The High Court has held a neurosurgeon liable for offering a patient cervical disc surgery without due regard to clinical signs that did not support a diagnosis of nerve-root compression. The court awarded €100,000 in general compensatory damages.
The case concerned a cervical discectomy performed on Hugh O’Neill by Daniel Rawluk at Blackrock Clinic on 12 January 2001. O’Neill had reported weakness and tremor in his left arm, reduced grip and difficulty with manual tasks, but no significant pain. An MRI showed a disc herniation at C5/6. Rawluk advised that surgery was an option, and the procedure went ahead after O’Neill considered whether to proceed.
O’Neill’s claim was that the operation should not have been undertaken and that it left him with neck pain and no improvement in his hand. He did not allege that the surgery itself had been performed incompetently, and the judge said the claim was not based on lack of informed consent. The proceedings also initially included a claim against neurologist David Moorhouse over an alleged failure to diagnose Parkinson’s disease. That part of the case was discontinued in 2005; the judgment said the later diagnosis was independent of the issues before the court.
The court heard differing expert evidence about whether the MRI showed clinically significant compression and whether surgery was indicated. The judge found the plaintiff’s expert witnesses more persuasive. He concluded that the tremor and hand weakness could not be attributed to nerve-root compression at C5/6: O’Neill had reported no significant pain and had increased, rather than impaired, reflexes.
Applying the test in *Dunne v National Maternity Hospital*, the judge found that the course taken was one no similarly qualified practitioner exercising ordinary care would have followed. He held Rawluk liable in damages.
In assessing compensation, the judge considered the surgery’s risks, the pain O’Neill experienced afterwards, the incision scar and the absence of tangible benefit. He also had to distinguish those effects from the later progression of Parkinson’s disease, which would have occurred independently. The court assessed the entirety of the claim at €100,000 and did not divide the award between past and future pain and suffering. The judgment does not specify a separate award for special damages.