The High Court awarded a woman €502,700 after finding that a consultant physician and a hospital were negligent in aspects of their care for her ulcerative colitis. The judgment, delivered by Mr Justice John Quirke on 11 October 2007, found that failures in communication, hospital staffing, discharge advice and the response to an urgent call contributed to her suffering and the consequences of a perforated colon.
The plaintiff had been treated for ulcerative colitis from 1997. The court found that she was extremely ill when she attended hospital on 20 December 1999 and should have been admitted. Instead, she was sent home after examinations on 20 and 21 December. The judge found that the failure to provide appropriate care caused about nine days of severe, unnecessary pain and distress.
The court also found a serious failure by consultant Dr Long and the hospital to communicate and consult with the plaintiff and her family. That failure contributed to her deteriorating quality of life, distress and embarrassment, and her decision to leave school. The court found that the hospital failed to provide an appropriately qualified consultant physician or surgeon during her admission from 29 April to 2 May 2000. It also found that Difene was inappropriately prescribed during that admission, and that Dr Long negligently failed to review the hospital documentation and stop the prescription. The judge did not find, however, that Difene directly caused the perforation.
On discharge on 2 May, the plaintiff and her family were not told to contact the hospital immediately if her condition worsened. On the night of 8 May, her mother called the hospital seeking urgent help. The court accepted that she was told to give her daughter paracetamol and call the GP the next morning, rather than bring her to hospital or seek immediate medical care. The judge found that this advice was seriously negligent.
The court concluded that the plaintiff probably developed a toxic megacolon that perforated at about 10am on 9 May. It found that, with proper warnings and an appropriate response to the call, she would probably have been admitted more than 24 hours earlier and operated on sooner. Earlier treatment would probably have reduced the damage and complications. The court did not find that the decision to discharge her on 2 May was itself negligent.
The perforation led to emergency surgery, removal of most of the large bowel and an ileostomy, followed by serious infections and other complications. Two later attempts to form a pouch were unsuccessful. The court assessed damages at €125,000 for past general damages, €175,000 for future general damages, €25,000 for past loss of earnings, €150,000 for future loss of earnings and €27,700 for future medical expenses.
The judge attributed 35% of fault to Dr Long and 65% to the hospital, while noting that the apportionment was rudimentary and not based on scientifically reliable evidence. Judgment was entered for €502,700.