Birth injuries court case settled

The High Court has approved a settlement of €500,000 against two doctors 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 consultant psychiatrist Professor Patricia Casey or consultant obstetrician Dr Mary Holohan.

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 today.

The court heard Ms McGillin had been treated by Prof Casey since 1994 and had been diagnosed with mild bi-polar 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 which opened a week ago, it was alleged both doctors should have ensured Rebecca’s mother was taken off Lithium and Epilim in pregnancy. Ms McGillin became pregnant in July 2000 after being treated by Dr Holohan for some six months with a view to improving her fertility chances.

Ms McGillin was on both drugs prior to pregnancy and also took both at 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 prior to 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 pregnancy but that claim was disputed.

Approving the settlement of €500,000, plus legal costs, the President of the High Court, Mr Justice Nicholas Kearns described it as a “very good” settlement and wished the child and her family well into the future.

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

Counsel said it was quite clear Ms McGillin was “not to blame” for what had happened to her daughter and the issue was whether the mother’s condition was treated in a reasonable way. A plea by Prof Casey of contributory negligence against Ms McGillin had been withdrawn at the outset of the case, he added.

He said their case was Ms McGillin should have been taken off the drugs and “certainly” should have been taken off sodium valproate (Epilim). The essence of the defence appeared to be both defendants believed the medication was required to control her depression and there was an issue of balancing the risks to herself and the foetus, he said. His side did not regard this as a very good defence but there were always risks, an offer had been made now and his side were recommending it.

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

The judge told Barry McGillin, father of Rebecca, he had looked at the medical reports in the case and regarded the settlement as a good settlement which he was happy to approve. He added Rebecca was very lucky to have parents who were so devoted to her. 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 by her father, 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. She also said, while she was advised by Prof Casey of certain risks from Lithium in the first trimester, 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 Prof Casey would say she had advised Ms McGillin, prior to 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 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 disputed the claim they had advised that a high dose of folic acid would negate any risk from Epilim.