The High Court has quashed the Nursing and Midwifery Board of Ireland’s decision to erase two nurses from the register and directed it to reconsider the sanction. The court did not overturn the findings of professional misconduct or substitute a penalty of its own.
The case arose from the death of an elderly patient, Hannah Comber, in a hospital on 22 June 2006. A Fitness to Practise Committee found both nurses guilty of professional misconduct and recommended censure. The nurses did not challenge those findings in the High Court; they challenged the Board’s decision to impose the more severe sanction of erasure in March 2015.
The court described the misconduct as serious and at the upper end of the scale. It involved failures concerning care, records and the passing on of relevant information after the patient’s unexpected death. The findings differed between the nurses. One was found to have failed to continue CPR until medical assistance arrived, keep an adequate record, inform relevant people of the circumstances, and provide inaccurate or untrue information in an initial Garda statement. The other was found to have failed to make an adequate record, ensure the patient was properly observed when the care assistant might be asleep, and pass on relevant information. Each nurse was also found not guilty of other allegations.
The Board said censure was not commensurate with the seriousness of the proven misconduct. The court accepted that assessment of seriousness, but said the Board’s brief reference to having considered mitigating factors did not establish that it had adequately weighed them. Those factors included the nurses’ clean records before the incident, the once-off nature of the conduct, their insight into shortcomings in the documentation, the absence of a hospital policy for unexpected deaths, and delay in the Board process. The court considered the first four years of that process unreasonably long and said that period should have been considered in mitigation.
The court also held that the 2015 Board meeting required a quorum of 12 under the Nurses Act 1985, although only nine members attended. However, it ruled that the nurses were estopped from relying on that issue because it had not been raised at the hearing, where the number present was apparent.
The court concluded it could not be satisfied that the Board had approached sanction with adequate regard to mitigation. It quashed the erasure decision and directed the Board to reconsider sanction in light of the judgment. It did not decide what sanction should follow; that decision remains with the Board.