Settlement of €12.2m for two brothers with cerebral palsy

The High Court has approved a total €12.2m settlement for two brothers with cerebral palsy, born just over a year apart, who sued over alleged medical negligence.

The settlement was made without admission of liability and the claims were strongly disputed.

Michael Hickey was born at 29 weeks gestation on August 11th, 2012 and his brother Ned was born at 31 weeks on August 15th, 2013.

Both were born in poor condition and later diagnosed with a form of cerebral palsy affecting the lower limbs.

Both boys sued through their mother Sineád, of Farrenboley Cottages, Windy Harbour, Dublin 14.

Their cases were against a consultant gynaecologist, Mona Joyce, with a registered place of business at the Blackrock Clinic, Dublin, and the Coombe Women & Infants University Hospital.

The settlement, reached after mediation, involves a payment of €6.1m each for the boys, who are attending school and said to be doing well but facing certain challenges.

Richard Kean SC, instructed by solicitor Caoimhe Haughey, for the boys, told Mr Justice Kevin Cross on Tuesday there was a strong dispute about liability and virtually every aspect of the claims in both cases were contested.

The parents, Sineád and Mark Hickey, supported the settlements and their separate actions had also been settled, he said.

Mr Justice Kevin Cross noted the particular risks in the cases and counsel’s opinion was there was a 50-50 risk in relation to establishing negligence in Michael’s and an “even higher” risk in Ned’s case.

He approved the “very good” settlements and praised the parents for their efforts for the boys to date including fundraising for specialised treatment in the US.

Mr Kean told the court Dr Joyce was not involved in any of the procedures undergone by Ms Hickey at the Coombe and there was a strong dispute about how germane the procedures were.

The claims on behalf of the boys included, after Ms Hickey was referred to Dr Joyce about April 2007, following a smear test showing CIN2 (High Grade), abnormal cells found on the surface of the cervix, the doctor performed two LLetz (large loop excision) procedures, one in 2007 and the second in 2010.

It was claimed Ms Hickey was not advised excision treatments increased the risk of pre-term labour, preterm pre-labour rupture of membranes and preterm delivery.

Necessary and appropriate

It was claimed the hospital failed to carry out any or any adequate assessment of her cervical length to identify cervical shortening and that she was not advised of the option of cervical cerclage, also known as cervical stich, a treatment for cervical weakness when the cervix starts to shorten and open too early during a pregnancy.

It was claimed, as a consequence of alleged negligence and breach of duty, Ms Hickey’s cervix was rendered incompetent by Dr Joyce and this was not adequately assessed or recognised by the hospital.

It was claimed Ms Hickey consequently had preterm rupture of membranes and a preterm delivery of Michael.

It was claimed, following Michael’s birth, the hospital failed to discuss with and advise Ms Hickey about the risks of a subsequent preterm delivery.

In her defence, Dr Joyce denied the claims against her. She pleaded the procedures undergone by Ms Hickey were necessary and appropriate to decrease the risk of cervical cancer.

She pleaded Ms Hickey, irrespective of the risk of pre-term labour, would have, and did, elect to undergo them.

In its defence, the hospital also denied any negligence and pleaded there was adequate cervical assessment and monitoring. It also pleaded Ms Hickey’s cervical length did not warrant a cerclage procedure and the management of mother and boys was consistent with a high standard of care.

In a statement after the hearing, Sineád and Mark Hickey said “words cannot convey the emotional effort to get here today” and the past six years “have at sometimes been unbearable”.

They thanked their families and lawyers.