The High Court dismissed a negligence claim brought by a 79-year-old man who suffered sciatic nerve damage during a right hip replacement in December 1995. The judge found that the plaintiff had not established that the surgeon or the Midland Health Board failed to use appropriate care.
The plaintiff underwent the operation at Tullamore Hospital on 21 December 1995. During the procedure, a spiral fracture developed in his femur while the surgeon was removing a trial prosthesis. The judgment states that this type of fracture can occur and is not, by itself, negligence. The surgeon used a clamp and plastic bands to hold the fracture while completing the replacement.
The plaintiff could not move his right leg after surgery. The surgeon re-explored the operation on 23 December and found a contusion, or bruise, to the sciatic nerve near the greater trochanter. The parties agreed that the contusion caused the plaintiff’s disability. The nerve could not be repaired, the judgment says.
The plaintiff alleged that the nerve was injured through contact with a clamp, forceps or instrument used to place the bands, or was trapped by the bands. The defendants denied liability and argued that traction during the operation could have caused the injury without negligence. Two orthopaedic experts gave evidence on the competing explanations.
The judge accepted the surgeon’s evidence that he had used the clamp, introducer and bands further down the femur, not near the greater trochanter. The judge was satisfied that the nerve injury was not caused by those instruments. Applying the stated test for medical negligence, the judge found the plaintiff had failed to prove that the defendants fell below the required standard of care. The judgment said the defendants’ account was more likely on the balance of probabilities.
The defendants also relied on the statute of limitations, arguing that the claim was out of time. The plaintiff’s plenary summons was issued on 6 January 1999. The judge rejected the limitation defence, concluding that the plaintiff could not reasonably have known the specific act alleged to constitute negligence during the relevant period. That ruling did not succeed the claim: after considering negligence, the court dismissed it.