The Supreme Court has set aside a High Court finding that St. James’s Hospital was liable in negligence for a patient’s shoulder injury and ordered a new trial on liability. It did not decide whether the hospital was negligent or determine the patient’s damages.
The appeal concerned an operation at St. James’s Hospital in December 1996. The patient, Christopher Doherty, said he developed severe pain and lasting disability in his right shoulder and arm after a Nissen fundoplication operation. His case was that he suffered a traction injury to the brachial plexus while under anaesthetic. The hospital’s expert evidence attributed his condition to brachial neuritis instead.
The High Court accepted the traction injury explanation, dismissed the claim against the surgeon and found the hospital liable. The trial judge relied on the principle of res ipsa loquitur, under which the circumstances of an injury may provide a prima facie case requiring a defendant to respond. He considered that the hospital had not shown that the injury occurred without negligence, in part because staff could not recall the specific operation and some staff who had been present did not testify.
Delivering the Supreme Court judgment on 15 July 2004, Chief Justice Keane said the trial judge was entitled to prefer the patient’s account, supported by his wife and Father Flanagan, that he had severe pain and restricted movement soon after the operation. The judgment also described the absence of hospital records of those complaints as reflecting, at best, a “singularly inadequate system of record keeping”.
But the Supreme Court held that the trial judge had erred by deciding between the competing medical explanations without weighing hospital evidence about the procedures normally used during the operation and the evidence that staff had no recollection of those procedures being departed from. The court said that lack of specific memory did not, by itself, prevent the hospital from showing that it had taken proper care. The trial judge had imposed an unreasonably high burden of proof and gave too much weight to the absence of some staff witnesses, the court found.
The Supreme Court allowed the appeal, set aside the High Court order and substituted an order for a new trial. The judgment leaves the question of liability unresolved; the source records no decision on damages.