The High Court awarded Leo Green €96,403 in damages after finding that failures to investigate and treat a small bowel injury caused infection and contributed to a substantial abdominal hernia. Mr Justice Cross ruled that the action was not barred by the limitation period.
The court found that a full tear occurred during surgery on 11 December 2007 at the defendant hospital in Tallaght. The judge accepted evidence that the surgeon physically examined the bowel during that operation, but found that the examination did not reveal the tear. He concluded that negligence had not been established on that allegation.
The court reached a different conclusion about the care on 14 and 15 December. The patient had raised temperature, white cell count and CRP levels, which the judge found were significant signs of infection. After an examination showed that the colon repair was intact, the small bowel should have been investigated by CT scan or similar imaging, the judge said. He found that the failure to do so was negligent and that imaging would probably have revealed the leak, prompting an operation on 14 or 15 December.
Instead, a second operation took place on 19 December. The patient was critically ill, spent time in intensive care and later required another operation to close an ileostomy and remove the bag. The judge accepted expert evidence that earlier intervention would probably have avoided the stoma and bag and reduced the risk of the hernia. He found that the delay and ensuing infection were causally connected to the patient’s injuries.
The defendant relied on the two-year limitation period. The judge found that the patient knew he had a hernia but, after consulting a surgeon in 2009, had been advised that it was mainly due to longstanding abdominal muscle separation, with only a small contribution from the operation. The judge held that the patient could not have known the specific connection between his injuries and the failures to investigate and operate until the medical records or expert report identified it. The proceedings, begun in August 2012, were therefore not time-barred.
The court assessed general damages at €60,000 for pain and suffering to date and €35,000 for future pain and suffering. Special damages had been agreed at €1,403, bringing the total award to €96,403. The judgment assessed damages; the source does not state a separate costs order.