The Court of Appeal has upheld an order requiring two central issues in a child’s medical negligence action against the HSE to be decided before the remainder of the case.
The anonymised plaintiff, PT, was born at Hospital X on 18 February 2013 and later diagnosed with conditions including neurodevelopmental impairment and Autism Spectrum Disorder. Through his parents, he alleges that negligent obstetric, neonatal and paediatric care caused his injuries. The HSE denies negligence and disputes that the conditions alleged were caused by his care at birth.
In March 2025, the High Court directed a modular trial dealing first with two questions: whether staff failed to recognise that a cardiotocograph, or CTG, was recording the mother’s heart rate rather than the foetal heart rate, and whether there was a breach of duty in not intubating PT from 13:33 on the day of his birth.
PT appealed, arguing that evidence concerning the cause and severity of his injuries was closely connected to those issues. His side contended, among other things, that evidence of prolonged foetal distress and hypoxic ischaemic encephalopathy could support the allegation that the foetal heart rate had not been properly monitored.
The HSE argued that the two questions could be determined separately and that doing so could avoid weeks of unnecessary evidence if PT failed on either central liability issue.
Mr Justice Binchy, giving the Court of Appeal judgment, accepted there had been some weakness in the High Court’s explanation and that it had compared the proposed module with a full unitary trial rather than the already-agreed liability-only trial. However, he found those errors did not justify overturning the order.
The court held that the CTG issue was capable of being determined separately, that some saving of time and cost was clear, and that no specific prejudice had yet been established. It also noted that the trial judge retains flexibility to hear additional evidence or alter the procedure if fairness requires it.
The appeal was dismissed. The court’s preliminary view was that the HSE should receive its appeal costs, subject to further written submissions.