Birth disability case settled with €500,000 payout

A SETTLEMENT of €500,000, plus legal costs, has been approved by the High Court against consultant psychiatrist Prof Patricia Casey and consultant obstetrician Dr Mary Holohan in the case of a child born with disabilities allegedly caused by prescription drugs taken by her psychiatrically ill mother during pregnancy.

The settlement in the case of Rebecca McGillin, now aged eight, is without admission of liability by either Prof Casey, practising out of of the Mater hospital, or Dr Holohan, practising out of the Rotunda Hospital.

They had denied all claims against them, including of negligence in their treatment of the child’s mother, Lisa McGillin, whose separate action also settled yesterday.

The court heard Ms McGillin had been treated by Prof Casey since 1994 and had been diagnosed with mild bipolar disorder and depression.

Her medication prior to and for certain periods during her pregnancy included Lithium, used as a mood stabiliser, and Epilim, an anti-convulsant primarily used to treat epilepsy but also used in the treatment of depression.

The active ingredient in Epilim is sodium valproate.

In proceedings that opened a week ago, it was alleged both doctors should have ensured Ms McGillin was taken off Lithium and Epilim in pregnancy. Ms McGillin became pregnant in July 2000 after being treated by Dr Holohan for about six months with a view to improving her fertility chances.

Ms McGillin was on both drugs before her pregnancy and also took both at some stages in her pregnancy, the court heard.

In evidence, Ms McGillin said she went off Lithium for most of the first trimester but resumed taking it before the end of that 12- week period because she had a relapse of her illness. She also said she ceased taking all drugs, including Epilim, after four months into her pregnancy, but that claim was disputed.

Approving the settlement of Rebecca McGillin’s case yesterday, the president of the High Court Mr Justice Nicholas Kearns described it as a “good” settlement and wished the child and her family well into the future.

The judge was told by Aongus Ó Brolcháin SC, for Rebecca, that the separate action by Ms McGillin against Prof Casey and Dr Holohan had also been settled without admission of liability and could be struck out with an order for taxation of Ms McGillin’s costs.

Mr Justice Kearns, who was approving the settlement, noted that Mr Justice John Quirke, who heard the case over four days, had made it clear there was no question of the mother being to blame.

The judge told Barry McGillin, father of Rebecca, that he had looked at the medical reports in the case and regarded the settlement as a good one which he was happy to approve. Rebecca was very lucky to have parents who were so devoted to her, he added. Mr McGillin said he was happy with the settlement as it protected Rebecca.

Rebecca, now living in Omagh, Co Tyrone, was born in April 2001 with a deformed hand, thin lips, problems with balance and other features of sodium valproate syndrome. She was described as a bright, cheerful, attractive little girl whose mental capacity is not affected by her condition and as being of above-average intelligence.

In the action brought on her behalf, it was alleged the injuries were a result of negligent treatment of her mother by Prof Casey and Dr Holohan relating to the medication prescribed for Ms McGillin.

In evidence, Ms McGillin said she had trusted both doctors, particularly Prof Casey, and was never advised by either to cease taking Epilim during pregnancy.

While agreeing she was advised by Prof Casey of certain risks from Lithium in the first trimester, she said she was told by both defendants any risk from Epilim would be negated by taking a high dose of folic acid.

The court was told that Prof Casey would say she had advised Ms McGillin, before and during her pregnancy, about the risks from certain drugs and had sent her documents to that effect in September 1998 and August 2000.

Prof Casey would also say she had advised Ms McGillin there were risks to herself should she cease her medication and risks to the foetus from the medication, her counsel, Murray McGrath SC, said.

The court also heard that Dr Holohan’s defence would be that she had outlined risks from both Epilim and Lithium, including risks of congenital heart defects, cleft palate and neural tube defects.

Both defendants strongly disputed the claim they had advised a high dose of folic acid would negate any risk from Epilim.