The High Court has dismissed Eileen Tynan’s personal injury claim against Bon Secours Health System Company Limited and consultant cardiologist Heiko Kindler over a pacemaker procedure at the Bon Secours Hospital in Cork in July 2018.
In a judgment delivered on 11 February 2025, Mr Justice Paul Coffey found that the anaesthesia and pain relief were adequate to prevent avoidable pain from physical trauma. He found that Ms Tynan complained of pain once, at about 11.04am, while Dr Kindler was accessing and dilating a vein. The complaint was promptly treated with additional local anaesthetic and 25 micrograms of fentanyl, the court found.
The judge preferred Dr Kindler’s account to Ms Tynan’s evidence that she endured severe pain throughout the procedure, repeatedly asked for it to stop and was ignored. He found she did not make repeated complaints of significant pain and did not cry audibly and intensely during the procedure. The court also found she became tearful before it ended and experienced anxiety and some subjective sense of trauma, but that the hospital team did not know she was anxious or tearful beneath the drape.
The court rejected a claim that Dr Kindler breached his duty by failing to discuss or offer midazolam before the procedure. It found its use was a matter of clinical judgment and that the hospital’s sedation policy did not apply in the circumstances. The judge also rejected the claim that staff should have given pre-procedure sedation because of anxiety allegedly caused by an earlier, unnecessary attempt to insert a second cannula. He found Ms Tynan had not shown that the incident made her anxious or that staff knew or ought to have known she was anxious.
The judgment identified a breach by the hospital: the pain reported at 11.04am should have been recorded in the nursing notes. The judge described this as a technical breach that did not itself cause injury. He found the absence of a note about the fentanyl’s effect was not, by itself, a breach of duty.
The judge said the only remaining possible liability issue—whether staff should have recognised tearfulness beneath the drape—had not been part of the pleaded case and had not been properly addressed in evidence. He also found the psychiatric evidence relied on a version of events that differed substantially from the facts he had found, leaving no reliable basis to assess causation or damages. He dismissed the claim.