Coombe found liable for catastrophic injuries suffered by baby at birth

The Coombe women’s hospital in Dublin is facing a multi-million euro bill in damages and legal costs after a High Court judge ruled yesterday it is liable for catastrophic injuries suffered by a boy minutes after his birth at the Dublin hospital.

Had Eoin Dunne been effectively ventilated nine minutes after birth rather than at 17 minutes, he would likely not have suffered his devastating injuries, Ms Justice Mary Irvine found.

The delay was unacceptable and the hospital was negligent in failing to ensure the child received the type of intubation and ventilation “mandated in the first 10 minutes of his life”.

What might be relevant to the failure to have a senior member of the paediatric staff capable of carrying out an intubation in attendance within the first five minutes of Eoin’s life was that, although an “extremely high” number of babies were delivered at the Coombe, about 8,000 a year, there was only one paediatric registrar on duty, the judge also remarked.

Cerebral palsy

Eoin (10), Malahide, Co Dublin, is wheelchair-dependent with severe dyskinetic cerebral palsy.

In his action against the Coombe Women’s and Infants’ University Hospital, it was claimed he suffered those injuries due to delays by the hospital in resuscitating him in the minutes after his birth.

The case, which ran for 43 days extending over about a year, was brought on Eoin’s behalf by his mother, Dr Fiona Murphy, an anaesthetist.

In her detailed judgment yesterday on liability, Ms Justice Irvine founds Eoin’s injuries were caused as a result of suffering a period of near total acute hypoxic ischaemia which began about two or three minutes before his birth and ended when his heartbeat was restored about 20 minutes later.

If the hospital had acted with reasonable care for Eoin’s welfare, there was no reason why he should not have been effectively ventilated by the time he was nine minutes old, she found.

Had that occurred, he would not have gone on to develop the injuries.

Eoin was born in moderate condition at 6.35am on July 30th, 2002, without any inherent defect or genetic abnormality, as the hospital, among various claims, had alleged.

Given his condition at birth, Eoin should have responded to positive pulmonary ventilation had it been effectively delivered.

Eoin was probably intubated for the first time at about 6.52am and, in response to prompt administration of intravenous adrenalin, his heartbeat began to recover when he was about 23 or 24 minutes old.

Failure to deliver

It was highly likely a failure to deliver effective bag and mask ventilation was responsible for the decline in Eoin’s agpar score over his first five minutes, Ms Justice Irvine said.

However, she did not believe the deterioration over those five minutes could be ascribed to any negligence on the part of the midwifery staff involved.