The High Court has dismissed a woman’s clinical negligence claim against Coombe Women and Infants University Hospital and the Health Service Executive, finding no negligence in her care following two post-partum haemorrhages in 2019.
In a judgment delivered on 8 July 2025, Ms Justice Emily Egan said the plaintiff experienced a primary haemorrhage after giving birth at the Coombe and a secondary haemorrhage in the weeks that followed. The cause of both was retained products of conception. The plaintiff alleged that the Coombe failed to properly diagnose and treat the first haemorrhage, and that Midland Regional Hospital, Portlaoise, failed to diagnose and manage the later bleeding in a timely way.
The court considered concerns about the Coombe’s response to blood loss during and after delivery. The records included conflicting blood-pressure readings at 2am: one reading was very low, while two recorded around the same time were normal. The judge found that the plaintiff’s blood loss had probably been underestimated, but that she responded quickly to treatment, her bleeding was controlled and her condition stabilised. On the evidence, the care provided was reasonable, and the later bleeding episodes could not be shown to have been preventable by earlier escalation.
The plaintiff also said her waters were broken without her consent and that she was denied an epidural. The judge accepted the midwife’s evidence that she routinely sought consent for both an examination and artificial rupture of the membranes. The epidural was not administered because labour progressed quickly and delivery occurred before it could be given; the plaintiff’s experts did not criticise that decision. The court found no breach of care on either issue.
At the Portlaoise hospital, clinicians initially treated the plaintiff for a possible uterine infection and used medication intended to help expel clots or retained tissue. The court found that conservative management was a reasonable clinical option given the risks of surgery soon after delivery. Although a planned follow-up ultrasound was not arranged, the plaintiff returned to hospital before the two-week period had passed, and the judge found that an earlier scan was unlikely to have reliably distinguished a clot from retained tissue. On 26 November, management options were discussed; the plaintiff agreed to another week of conservative treatment. Surgery to remove retained tissue was performed on 4 December.
The judge also found that the plaintiff had not established that, if offered surgery earlier, she would have chosen it. She was not satisfied that the plaintiff’s adjustment disorder was caused by negligence: the psychiatric evidence attributed it to the eventual need for surgery, which the judge found was unavoidable regardless of the hospitals’ actions. The court dismissed the claim.