A young boy would not be severely mentally and physically disabled except for the "substandard and negligent" management of his birth at the National Maternity Hospital in Dublin, a High Court judge found today in his judgment on the longest running birth injury case here.
The NMH is now facing a legal costs bill of Eu 4 million for the marathon 54 day case, plus an expected multi-million Euro award of damages, after Mr Justice Daniel Herbert found it was liable for the devastating injuries sustained by six-year-old Paul Fitzpatrick in the circumstances of his birth at the hospital on December 26th 2001.
The judgment was on the issue of liability only and the amount of damages will be assessed at a later hearing. Paul, who is wheelchair bound, and his parents, Ms Gilroy and Mr Paul Fitzpatrick, of St Catherine's Close, Carman Hall, Dublin, were in court for yesterday's decision, which took some four and a half hours to deliver.
In his 109 page decision, the judge found Paul should have been delivered some half an hour earlier than he was and, if that had occurred, he would not have sustained irreversible brain injury leaving him totally dependent for the rest of his life.
He found the hospital field to properly interpret the foetal heart record at and after 6.30 am on December 26th and, particularly after 7.10am, had failed to act correctly in light of that "very shocking" record. He found the child's brain injury began about 7.10am and continued occurring until he was delivered at 8.03am.
He found the damages occurred slowly but over a period of time of less than one hour prior to 8.03am. By 7.38am, Paul had already suffered irreversible brain injury and every minute after that time resulted in more injury.
The evidence indicated that, when Paul was born, he was initially considered to have been born dead, the judge noted. He found the hospital had particularly failed in not calling the obsetrical duty registrar, whom the judge noted was in a nearby room, between 7.10 and 7.12am; in not delivering Paul between 7.33 and 7.38am and in fact delivering him only at 8.03am; in not stopping the use of the delivery accelerant drug, Oxytocin; and in not telling Paul's parents he was in distress and needed to be delivered immediately.
He was satisfied hospital staff knew there was an emergency involving Paul since at least 7.13am, the judge said. The judge rejected claims by the hospital that the delay was excusable because of alleged untoward delay by Ms Gilroy in permitting a suction cup vaginal delivery and ruled there was no material or untoward delay by Ms Gilroy .
He also found Ms Gilroy was not told there was an emergency or that Paul was in distress and found that, if she had, she and her husband would have consented to whatever procedure was necessary.
He further ruled that Ms Gilroy's refusal of consent to an episiotomy (a surgical incision to enlarge the vagina intended to assist childbirth) or to a forceps asisted delivery would not have occurred but for the failure of a senior midwife and obsetricial registrar to tell Ms Gilroy and her husband "in plain and unequivocal terms" that Paul would die or suffer serious brain injury unless delivered immediately.
He accepted Ms Gilroy was told only that the baby was tired and that she was told this very shortly before delivery.
It was negligent and "seriously substandard" for the hospital not to have told the parents of the seriousness of the situation, he ruled. He also rejected entirely the idea that the parents were "difficult" to deal with or that they should be considered to be at fault because they did not instantly abandon what they had indicated in their birth plan, the judge said.
In a statement after today's judgment, the parents of Paul Fitzpatrick said that while they were delighted to have won the case on behalf of their son, they had "nothing to celebrate". "The National Maternity Hospital have ruined our lives and left us devastated and broken hearted every day.
They have taken away our sons right to a normal and healthy life and left him struggling and and fighting for everything. Nothing can ever compensate him or us for what they have done," Ms Michelle Gilroy and Mr Paul Fitzpatrick said.