The Supreme Court has overturned a High Court finding of negligence against St James’s Hospital arising from the death of 33-year-old Joseph Wolfe from an exceptionally rare tumour.
Mr Wolfe died at the Dublin hospital in November 1991 from a phaeochromocytoma, an abdominal tumour that was discovered only after his death. The court heard that the condition occurs in roughly one to four people per million and that Mr Wolfe was unusual even among those patients because his blood pressure remained normal.
His widow, Carol Wolfe, brought a fatal injuries action against the hospital and consultants Michael Buckley and Donald Weir. The claim against Dr Weir was withdrawn at the outset.
Mr Wolfe had attended St James’s in 1989 with severe headaches, vomiting and shaking attacks. Tests did not identify the tumour. He returned in April 1991 complaining of abdominal pain and recurring panic attacks. An investigation then found an active duodenal ulcer, which was treated successfully. The tumour remained undetected.
The High Court rejected the central allegation that doctors were negligent in failing specifically to suspect and diagnose a phaeochromocytoma. It accepted medical evidence that, because Mr Wolfe was not hypertensive, the tumour was too remote a possibility to require investigation.
However, the trial judge separately found the hospital negligent for failing to investigate the panic attacks further, reasoning that additional abdominal testing would have revealed the tumour. He awarded Mrs Wolfe £112,429.
Mr Justice Fennelly, delivering judgment in the Supreme Court, held that this alternative finding was not supported by the evidence. The expert evidence favouring further abdominal investigation had been based on suspicion of a phaeochromocytoma, a theory the High Court had already rejected. There was also no expert evidence establishing that panic attacks, independently of suspected tumour, required the additional abdominal testing envisaged by the trial judge.
The Supreme Court therefore allowed the hospital’s appeal. Mrs Wolfe’s cross-appeal seeking findings of negligence on the tumour diagnosis issue and against Dr Buckley was dismissed.