Court hears brain-damage case

A young girl suffered “devastating and permanent injuries” due to an alleged failure to treat her hydrocephalus in the weeks …

A young girl suffered “devastating and permanent injuries” due to an alleged failure to treat her hydrocephalus in the weeks and months shortly after she was born, it was claimed at the High Court today.

Jade Keane, now aged 10, was born at the Natuional Maternity Hospital (NMH), Holles Street, Dublin, on March 21st. 2001, and suffered brain damage that has left her blind, wheelchair bound, and requiring care for the rest of her life, the court heard. It is claimed the cause of the injuries was hydrocephalus, also known as “water on the brain.”

Through her mother Gillian Keane, Wyatville Park, Loughlinstown, Co Dublin, the child has sued the HSE, Dr Dermot Stones Albany Court, Shanganagh Road, Ballybrack, Co Dublin and the NMH over alleged negligence and breach of duty of care in relation to her treatment.

Among a range of claims, it is alleged both the HSE and Dr Stones failed to act when the child’s head began to enlarge to an abnormal size and failed to act on her family’s concerns about the degree of the head enlargement.

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It is further alleged the NMH failed to observe the child’s head size was abnormal, failed to act in accordance with good standards appropriate to a maternity hospital and failed to intervene surgically.

The court heard today negligence has been admitted in the case but all of the defendants disputed the claims as to causation of the injuries suffered.

The defendants have claimed the child had hydrocephalus both at and prior to her birth and her injuries were caused by a pre-existing condition.

In its defence, the HSE denies the wrongs alleged against it. The HSE admits it did not act when Jade’s head was observed by a public health nurse to have been outside the normal range, that she should have been referred for an assessment and that there was a delay in diagnosing her condition. It denies its admissions amounts to actionable negligence.

In its defence, the NMH said Jade’s head circumference was 39cm when she and her mother were discharged a few days after her birth. While documentation had said the circumference was 35cm it was now being asserted by the hospital that handwritten notes showed the circumference was 39cm.

The hospital admitted in its defence, with a head circumference of 39cm at birth, Jade should have been been reviewed by a doctor at the hospital before being discharged and that a follow-up should have been planned.

In his defence, Dr Stones denies any negligence or that he failed to recognise that Jade was suffering from the condition. He also denied her injuries were caused by any delay on his part.

Opening the case today, Denis McCullough SC, for the child, said it was her case Jade suffered from the condition in the weeks after she was born.

Hydrocephalus is a condition in which there is an abnormal accumulation of cerebrospinal fluid (CSF) in the ventricles, or cavities, of the brain, he said. Due to increased intracranial pressure inside her skull, Jade’s head began to enlarge.

Counsel said that it was their case the Jade’s head circumference was measured at 35cm when she was discharged from Holles Street. It was difficult to accept the child would have been discharged from the hospital if her head circumference was 39cm as it was now being claimed, he said.

After she was discharged Jade attended with a public health nurse at Loughlinstown Clinic on seven occasions between April 9th and June 5th 2001, he said. She also attended with her GP Dr Stones on April 30th, May 15th and 28th 2001.

On each of those visits, her head circumference had increased from 35cm to 47cm and that should have indicated to the defendants that something was wrong, he said.

Jade, whose head circumference was up to 47.5cm, was diagnosed with hydrocephalus in June 2001 and had emergency surgery performed on June 11th 2001 at Crumlin Children’s Hospital.

The case, before Mr Justice Sean Ryan, is expected to last for several weeks.