Man with profound brain injury settles case over alleged delayed diagnosis for €10 million

A 42-year-old man with a profound brain injury who sued over an alleged delay in the diagnosis of his tuberculosis meningitis has settled a High Court action for €10 million.

The man had two strokes 12 years ago and, as a result of the brain injury, he can never work again and now lives in a residential facility.

It was claimed that early diagnosis of the tuberculosis meningitis and prompt treatment with anti-tuberculosis triple or quadruple therapy would have led him to make a full recovery and would have avoided the strokes. All the man’s claims were denied.

He sued the HSE over the care he received between October 2009 and around January 2010 at Connolly Hospital in Blanchardstown, Dublin. He presented with back pain, weight loss and other symptoms and alleged a delay in the diagnosis of tuberculosis meningitis. His side contended that when he first presented to the hospital he did not have neck rigidity, which they say suggests his disease was in the early stages and eminently treatable.

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The settlement against the HSE is without an admission of liability.

The man’s counsel, Edward Walsh SC, instructed by Lucy Boyle of Tormeys Solicitors, told the court his client sustained a profound brain injury after having two strokes in April and November 2010.

He said the man began to develop back pain in September 2009 and that by October he could not walk or drive, so his mother brought him to the hospital’s emergency department. At that time the provisional diagnosis was thought to be sciatica and the man was prescribed painkillers and given a sick note for 10 days off work.

A lumbar MRI scan, carried out in a private capacity in October, was allegedly reported as normal. Counsel said it was their case that the scan in fact showed a 2.5cm mass and if read correctly alarm bells would have sounded and a tuberculosis meningitis diagnosis made.

He said the man lost 25kg over a number of months and at one stage suffered a blackout on the way to the cinema and later had hallucinations. There were indicators of underlying tuberculosis meningitis which should have warranted a multidisciplinary investigation, counsel said.

The man went back to the hospital on January 17th, 2010, and a five-day history of fever, headache, nausea and vomiting was recorded. Various tests were carried out and the man’s case was reviewed. On January 20th, he was transferred to Beaumont Hospital. A repeat lumbar puncture was performed the next day and TB meningitis was noted.

In the proceedings, it was claimed there was an alleged failure to have any regard to the fact that the man looked thin and had lost weight over a number of months. There was an alleged failure to have regard to the history of night sweats, malaise, nausea, headache as well as a history of confusion, disorientation and slurring.

By the evening of January 17th, 2010, there was an alleged failure to put the piece of information together to make tuberculosis a principle diagnosis and to start anti-tubercular treatment. There was an alleged failure to combine lumbar puncture results which showed a high level of protein with clinical information available which clearly pointed to tuberculosis meningitis, it was claimed. All the claims were denied.

Approving the settlement, Mr Justice Paul Coffey said it was fair and reasonable.