The High Court found that a hospital resident medical officer negligently failed to investigate a patient’s worsening condition or alert his consultant, delaying emergency surgery by about 17 hours. The court awarded the patient €310,000 for pain and suffering and past care.
The judgment, delivered by Ms Justice Irvine on 1 April 2014, concerned Gerry Foley’s claim against Bon Secours Health System Limited, trading as Bon Secours Hospital Galway, and Dr John Nee. Mr Foley alleged that negligent care after an incisional hernia repair led to serious complications. The proceedings had initially also named the surgeon who performed the repair, but the claim against him was discontinued in January 2014.
Mr Foley was reviewed by Dr Kah Hoong Chang, the hospital’s resident medical officer, shortly after 6pm on 26 August 2007. He had developed worsening crampy abdominal pain, nausea and bloating. Dr Chang considered the cause to be a post-operative ileus and ordered fluids, no food and observation. The judge found that Mr Foley had already developed an anastomotic leak by that afternoon, though its presence was not then known to Dr Chang.
The court accepted evidence from Professor Michael Keighley about the symptoms and required standard of care. It found Dr Chang should have considered a leak, arranged an urgent chest X-ray and contacted Mr Nee about the deterioration. The judge concluded that the X-ray would have shown gas in the abdomen and that Mr Nee would have attended and begun surgery that evening. Instead, the leak was diagnosed the following morning. Mr Foley was transferred to University College Hospital Galway, where he underwent emergency surgery at about 2pm.
The judge found the delay significantly worsened Mr Foley’s outcome. The later operation was followed by a four-month period of serious illness, including intensive care, renal failure requiring dialysis, a tracheostomy and a major abdominal wound. The judgment also noted that Mr Foley would have required surgery for the leak even without negligence, and that several later health problems were not attributable to the defendants’ negligence.
The court dismissed the claim against Mr Nee at the close of the plaintiff’s case. It found that, even if his brief visit on 26 August fell short of the expected care, it would not have changed the outcome. The judge also found that Mr Foley’s 2009 retirement was due to his overall health, particularly a stroke, and made no award for loss of earnings or future care. The damages awarded were €200,000 for pain and suffering to date, €100,000 for future pain and suffering and €10,000 for past care.