The High Court dismissed the Health Service Executive’s application for contribution from Dr Nirmala Kondavetti in a medical negligence case concerning a boy’s birth at Sligo General Hospital in 1996. Mr Justice Fullam found that Dr Kondavetti was not at fault in her involvement in the management of labour and that her actions did not contribute to the injuries.
The judgment dealt only with the contribution claim brought by the HSE against Dr Kondavetti under section 27 of the Civil Liability Act 1961. The main action had already settled between the child and the defendants. That settlement included €1,755,000 and undertakings concerning future care. The court did not determine the settled claims or apportion responsibility between the HSE and the consultant obstetrician, Dr Carthage Carroll.
The boy suffered severe injuries associated with oxygen deprivation before birth and further injury after birth. The judgment records that he has spastic quadriplegia, is fully dependent on others for daily activities and has a significantly reduced life expectancy.
The court heard that a cardiotocograph (CTG) trace was abnormal from about 4.40am on 6 September. The labour ward midwife, Geraldine O’Brien, was responsible for interpreting the trace and communicating concerns to Dr Carroll, who was the consultant on call and in overall charge. Dr Kondavetti was a locum senior house officer (SHO), with no CTG training or experience when she began work in Ireland.
The court found that Ms O’Brien spoke to Dr Carroll at about 5.15am and was instructed to prepare for a Caesarean section. In a later call, she passed those instructions to Dr Kondavetti, who attended the labour ward, took bloods, obtained consent for the operation and completed other tasks. The court rejected the allegation that Dr Kondavetti instructed the midwife to stop the CTG. It also found that the CTG was not discussed in their call.
Dr Kondavetti recorded the trace as poorly reactive with a “sinusoidal pattern”, a description the court noted was wrong. It accepted evidence that she did not understand the significance of the readings and was acting under a Caesarean plan made by the consultant on information from the midwife. The experts agreed that, in those circumstances, it was not reasonable to expect the SHO to intervene. The court found that she performed her assigned tasks to the required standard and had no involvement in the later period of labour or the postnatal injury.
The court concluded that Dr Kondavetti’s actions did not contribute to the boy’s injuries and dismissed the HSE’s application for contribution.