The High Court dismissed Peter Dunne’s medical negligence action over surgery on his left middle finger, finding that he had not proved the 1997 operation was negligent. The court also concluded that the defendants had not established that the claim was time-barred.
Dunne was injured in October 1997 and underwent surgery at St. James’s Hospital on 2 November. A trainee surgeon, Mr. Ciarán McDonnell, removed the nail, trimmed bone, brought soft tissue over the bone and applied a skin graft. The remaining nail later grew in a curved shape, causing pain and difficulty using the finger. A second operation in September 1999 amputated the fingertip; Dunne did not allege negligence in that operation and returned to work several months later.
His expert, Mr. Ronald Evans, said the nail bed had been pulled over the fingertip during the first operation, making abnormal nail growth likely. He considered that the fingertip should instead have been shortened, as it was in the later operation. McDonnell, who had no specific recollection of the surgery, said the operation notes suggested that the skin graft was used to avoid pulling the nail bed into an abnormal position. The defendants’ expert, Mr. Michael Earley, considered the approach a reasonable choice among several accepted methods, given the aim of preserving finger length and the limited evidence favouring one technique.
Justice Michael Peart said the evidence did not establish, on the balance of probabilities, that McDonnell had pulled the nail bed forward. The court also found that using a skin graft was not, by itself, negligent, and that trying to preserve functional finger length was reasonable. It was not negligent for the trainee to operate after taking advice from a senior surgeon who was not physically present in the theatre. The judge concluded that the operation had not been proved negligent, even though its outcome required further surgery.
The defendants also argued that the claim was out of time. The judge found that Dunne’s awareness of problems with the finger and the possibility of further surgery did not, by themselves, give him the knowledge needed to bring a negligence claim. The evidence did not show unreasonable delay in obtaining expert advice, and the defendants had not established when they provided the medical records requested by his solicitor in March 1999. The limitation issue had not been ordered as a preliminary issue; the judge considered it alongside the merits. The action was dismissed against all defendants.