Doctor and HSE found liable for boy's post-birth injuries

THE HIGH Court has ruled a consultant paediatrician and the HSE are both liable for an estimated €3 million damages to be paid to a young boy over delays in treating life-threatening serious intestinal injuries sustained after his birth at Tralee General Hospital.

Mr Justice John Quirke yesterday ruled the consultant paediatrician Dr Robert Fitzsimons must make a contribution of 75 per cent to the award while the hospital must pay 25 per cent.

The judge noted the defendants had on the ninth day of the trial expressly or implicitly acknowledge Paul Healy's injuries were caused by negligence or breach of duty of either or both of them, and a settlement was reached between the plaintiff and defendant, with the court to determine how liability should be apportioned.

The amount of damages for Paul Healy (9), who suffered necrotising enterocolitis, a serious bowel condition requiring continued medical care, was agreed between the defendants at an earlier stage and the issue to be determined by the court was liability.

Paul, through his mother Michelle Healy, of Knockanish, Tralee, had sued the HSE and Dr Fitzsimons, who provided paediatric care to the boy before, during and after his birth at the hospital on February 14th, 2000.

The judge ruled that Dr Fitzsimons's failure to refer the child for investigation, after his second instance of bile-stained vomiting, fell below the standard expected of a paediatrician, and was not consistent with approved medical practice here in 2000. If Dr Fitzsimons had referred Paul for investigation by 7pm on February 16th, Paul would probably not have suffered injury, he found. He said the hospital also failed to apply minimum standards required for observation of the child and was negligent and in breach of its duty of care to him.

The decision to discharge the child from hospital three days after his birth was unacceptable and wrong in circumstances of the child's weight loss, where the staff had not first satisfied themselves his bile-stained vomits were not due to an intestinal condition.

The staff also gave the child's mother "totally inappropriate" advice and instructions, he added. However, the staff were entitled to look to Dr Fitzsimons for direction and supervision, and he failed to provide that. On the evidence, the judge said he was satisfied both defendants were jointly and severally liable for the boy's injuries.

Earlier, the judge noted, while Paul appeared in excellent condition at birth, there had been a natural interference with the return of his foetal intestine from his physiological hernia to his abdominal cavity, and Paul was born with what is termed a malrotation.

It was not alleged the malrotation should have been detected at birth, but that Paul exhibited the classic symptoms of it and should have been treated as a surgical emergency. Instead, he was discharged on February 17th and readmitted the next evening where acute bowel obstruction was diagnosed.