The High Court found that a symphysiotomy performed on Olivia Kearney after the birth of her son by caesarean section in 1969 was wholly unjustified, and awarded her €450,000 in general damages.
Mr Justice Ryan’s judgment, delivered on 23 March 2012, followed a trial of the claim against the first defendant, Eithne McQuillan, who was described as the nominee of the hospital’s owners and occupiers at the time. The claim against the North Eastern Health Board had been struck out before the hearing.
Ms Kearney was 18 when she gave birth at Our Lady of Lourdes Hospital in Drogheda. Labour had been induced, but it did not progress and the baby was in a position that prevented a vaginal delivery. The consultant obstetrician performed an emergency caesarean section. His operation note also recorded that a symphysiotomy—a division of the joint between the pubic bones—was performed before the wound was closed.
The case had earlier been struck out over delay, but the Supreme Court allowed Ms Kearney’s appeal after her claim was reformulated. At trial, the issue was whether there was a realistic medical reason for the symphysiotomy in the circumstances of 1969. The High Court was not deciding the earlier delay application again.
The plaintiff’s experts said the operation could not be justified without pelvic disproportion, meaning the baby’s head could not pass through the mother’s pelvis. The defence expert said the labour records might have raised that possibility for the obstetrician. The judge concluded that the evidence did not establish disproportion or a basis for diagnosing it. The hospital’s clinical report recorded “incoordinate uterine action” as the reason for the caesarean, and later pelvic measurements were normal. The judge also found that a minority view among Irish obstetricians favouring symphysiotomy after caesarean section did not establish a general and approved practice, and that the procedure had inherent defects.
On damages, the court accepted evidence that Ms Kearney had suffered long-term physical problems and that learning in 2002 that she had undergone the procedure contributed to a grave psychiatric illness. The defendant argued that the later psychiatric evidence should be excluded because of the way the claim had been reformulated. The judge rejected that argument, holding that the Supreme Court had dealt with liability, not damages.
The court assessed general damages at €300,000 for past loss and €150,000 for future loss. The judgment does not state a separate order for interest or costs.