiqa report into failings at the Portlaoise Hospital. The damming report prompted HSE chief Tony O´Brien to call for a “clear-out of uncompassionate staff”, but Health Minister Leo Varadkar believes that a “wall of silence” is to blame for the spiralling increase in medical negligence claims against the HSE. Minister Varadkar said that an “open disclosure” initiative by the HSE and State Claims Agency – which was implemented to handle grievances by patients – was failing to work and, rather than being contained within a hospital, patients who had a negative experience were going to the courts to get answers to what went wrong because hospital management are failing to engage with them. The Minister added: “When something goes wrong, it’s OK to say that you’re sorry about what happened. It does not mean you’re accepting liability. There is a never a good reason to conceal the truth from a patient or their family once the facts are known. Aside from making sense from a human point of view, it’s the right thing to do financially”. The Department of Health is said to be drawing up legislation to underpin the policy of open disclosure in the Health Service and to enable healthcare employees to provide information to patients and their families without prejudicing any future medical negligence claims against the HSE.

The High Court has approved a €2.1 million interim settlement of compensation for cerebral palsy due to the use of Syntocinon in favour of a seven-year-old boy. Patrick Brannigan was born in poor condition by emergency Caesarean Section at the Cavan General Hospital on 20th July 2007. Prior to his delivery a cardiotocography (CTG) trace had shown signs of foetal distress and Patrick´s mother – Niamh – had been administered Syntocinon to accelerate her labour. However, rather than result in a healthy birth, the Syntocinon had the effect of starving Patrick of oxygen in the womb and he was born suffering from dyskinetic cerebral palsy. Now seven years of age, Patrick is confined to a wheelchair and has no means of communication. Through his mother, Patrick claimed compensation for cerebral palsy due to the use of Syntocinon – alleging that the drug should never be administered when there are signs of foetal distress. The claim also stated that Cavan General Hospital mismanaged his birth and there was a failure to monitor the baby while labour was in progress. Cavan General Hospital admitted that a “catalogue of errors” had resulted in Niamh and Patrick receiving a sub-standard level of healthcare. The hospital apologised to the family and an interim €2.1 million settlement of compensation for cerebral palsy due to the use of Syntocinon was agreed upon, subject to approval by a judge. Consequently at the High Court in Dublin, Mr Justice Kevin Cross was told the circumstances leading up to Patrick´s birth. He also heard that Patrick is a cheerful, good humoured boy who is cared for full-time by his parents. The judge approved the interim settlement of compensation for cerebral palsy due to the use of Syntocinon and adjourned the hearing for three years. In three years time, it is hoped that a periodic payment system is introduced so that awards to plaintiffs can be made more accurately and fairly. If no legislation is passed to allow for a periodic payment system, a final settlement of compensation for cerebral palsy due to the use of Syntocinon will be approved. For more information about Syntocinon and the birth injuries it can cause when administered incorrectly, please read Syntocinon Compensation Claims.

The State Claims Agency has called for national guidelines to be issued for the use of a birth-inducing drug to prevent future Syntocinon compensation claims. Syntocinon is the brand name of a synthetic drug (oxytocin) frequently used in maternity units to induce labour and accelerate contractions. For many women it speeds up the delivery process, helps the womb to contract after childbirth and prevents excessive bleeding. However, both mother and child have to be carefully monitored during the administration of the drug. Syntocinon can caused adverse reactions with other medication and escalate foetal distress when a baby is deprived of oxygen. Syntocinon is listed as one of ten “high-alert medications”, and has been identified as one of the causes for the death of four babies at the Portlaoise Hospital in the past six years. There have also been several Syntocinon compensation claims made against the HSE when children have survived foetal distress, but have been born suffering from cerebral palsy. One of the more recent Syntocinon compensation claims was heard at the High Court in February. It resulted in a three-year-old girl being awarded an interim settlement of €2.32 million due to a failure to monitor her heartbeat after Syntocinon had been administered to her mother. Lack of Consistency in Syntocinon Use A report recently released by the State Claims Agency – the agency that pays settlements of Syntocinon compensation claims – has shown an alarming lack of consistency in the way Syntocinon is used in maternity departments and how mothers and babies are monitored. The report revealed that one maternity unit had no guidance on the drug´s use; thirteen had dissimilar guidelines; six had introduced policies; five relied on protocols; three had developed procedures and one had a “checklist”. The State Claims Agency’s clinical risk adviser, Mary Godfrey, has said that national guidelines are required to improve outcomes for mothers and their babies, and to reduce the number of Syntocinon compensation claims made against the state. However Ms Godfrey neglected to comment on one area of the report which stated “No service obtains explicit written consent from women prior to starting them on the drug.” This is an important issue which needs to be addressed if the State Claims Agency wishes to reduce the number of Syntocinon compensation claims made against the HSE.

Another High Court judge has added his voice to the calls for periodic payments for medical negligence claims to avoid errors in compensation payments. For many years, high-profile High Court judges have called for legislation to be passed in order to enable periodic payments for medical negligence claims. Mr Justice Iarfhlaith O’Neill, Mr Justice John Quirke and Ms Justice Mary Irvine have each expressed their frustration at the lack of a structured payment system which, they claim, results in awards of medical negligence compensation becoming a “lottery”. Inasmuch as reports are always compiled into a plaintiff´s future requirements and compensation awarded on the basis of “anticipated life expectancy”, the judges are conscious that a long-living plaintiff will find their settlements inadequate for their needs. There has also recently been a case in which a judge increased a settlement of medical negligence compensation to account for the decline in interest rates. Now Mr Justice Bernard Barton has added his voice to the calls for periodic payments for medical negligence claim,s after refusing an application by the National Maternity Hospital to award an interim payment of compensation to a child suffering from catastrophic birth injuries, and have the child´s needs reviewed again in ten years. The case is O’Neill vs National Maternity Hospital. Although the National Maternity Hospital has admitted negligence, the settlement of the claim is being delayed because the two parties cannot reach an agreement on how much medical negligence compensation the plaintiff is entitled to. Whereas some consensus of opinion has been reached in terms of general damages for pain and suffering, there is a wide difference between what the plaintiff´s counsel are claiming for the child´s future aids and appliances (€445,000) and what the National Maternity Hospital is prepared to pay (€37,000). Other areas of disagreement include future care and accommodation requirements and future loss of earnings, and the National Maternity Hospital argued that a ten-year adjournment of the case would help to resolve the areas of uncertainty. Mr Justice Barton agreed that the proposals was not without it attractions, as a more accurate settlement of medical negligence compensation would be more ascertainable by the time the injured girl reached the age of majority; however, the injured girl´s mother disagreed with the proposal – citing the psychological harm that her daughter might experience due to years of assessments. The judge said that in the absence of agreement between the parties, there were no exceptional circumstances that would make it permissible for the Court to intervene against the express wishes of the child’s mother. The judge dismissed the proposal by the National Maternity Hospital, saying that she had exercised her constitutional rights as part of the family unit under the Constitution, and that if a system of periodic payments for medical negligence claims was in place, this situation would not have arisen.

Irish Barrister Doireann O’Mahony last week wrote an opinion piece for the Irish Times, in which she commented on informed consent in medical negligence cases. Doireann O´Mahony qualified as a Junior Counsel in 2012 and specialises in Medical Law. Her book “Medical Negligence and Childbirth” is due to be published later this year, and – due to her expertise in the area – Ms O´Mahony was the perfect legal professional to comment on a recent UK case in which a new benchmark was set on what constituted informed consent in medical negligence cases. The case in question was Montgomery vs Lanarkshire Health Board – a case that had been appealed to the Supreme Court in the UK, after the mother of a child who suffered avoidable birth injuries at Bellshill Maternity Hospital in 1999 had been denied compensation by both the Outer and Inner Houses of the Court of Session in Edinburgh. The mother – Nadine Montgomery – is petite in stature and suffers from Type 1 diabetes. Women who suffer from Type 1 diabetes are more likely to have larger babies and – prior to the birth of her son – Nadine had expressed concerns about being able to deliver her child safely. When her son – Sam – was born, his shoulder got trapped in the birth canal and he suffered shoulder dystocia as medical staff tried to free him. Due to the umbilical cord also being trapped, Sam was deprived of oxygen during his delivery and – in addition to sustaining a permanent brachial plexus injury during his birth – also suffers from cerebral palsy. Nadine Montgomery subsequently sued the Lanarkshire Health Board (now NHS Lanarkshire) on the grounds that she would have chosen a birth by Caesarean Section had the risk of shoulder dystocia in a natural birth been explained to her. During the Supreme Court hearing, Nadine´s consultant gynaecologist – Dr Dina McLellan – admitted that Nadine had repeatedly expressed concerns about giving birth naturally, but said that she had chosen not to explain the risk of shoulder dystocia because if she explained to diabetic women, they would all want it. Dr McLellan told the court that, in her view, it was “not in the maternal interests for women to have Caesarean Sections”. The seven Supreme Court judges unanimously disagreed with the consultant gynaecologist and said in their judgement that social and legal developments “point away from the relationship between the doctor and patient based on medical paternalism”. The judges ruled that a doctor has a duty of reasonable care to ensure that patient is aware of any material risks involved in any recommended treatment and that “it was incumbent on Dr McLellan to advise Mrs Montgomery of the risk of shoulder dystocia if she were to have her baby by vaginal delivery, and to discuss with her the alternative of delivery by caesarean section.” The Supreme Court awarded Nadine £5.25 million compensation for the birth injuries that her son had sustained during his delivery, and said it would be a mistake to view patients in the modern world as “uninformed, incapable of understanding medical matters or wholly dependent upon a flow of information from doctors” – effectively moving the goalposts in respect of informed consent from the “doctor-knows-best professional standard test” to a “reasonable patient test”. Implications for Informed Consent in Medical Negligence Cases in Ireland Doireann O´Mahony welcomed the judgement of the UK Supreme Court and the implications for informed consent in medical negligence cases in Ireland. Ms O´Mahony commented that a patient-centred approach to the issue of informed consent has been adopted in virtually every major common law jurisdiction – including the United States, Canada and Australia. A patient-centred approach to informed consent in medical negligence cases has twice been the preferable test to resolve medical negligence claims in Ireland – in Geoghegan vs Harris (2000) and in Fitzpatrick vs White (2007). Interestingly, in both cases the presiding judge was Mr Justice Nicholas Kearns, who took the opinion that medical professional had a duty of care to impart certain information regarding risks, where those risks were likely to be relevant in the eyes of a reasonable patient. Although the two cases mentioned above were in respect of dental medical negligence and eye surgery medical negligence, Ms O´Mahony compared the two cases to the rights of a pregnant woman prior to and during childbirth. She wrote: A pregnant woman must be given sufficient understanding to enable her to make a choice in circumstances where she is free to exercise choice. That is what consent is all about and pregnancy is a particularly powerful demonstration of it. Once pregnant, there are only two possibilities, vaginal birth or Caesarean section. There is no third alternative. While most doctors are meticulous in obtaining “consent” for operative intervention, they seem to have little appreciation of the need, equally great, for proper consent to the non-surgical alternative. Ms O´Mahony concluded her article on informed consent in medical negligence cases by saying that a professional standard test has no place in the 21st century when it comes to childbirth. She welcomed the move away from a paternalistic philosophy in Ireland, and set a question for those who opposed to the reasonable patient test – “what risks of elective Caesarean section could outweigh the known risk, in any particular case of vaginal delivery?”

A claim for a failure to treat the mother of a brain damaged girl has been resolved in the High Court after a judge approved a €2.6 million compensation settlement. Caoimhe Flood (8) was born at the Rotunda Hospital in Dublin in April 2006, suffering from cerebral palsy after an alleged failure to treat her mother – Marlis – who had a history of ante partum haemorrhage associated with abdominal pain. Marlis had attended the Rotunda Hospital on a regular basis from February onwards, and was an inpatient from March 30th to April 2nd because of her abdominal pain. On April 3rd Marlis returned to the hospital for a scan and complained of other symptoms. It was alleged that the scan was not performed and that Marlis was discharged home. However, the following day Marlis again returned to the hospital with increasing abdominal pain. An examination revealed that she was dilated, and Caoimhe was born later that evening – after what Marlis considered to be an avoidable delay. After her daughter was born, Marlis made a claim for a failure to treat on Caoimhe´s behalf – alleging that the little girl´s birth injuries could have been avoided if the hospital had responded appropriately to her history of ante partum haemorrhage and abdominal pain. The allegations were denied by the Rotunda Hospital; but, in 2012, the hospital agreed to a €1.3 million interim settlement of compensation for a failure to treat without an admission of liability. This week, the claim for a failure to treat was back at the High Court again for a final settlement to be approved. At the hearing Mr Justice Bernard Barton heard how Caoimhe had to be fed via a tube during the first year of her life and now needs full time care as she is a spastic quadriplegic. Approving a final settlement of €2.6 million, the judge said that he was very relieved for the Flood family that the claim for a failure to treat had finally and completely been resolved.

The High Court has approved an interim settlement of compensation for a three year old girl after hearing of cerebral palsy medical negligence at Kerry General Hospital. Skye Worthington (now 3 years old) was born at the Kerry General Hospital on 22nd April 2011, after her mother – Colleen – had been given syntocinon to speed up her labour. Although the syntocinon resulted in Colleen´s contractions accelerating, a prolonged deceleration of Skye´s heartbeat in the womb was ignored. Skye – from Castlegregory in County Kerry – sustained brain damage due to a lack of oxygen in the womb and now suffers from cerebral palsy. She has to be fed through a tube, has difficulty sitting still, and can only communicate by using her eyes. A review of the management of Skye´s birth found that if she had been born just fifteen minutes earlier, she would not have suffered the devastating injuries. On her daughter´s behalf, Colleen made a claim for compensation against the HSE – alleging cerebral palsy medical negligence at Kerry General Hospital. The HSE acknowledged that errors had been made in the management of Skye´s birth and an interim settlement of €2.32 million compensation was arranged while an assessment takes place to consider Skye´s future requirements. At the High Court, Skye´s parents were read a statement in which the HSE and Kerry General Hospital apologised unreservedly for the errors in the management of Skye´s birth. The statement also said that lessons had been learned from a review of Skye´s birth in which her parents had participated, which had helped clarify a number of important issues. Mr Justice Kevin Cross described the apology as “out of the ordinary” and explained to Skye´s parents that the interim settlement of compensation for cerebral palsy medical negligence at Kerry General Hospital was for the next three years. Once the assessment of Skye´s future requirements had been concluded, the family would have the option of annual periodic payments subject to legislation being passed, or take a lump sum payment in final settlement of Skye´s hospital negligence claim.

A €250,000 settlement of compensation for Erb´s Palsy has been approved in the High Court in favour of an eleven-year-old girl. Keelan Murray from Newtownmountkennedy in County Wicklow was born at the National Maternity Hospital in January 2004. During her delivery, Keelan was identified as having shoulder dystocia – an obstetric emergency in which the shoulders fail to clear the pubic symphysis – which can lead to damage to the brachial plexus nerves if excessive force is used to extract the shoulders. Damaged brachial plexus nerves can heal themselves over a period of time but, as in Keelan´s case, sometimes the damage is permanent – a condition known as Erb´s Palsy. Now eleven years of age, Keelan is unable to fully use her right arm due to nerve damage she sustained during her delivery and has had to adapt to writing with her left hand. An operation to repair the damage in 2012 failed to improve her condition and through her mother – Sharon – Keelan made a claim for compensation for Erb´s Palsy against the hospital. In her legal action Keelan alleged that traction was incorrectly applied to facilitate her delivery despite shoulder dystocia having been diagnosed. The National Maternity Hospital denied that Keelan´s condition had been caused by medical negligence but an offer of compensation for Erb´s Palsy amounting to €250,000 was made without admission of liability. As Keelan is still a legal minor, the offer had to be approved by a judge before the settlement could be accepted. Consequently, at the High Court, Mr Justice Kevin Cross was told how Keelan is a bright young girl who still manages to participate in sports despite her disability. The judge said that it would be prudent to accept the offer of compensation for Erb´s Palsy in the circumstances and approved the settlement – wishing Keelan well for the future.

A High Court judge displayed her frustration at the failure of Ministers to introduce periodic payments when approving a second interim payment of compensation in part-settlement of an obstetrician negligence claim. Ms Justice Mary Irvine has many times called for legislation to be passed so that periodic payments can be awarded to claimants with catastrophic life-long injuries and, at the High Court in Dublin, the judge once again displayed her frustration at not being able to approve a structured settlement in the case of Luke Miggin – an eight-year-old boy who suffered severe brain damage prior to his birth due to the negligence of his mother´s consultant obstetrician. Luke was born at the Mullingar General Hospital on 26th February 2006 after consultant obstetrician Michael Gannon had failed to act on CTG traces taken throughout the day which showed a deceleration of the foetal heart rate. Luke´s delivery was delayed several hours longer than would reasonably be expected, and when he was born needed resuscitation and was transferred to the special care baby unit. Because he was starved of oxygen in the womb, Luke now suffers from cerebral palsy, is unable to walk and requires around-the-clock attention. Through his mother – Emily Miggin of Athboy, County Meath – Luke made an obstetrician negligence claim for compensation, and in 2010 Dr Gannon and the Health Service Executive admitted liability. In January 2011, an interim settlement of compensation amounting to €1.35 million was approved by Mr Justice John Quirke, and Luke´s obstetrician negligence claim adjourned for three years to allow time for a periodic payment system to be introduced. However, with no such structured compensation system yet in place, Emily Miggin returned to the High Court to have a second interim payment of compensation approved by Ms Justice Mary Irvine. Judge Irvine commended Emily for her patience and commented that ongoing litigation prevents families such as the Miggins from getting on with their lives. She apologised for her frustration at not being able to approve a structure settlement and criticised successive Ministers of Justice for failing to deliver on their promises of a periodic payment system. Judge Irvine then approved the €580,000 interim settlement of compensation and adjourned Luke´s obstetrician negligence claim for a further three years, when the family will have to have Luke´s future needs re-assessed and return to court once again.

The High Court has approved an interim settlement of compensation for cerebral palsy due to a delayed delivery in favour of a teenage girl who delayed delivery resulted in her sustaining life-long injuries. Mary Malee was born by emergency Caesarean section at the Mayo General Hospital on October 11th 1999, after there had been a delay in finding a consultant gynaecologist to assist with the delivery. As a result of the hospital´s alleged negligence, Mary was born with cerebral palsy and is now confined to a wheelchair. Through her mother – Maura Malee of Swinford, County Mayo – Mary made a compensation claim for cerebral palsy due to a delayed delivery against the hospital and Health Service Executive (HSE), alleging that there had been a failure to intervene and conduct a Caesarean section in a timely manner, and a failure to ensure the presence of a paediatrician when it was known that the foetus was suffering distress and likely to need resuscitation. Mayo General Hospital and the HSE both denied their liability for Mary´s birth injuries; but, at the High Court in Dublin, Ms Justice Mary Irvine heard that an interim settlement of compensation for cerebral palsy due to a delayed delivery had been agreed amounting to €1.5 million, with a further assessment to be conducted within two years. The judge also heard that Mary was Maura Malee´s fourth child, and that Maura had attended the consultant gynaecologist who had delivered her three previous children several days before Mary was born. The gynaecologist had told Maura that he would not be able to attend her at Mary´s delivery as he was about to start treatment for cancer, but would make arrangements for her to be transferred to the care of another consultant. Maura saw her GP the following day and was told to go to hospital immediately as she was exhibiting symptoms of pre-eclampsia. She was transferred to the labour ward and underwent a CTG shortly before 6.00am which showed a series of decelerations and a consultant was called. When he arrived at shortly before 7.00am, there was an alleged failure to communicate the severity of Maura´s condition and the Caesarean operation did not take place until after 7.20am. . In court, Mary´s legal representatives stated that had it been possible to commence the birth earlier Mary´s injuries could have been avoided and, after a statement had been read out by Mary (14) 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 cerebral palsy due to a delayed delivery and adjourned the hearing.

A man from South Wales is to receive compensation for injuries caused by excessive force at his birth which left him with a permanently paralysed left arm. Jamie Lewis from Blackwood, Caerphilly, was delivered at the Royal Gwent Hospital in Newport in 1991 suffering from nerve damage in his neck after the delivery team at his birth had used excessive force to free him when he became trapped in the birth canal. Suffering injuries similar to brachial plexus damage, Jamie grew up unable to use his left arm and hand and was unable to pursue the activities of his peers which made him a target for bullying and hindered his social development. When Jamie was four years of age, his mother – Cheryl Lewis-Thomas – attempted to make a claim for injuries caused by excessive force at birth, but the solicitor she approached at the time declined to take the case and Cheryl dropped her action against the local health board. Cheryl was encouraged to pursue compensation for injuries caused by excessive force at birth once again; and, when Jamie was eighteen years of age, he made a claim against the Aneurin Bevan University Health Board – which had taken over responsibility for healthcare at the Royal Gwent Hospital. Jamie spoke with a solicitor who this time believed that he had a viable claim, and the solicitor argued successfully that the delivery team when Jamie was born had failed to follow the correct procedures after Jamie had become trapped in the birth canal. The Aneurin Bevan University Health Board accepted liability for Jamie´s arm paralysis due to the negligent actions used to free him at the time, and an out of court settlement of compensation for injuries caused by excessive force at birth was agreed for Jamie (now twenty-three years of age) amounting to £450,000.

The High Court has heard calls for the HSE to apologise for the cerebral palsy negligence that led to a young girl being traumatised at birth and suffering permanent injuries. Grace Orchard from Carrigaline in County Cork was born at St Finbarr´s Maternity Hospital on 23rd February 2006 after her mother had been administered syntocinon to help speed up her contractions. According to the evidence provided at the High Court in Dublin, the drug had been administered inappropriately and, as a result, Grace was delivered by forceps after four previous attempts to bring her into the world – including one using a vacuum cup – had failed. Grace had to be resuscitated after her delivery, and was badly bruised due to the trauma she had experienced. She was subsequently diagnosed with dyskinetic cerebral palsy which – according to counsel – was attributable to “appalling poor handling” by hospital staff during her delivery. Describing the circumstances of Grace´s birth as a “tragedy”, Grace´s counsel told Mr Justice Daniel Herbert at the High Court that Grace had been left in a catastrophic position and that the HSE should apologise for the cerebral palsy negligence. The Court heard that Grace´s family did everything they could for her during her early years – including taking her to a specialist centre in New York for physiotherapy – and that Grace had been accepted into mainstream school, but the services available to her are being reduced due to cut-backs. Through her mother – Deidre O´Callaghan – Grace made a compensation claim for cerebral palsy negligence against St Finbarr´s Hospital and the Health Service Executive (HSE); and the HSE admitted liability two weeks before the court hearing was scheduled to commence. Consequently the case continues for the assessment of damages only.

A High Court judge has approved a settlement of compensation for a failure to act at birth which resulted in a child suffering serious brain injuries. At the High Court in Dublin, Ms Justice Mary Irvine heard how Katie Martin from Trim in County Meath was born at the Coombe Hospital on November 9th 2000, after her mother – Fiona – had been admitted to the hospital that morning complaining of having irregular contractions. Fiona underwent a CTG trace after her admission into hospital which suggested that Katie was being deprived of oxygen in the womb. However, it took nearly 90 minutes for staff at the hospital to act on the abnormal readings and organise an emergency Caesarean Section. When Katie was delivered, she showed no signs of life having suffered a cardiac arrest in the womb, but fortunately staff at the hospital were able to resuscitate her. Katie – now thirteen years of age – had suffered serious brain injuries as a result of being deprived of oxygen, and will need around the clock care for the rest of her life. Fiona Martin claimed compensation for a failure to act at the birth of her child against the Coombe Hospital; who contested its alleged liability for Katie´s injuries, and argued that Katie was starved of oxygen in the womb before her mother arrived at the hospital. The hospital prepared a full defence against the claim, arguing that that it was already too late to prevent an injury after Fiona´s arrival. However, Ms Justice Mary Irvine at the High Court heard that a settlement of €4 million compensation for a failure to act at birth had been negotiated without the hospital admitting liability. The judge was told that the case was before her for approval of the settlement and, after hearing the circumstances surrounding Katie´s birth, approved the settlement – commenting that it was a good one considering that the case had been contested by the defendant.

The National Director of Quality & Patient Safety at the Health Service Executive (HSE) has apologised “unequivocally” to four families who lost a child due to hospital childbirth medical negligence. The apology by Dr Philip Crowley came prior to an RTE Prime Time television program – “Controversy at Midland General Hospital, Portlaoise – Fatal Failures” – which highlighted failings in care at the hospital that led to four babies dying in childbirth. The program featured the story of Roisin and Mark Molloy from Tullamore, County Offaly, whose son Mark died shortly after being delivered on 24th January 2012. Medical staff at the hospital initially failed to inform the Molloys of the reason for their son´s death or conduct an investigation into the circumstances of his delivery. It was only after a four-month battle against the hospital authorities that the HSE acknowledged there had been signs of life when Mark was born and an investigation was initiated. The investigation took over twenty months to complete – a “lamentable delay” according to Dr Crowley – during which time the Molloys were fed misinformation by HSE officials. Among the things the Molloys were told was that childbirth deaths at the hospital were very rare; but when a subsequent independent clinical review reported “failures in the standard of care provided were casually linked to the foetal hypoxia damage that occurred [and the death of baby Mark]” it became clear that their son had been the victim of hospital childbirth medical negligence and the Midland Regional Hospital issued the Molloy´s with an apology. 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. The story found its way to the RTE Investigation Unit, who found two more examples of hospital childbirth medical negligence in which children had died, an investigation had been conducted, but the parents were never informed of the outcome. Among the four instances of children dying shortly after birth, investigators discovered that, although sub-standard care had been identified during the investigation into Mark Molloy´s death, no measures had been taken to deal with the shortcomings, and that the same mistakes had been repeated in the deaths of the other three children. It was also explained in the program that, in order to provide a “safe” level of service, the HSE recommends a ratio of one midwife for each twenty-eight women in the later stages of pregnancy. At the Midland Regional Hospital in Portlaoise there was a ratio of one midwife to seventy-five expectant mothers – a situation which resulted in “a lack of understanding of a deteriorating condition leading to a failure to seek timely medical assistance”. RTE investigators were shown a copy of a letter written in 2006 by midwifery staff to the then Minister for Finance Brian Cowen and Minister for Health Mary Harney in which concern was expressed over staffing levels at the hospital. The letter said a “real fear” existed that a mother or baby would die before staffing issues were addressed and that the situation had been made clear to the management at the hospital, but no action had been taken. Speaking on the Today radio program, the current Minister for Health James Reilly said that the hospital childbirth medical negligence at Portlaoise Hospital was “utterly unacceptable”, and that he planned to conduct a further investigation into the failings of care and the deception that the parents of the dead children had experienced.“I have asked the Chief Medical Officer to give me a report. It won’t take long and I will take action to make sure that this never happens again. I have put great emphasis on this.”

A High Court judge has approved a settlement of hospital negligence compensation for death following childbirth after hearing the tragic story of Dhara Kivlehan, who died shortly after giving birth to her first child. Dhara (29) had been admitted to Sligo General Hospital on 20th September 2010 for the delivery of her first child – Dior. At the time of her admission, she was two weeks passed her due date and exhibiting symptoms consistent with pre-eclampsia – high blood pressure and fluid retention around the feet and ankles (oedema). Blood test conducted on Dhara showed that she had abnormal liver and kidney function (a further symptom of pre-eclampsia), but the results of the blood test were not communicated to Dhara´s doctors for a further twelve hours. The morning following her admission, Dhara gave birth to her son, and was transferred to a side room. It was during Dhara´s thirty-six hours in the side room that her condition deteriorated and she was transferred to the Intensive Care Unit at Sligo General Hospital at 4.45pm the day after giving birth. At 11.00pm that night, Dhara´s condition became critical, and she was air-lifted to the Royal Victoria Hospital in Belfast, where she died of multiple organ failure four days later. Dhara´s husband – Michael Kivlehan from Dromahair, County Sligo – believed that the treatment Dhara had received in the side room of the maternity unit had been inadequate as his wife´s condition deteriorated, and made a claim for hospital negligence compensation for death following childbirth against the Health Service Executive (HSE). The HSE denied that there had been a failure by the Sligo General Hospital to acknowledge the significance and severity of Dhara´s deterioration or to treat her appropriately, and a trial date was scheduled for the case to be heard in court. However, shortly before the family´s claim for hospital negligence compensation for death following childbirth was due to be heard, the HSE admitted that there had been shortcomings in the care provided for Dhara and a settlement of hospital negligence compensation was negotiated. At the High Court in Dublin, Ms Justice Mary Irvine heard an apology from the HSE read out to the family before approving the agreed settlement of €800,000. The judge expressed her sympathy to Michael and Dior – who were in court for the approval hearing – but she also criticised the HSE for “holding out until almost the bitter end” before admitting liability and for causing the family unnecessary distress.

A High Court judge has approved the settlement of a claim against the HSE for cerebral palsy and criticised both the HSE and State Claims Agency for taking so long to resolve the case. Dylan Gaffney (6) from Kilcohan Park in Waterford was born at Waterford Regional Hospital on July 22nd 2007, in a poor condition after an emergency Caesarean Section had been performed on his mother – Jean – and with no paediatrician immediately available to provide adequate resuscitation. Jean Gaffney had previously requested a Caesarean Section delivery for Dylan, as her first daughter had been born by emergency C-Section after 51 hours of labour, and she had miscarried a second child. Her obstetrician had dissuaded her from having one, despite an ultrasound two days before Dylan´s birth indicating that he weighed nine pounds, four ounces. The ultrasound had been conducted after Jean had attended the Waterford Regional Hospital on July 20th because she believed her waters had broken. She was given an antenatal appointment for five days later but, on the morning of the 22nd, went into spontaneous labour and was admitted into the hospital. Jean was administered oxytocic – a drug to stimulate contractions – and told to commence pushing. According to Jean´s solicitor at the High Court, this was entirely inappropriate in the circumstances and a Caesarean should have been performed straight away. Instead, medical staff at the hospital waited until after 2.00pm in the afternoon to deliver Dylan. When Dylan was eventually resuscitated, he had been denied oxygen in the womb and was diagnosed with cerebral palsy and other injuries. After speaking with a solicitor, Jean made a claim against the HSE for cerebral palsy compensation in her son´s behalf, and wrote to the State Claims Agency in June 2009 with evidence of negligence compiled by an independent medical expert. Despite the evidence clearly showing that Dylan´s birth injuries were attributable to negligence before, during and after his delivery, the State Claims Agency denied everything and refused to consider Jean´s claim against the HSE for cerebral palsy. Ultimately, court proceedings had to be issued while Jean and her partner – Thomas Hayes – put their lives aside to care for Dylan. It was only shortly before Jean´s claim against the HSE for cerebral palsy was due to be heard that liability was admitted and discussions started to agree a financial settlement. At the High Court in Dublin, Ms Justice Mary Irvine heard that an agreement had been reached for Dylan to receive a lump sum payment of €8.5 million, as a more beneficial structured payment system was not yet available. The judge approved the settlement, but criticised the conduct of the Health Service Executive and State Claims Agency for the delay in admitting liability, and causing additional stress for Dylan and his family. She said that this was the second case within a week where the actions of the HSE and State Claims Agency were “highly regrettable”.

The Government has appointed Judge Yvonne Murphy to work out a solution to the issue of claims for symphysiotomy injury compensation following its U-turn on extending the Statute of Limitations. Dr James Reilly – the Minister for Health – announced this week in a press conference that Judge Yvonne Murphy has been asked to compile options for women who wish to make claims for symphysiotomy injury compensation. Around 300 women survive who underwent the controversial childbirth procedure in Irish hospitals between 1940 and 1990 – many of whom now have difficulty in walking, suffer chronic pain and incontinence as a result. Judge Murphy has been asked to look at feasible compensation options for review in February 2014, to compensate the women for the pain they experienced at the time of the symphysiotomy and throughout the rest of their lives. The Minister said that the Government would contribute to an ex gratia scheme if that was a recommended option , and it is believed that Judge Murphy will be speaking with insurance companies to explore whether they would contribute towards such a scheme. Originally the Government planned to allow a Private Members Bill introduced by Sinn Féin’s Health Spokesman Caoimhghín Ó Caoláin through the Dáil, which would have enabled a one-year window for the women claims for symphysiotomy injury compensation. However legal advisors told the Government that, by offering a window in the Statute of Limitations, they could face a legal challenge from the insurance companies who would have been liable for compensating the women and the support for the Bill was withdrawn. Caoimhghín Ó Caoláin criticised plans to keep the statute of limitations in place and said “The type of scheme outlined in the terms of reference offers the women no prospect of adequate compensation for what was so barbarically done to them nor the choice to pursue their rights in the courts.” However Tom Moran – Chairman of the support group Survivors of Symphysiotomy Ltd – welcomed the prospect of his members being able to resolve their claims for symphysiotomy injury compensation. “We welcome this decision to appoint the judge and we hope it leads to women finally being given a chance of some kind of closure.”

A twelve year old girl is to receive €2.3 million compensation for cerebral palsy due to a mismanaged birth after an interim settlement was approved at the High Court. Mary Conroy was heavily pregnant with her first child when she attended the Midland Regional Hospital in Portloaise on 10th November 2001 believing that her waters had broken. After being reassured that they had not, and everything was fine, Mary was sent home. On 13th November, Mary then attended the clinic of her personal consultant obstetrician – Dr John Corristine – and, following an ultrasound, insisted she be admitted into hospital. A CTG scan at the Midland Regional Hospital failed to show any sign of contractions, and Mary was advised to take a bath – but no hot water was available at the hospital – so Dr Corristine ordered that medicine should be administered to help induce labour. Mary gave birth to her daughter – Roisin – the following morning, but Roisin suffered seizures shortly after her birth and was transferred to a hospital in Dublin with adequate neo-natal facilities. However, Roisin failed to improve and was diagnosed with dyskinetic cerebral palsy. As a result of the injuries suffered prior to her birth, Roisin (now 12 years old) is permanently disabled and can only communicate through her eyes. Mary Conroy blamed herself for Roisin´s injuries, and insisted on having two further children delivered by Caesarean Section. Mary and Kevin Conroy both gave up their jobs to care for their daughter; believing for many years that nothing could have been done to prevent Roisin´s condition and that they had been “just unlucky”. However, after speaking with a solicitor – who initiated an investigation into the circumstances prior to Roisin´s birth – the couple found out that Roisin was entitled to compensation for cerebral palsy due to a mismanaged birth. A claim on Roisin´s behalf was made in 2011, but it was almost two years later – and weeks before the compensation claim for cerebral palsy due to a mismanaged birth was due to be heard in court – that Dr Corristine and the Health Service Executive (HSE) admitted liability for Roisin´s birth injuries. An interim settlement of compensation for cerebral palsy due to a mismanaged birth was negotiated that would see Roisin´s family receive an initial compensation payment of €2.3 million, with another assessment made of Roisin´s needs in two years time if a structure compensation system has not been introduced. The settlement was approved by Ms Justice Mary Irvine after the High Court had heard an apology read to the family by Dr Corristine and a representative of the HSE. In it both defendants said that “neither this apology nor the financial compensation granted by the court can negate the continuing heartache that the Conroy family must feel every day and appreciate that this continues to be a very difficult time for them.”

A couple, who alleged that their consultant gynaecologist had mismanaged the birth of their child, have resolved their claim for nervous shock over the death of their baby in an out-of-court settlement. Jane Farren and Feidhlimidh Wrafter from Rathgar, Dublin, made their claim for nervous shock over the death of their baby, Molly, who died on October 16th 2008 after being delivered in an emergency Caesarean Section. Jane had been admitted to the Rotunda Hospital in Dublin on October 15th after a spontaneous membrane rupture. She was administered Syntocinon to help induce labour and, at 3.45 am the following morning, was transferred to theatre to attempt a vacuum delivery. Molly was born half an hour later by C-Section, but could not be resuscitated and died. The couple alleged that their consultant gynaecologist and obstetrician Professor Fergal Malone had failed to properly manage the labour, delivery and birth of their child, and that staff at the Rotunda Hospital had failed to identify abnormalities in the foetal heart rate in a timely manner, which would have led to Molly being born earlier and possibly surviving. The couple also claimed that they were misinformed during the labour and delivery process, and led to believe after Molly´s death that there was nothing that could have been done to prevent it. Jane and Feidhlimidh also explored the possibility that Molly´s death could have been due to a genetic problem or a pre-labour trauma, despite the couple already having two perfectly healthy children. Professor Malone and the Rotunda Hospital denied that mistakes had been made which resulted in Molly´s death but, shortly before a scheduled hearing at the High Court, it was announced that the claim for nervous shock over the death of a baby had been settled for €150,000 without admission of liability, and that the case could be struck out.

A High Court judge has approved a second interim payment of compensation for cerebral palsy due to consultant negligence, as a structured system for the payment of compensation in Ireland has not been introduced. Two years ago, the Sheehan family from Mallow in County Cork were awarded an interim settlement of €1.9 million in respect of their eight-year-old daughter, Isabelle, who was born with severe paraplegic cerebral palsy after the consultant paediatrician treating Isabelle´s mother failed to act on blood test results which revealed a conflict of antibodies. The consultant paediatrician – Dr David Corr – admitted that he had made a mistake in the management of Catherine Sheehan´s pregnancy, which led to Isabelle´s terrible injuries when she was born at the Bon Secours Maternity Hospital in November 2004, and acknowledged that he should have referred Catherine to an expert in foetal medicine. After the initial settlement hearing, Mr Justice Iarfhlaith O’Neill approved the settlement of compensation for cerebral palsy due to consultant negligence and adjourned Isabelle´s case for two years to allow for the introduction of a structured system for the payment of compensation when a plaintiff has sustained lifelong injuries. As no structured system for the payment of compensation has yet been introduced, Isabelle´s case was heard again at the High Court by Mr Justice Kevin Cross; who was told that a further interim settlement of compensation for cerebral palsy due to consultant negligence had been agreed, which would pay for the care that Isabelle needs for a further two years. Mr Justice Kevin Cross approved the interim settlement of €635,000, after hearing that Isabelle was keeping up with the other children at her mainstream school and that she was a bright and intelligent little girl. The judge wished Isabelle a very good future and adjourned her case for another two years.

We have updated our medical negligence claims information page so that it is more comprehensive than ever before and offers advice on the procedures that need to be completed prior to claiming compensation for medical negligence in Ireland. As ever, the information we provide about medical negligence claims is no substitute for speaking directly with an experienced solicitor and, if you believe that you – or somebody close to you – has suffered a loss, an injury or the avoidable deterioration of an existing condition, which could have been prevented if you had received an acceptable standard of care, you are advised to discuss your individual situation with a solicitor without delay. You can visit our revised page containing medical negligence claims information by clicking on the link below: >> Medical Negligence Claims <<

A Circuit Civil Court judge has approved a settlement in a pre-birth injuries compensation claim after an agreement was negotiated between the two parties involved. Judge Matthew Deery approved the settlement after hearing how Aoife Sheehan (14) from Rathfarnham in Dublin was delivered prematurely at the Coombe Hospital in Dublin on 15th April 1999 at only thirty-six weeks. It had been alleged in the claim for pre-birth injuries compensation that Aoife had been born prematurely due to her mother – Martina Sheehan – having been involved in a car crash two days earlier which was responsible for the early onset of her labour. After her birth, Aoife suffered from respiratory distress syndrome and was transferred to the intensive care unit where a ventilator was used to control her breathing. Even when it was felt safe to remove the ventilator, Aoife remained in the intensive care unit for a further three weeks. Through her mother, Aoife made a pre-birth injuries compensation claim against the driver of the car Martina Sheehan had been in collision with – Elaine O’Connor, also from Rathfarnham – alleging that had the accident not occurred, Aoife would not have been born prematurely and suffered from respiratory distress. Insurers for Ms O´Connor denied their policyholder´s liability and claimed that there was no proof that the car accident was the cause of the early onset of labour and that pre-term babies were more pre-disposed to respiratory distress. They also stated that, as Aoife was not born at the time of the accident, she was ineligible to receive compensation for her pre-birth injuries. However, after protracted negotiations a settlement of the pre-birth injuries compensation claim was agreed that would see Aoife receiving €17,800. Approving the settlement, Judge Deery said that – given the circumstances and difficulties proving liability – the settlement was a good one.

A claim for cerebral palsy compensation has been adjourned for two years after an interim settlement of compensation for a thirteen-year-old boy was approved in the High Court. Ryan Brennan from Cahir, County Tipperary sustained irreversible brain damage during his birth at St. Joseph´s Hospital in Clonmel in January 2000; an injury which his parents – Lorraine and Raymond Brennan – believe was due to a failure to act by the hospital´s consultant obstetrician – Dr Brendan Powell. The Brennans alleged in their claim for cerebral injury compensation that abnormalities had been discovered in Ryan´s heart rate tracing hours before he was delivered, but no action had been taken by the doctor or staff at the hospital. Ryan had to be resuscitated after he was born and throughout the following day suffered seizures. Dr Powell and the Health Service Executive (HSE) – acting on behalf of St. Joseph´s Hospital – denied responsibility for Ryan´s injuries and the Brennans claim for cerebral injury compensation on the grounds of negligence, breach of duty and breach of contract However, Ms Justice Mary Irvine at the High Court in Dublin was told that an interim compensation settlement of 1.7million €uros had been agreed with the HSE without admission of liability to provide for Ryan´s immediate care and that the claim against Dr Powell could be struck out. After approving the interim compensation settlement, Ms Justice Mary Irvine adjourned the case for two years to allow reports on Ryan´s future requirements to be conducted and to allow time for the possible introduction of a periodic payment system to replace the current lump sum system of paying compensation for catastrophic injuries.