The High Court has ordered the Health Service Executive, Dr Dermot Stones and the National Maternity Hospital to contribute one third each following a settlement in a case concerning severe brain injury to Jade Keane as an infant.
Mr Justice Ryan delivered the judgment on 27 May 2011. The court was deciding a dispute between the defendants about how to share responsibility for the settlement; it was not assessing damages for Jade. The HSE and the hospital had settled her claim for €4.75 million after seven days of hearing. The settlement had been approved by O’Neill J, and Dr Stones’s representatives accepted it was reasonable. Jade had no further part in the contribution dispute.
Jade was born on 21 March 2001 with hydrocephalus, a build-up of fluid in the brain. The judgment said treatment during a critical period of about eight or nine weeks after birth could have prevented all or nearly all of her disabilities. A shunt was inserted on 11 June, but by then pressure had caused severe brain damage.
The hospital admitted negligence over the newborn assessment by Dr Christine Endig. She recorded Jade’s head circumference as 39 centimetres, a measurement the judgment said was grossly abnormal, but did not refer her for specialist assessment. A separate hospital entry incorrectly recorded 35 centimetres in the discharge summary sent to the public health nursing service and Dr Stones.
The HSE was responsible for the public health nurses. The judgment found repeated failures to recognise or act on Jade’s unusually large head. Nurse Anne Marie Lee suspected hydrocephalus during a clinic visit on 10 May but did not ensure adequate follow-up. The court also found fault in the subsequent handling of the case by Nurse Anne Marie Callery.
Dr Stones admitted failing to appreciate the significance of Jade’s head size at her six-week check-up on 30 April and at an appointment on 16 May. The judge accepted evidence from Jade’s mother, Gillian Keane, that she raised concerns about the child’s head size, feeding and increased sleep on 30 April and was reassured. The court was not satisfied that Dr Stones ignored a specific complaint about head size at a later visit on 28 May, and did not find that he had told the family the head shape was caused by the ventouse delivery.
Applying the Civil Liability Act 1961, the court rejected the hospital’s argument that later negligence had displaced its responsibility. Justice Ryan assessed fault by the extent each defendant departed from the expected standard of care. He found the hospital, the HSE and Dr Stones equally blameworthy and ordered each to bear one third of the contribution. The judgment did not specify a separate euro amount payable by each defendant.