The Supreme Court has upheld a medical negligence finding against St James’s Hospital and extended liability to consultant physician Dr Michael Buckley over the treatment of Joseph Wolfe before his death in 1991.
Mr Wolfe died at St James’s Hospital from a rare tumour known as a phaeochromocytoma, or “phaeo”, which can release excessive adrenaline and prove fatal if undetected.
His widow, Carol Wolfe, argued that doctors should have diagnosed the tumour from a combination of headaches, shaking, sweating and other symptoms. The High Court rejected that main allegation but found negligence because recurring episodes described as panic attacks were not separately investigated.
The hospital appealed. Mrs Wolfe cross-appealed against the rejection of the wider failure-to-diagnose claim and against the dismissal of her case against Dr Buckley.
Mr Justice Geoghegan held that the High Court was entitled to find negligence arising from the events of 1991. Mr Wolfe had specifically told Dr Buckley that he wanted treatment for the panic attacks rather than abdominal pain. Dr Buckley planned to review the issue after screening tests, but a peptic ulcer was then discovered and Mr Wolfe was later discharged by another doctor without the panic attacks being investigated.
The Supreme Court found that this did not excuse the failure. It held that Dr Buckley had a duty to ensure the panic attacks were followed up and that the High Court was entitled to infer that proper investigation would probably have led to discovery of the tumour.
However, the court rejected the broader claim that doctors should have diagnosed a phaeo earlier simply from the combination of symptoms. Mr Wolfe repeatedly had normal blood pressure, making the already rare condition exceptionally difficult to identify.
The hospital’s appeal was dismissed. Mrs Wolfe’s cross-appeal succeeded only to the extent that Dr Buckley was also found negligent, leaving judgment against both him and St James’s Hospital.