The High Court found the National Maternity Hospital negligent for failing to tell a patient to return to hospital after she fainted the morning following a sterilisation operation. It dismissed her negligence claim against the surgeon, Professor Colm O’Herlihy.
In a judgment delivered on 26 February 2010, Mr Justice O’Keeffe held that the hospital breached its duty of care when staff advised the patient’s husband to give her more painkillers and wait after he called the morning after surgery. The judge accepted expert evidence that her faint was most likely caused by blood loss and that she should have been brought in immediately. Earlier assessment might have limited the blood loss and avoided the respiratory problems she later developed, the judge said.
The patient underwent laparoscopic tubal ligation at the hospital on 14 October 1997. A blood vessel was injured during the procedure, which the judge described as outside the experience of the surgeon and the experts who testified. The court found no negligence in causing that injury.
That afternoon, the patient vomited in a day-care-centre toilet and blood spattered from the wound near her navel. The judge accepted her account and found that nurse M. Jacob was told about the episode. The nurse recorded that the site was oozing and that the surgeon inserted a stitch before discharge, but did not investigate further or record details. The judge found that the nurse should have investigated the bleeding and that this failure breached the hospital’s duty of care. The missing information entitled the surgeon to proceed on the information he had, and the judge found his examination and treatment consistent with acceptable practice.
The patient’s husband called the hospital around midnight because she was in severe pain. Staff advised more painkillers, which enabled her to sleep. The judge found that the evidence did not establish negligence in that response. He also found that the patient had been adequately informed to contact the hospital if problems arose after discharge.
The next evening, after further bleeding, she was taken to hospital in a shocked condition. The surgeon performed a laparotomy to stop the bleeding. She later required intensive care at St Vincent’s Hospital.
The court awarded €60,000 in general damages to the date of judgment, €10,000 for future damages and agreed special damages. In assessing the award, the judge took account of the fact that even with earlier treatment, the patient would have had some permanent scarring. The judgment was against the hospital.