The High Court criticised the Mater Misericordiae University Hospital after a woman detained there under court orders was transferred to another hospital without the court being informed. Mr Justice Nolan accepted a personal undertaking from the Mater’s chief executive that no further breach of such orders would occur.
The woman, identified in the judgment only as CBA, has anorexia nervosa. The court had made orders under its inherent jurisdiction directing that she remain detained at the Mater pending further order. The judgment says her body mass index had been falling dramatically and she was close to death. The court had also made an order under section 27(1) of the Civil Law (Miscellaneous Provisions) Act 2008 prohibiting publication or broadcast of material that could identify her as a person with a medical condition.
The judge said the transfer breached the court order. Her guardian ad litem went to the Mater to meet her and was told she had been discharged the previous day. The guardian had not previously been informed of the transfer.
Dr C, one of the woman’s clinicians, told the court he had been on leave. Before leaving, he had spoken to a consultant at another hospital about resuming her care. During his absence, Dr B, who had also been involved in her care, contacted a member of Dr C’s team and said she was medically stable and no longer needed admission from a medical perspective. The judgment says the clinicians and hospital administration, apart from Dr C, appeared unaware of the court orders.
The judge said nothing had been done to inform the court between the transfer and the return hearing. He described the incident as a fundamental breakdown in hospital systems and said responsibility rested primarily with hospital management, while also saying Dr C should have told colleagues about the orders.
The hospital outlined proposed safeguards, including an alert on its bed-management system, discussion at nursing safety huddles and operations meetings, an internal audit and a standard procedure. A warning-sticker system for files concerning patients subject to High Court orders was also introduced after the court suggested it.
The judgment said the transfer had affected the woman’s trust and made her nervous, and that her BMI had been affected. The judge accepted the chief executive’s undertaking on her own behalf and on behalf of the hospital. He said a future breach could prompt applications for her attachment and committal, or for sequestration of hospital assets. The judgment did not make either application; it accepted the undertaking.