The High Court decided yesterday that there was negligence in Beaumont Hospital's treatment of a German man in relation to an operation in 1992 for a growth on his throat. Mr Alfred Gottestein, who had lived in the State for many years, died while in intensive care after the procedure.
The action, by the widow of Mr Gottestein, who carried on business in Co Kerry, was against the Dublin hospital and Prof Michael Walsh, under whose care Mr Gottestein was stated to have been at the time of the operation. Mr Gottestein died in September 1992, aged 53.
Ms Ute Gottestein, who is also executrix of her late husband's estate, claimed that he was convalescing from surgery at the hospital when his tracheostomy tube became dislodged from its place in his trachea. As a result, it was submitted, he lost his airway, suffered cardiac arrest and died.
In a reserved judgment, Mr Justice Richard Johnson said he was satisfied that the failure to have in the hospital's intensive care unit (ICU) a person, nurse or doctor skilled in the replacement of a tracheostomy tube under the circumstances was an inherent defect in what appeared to be the practice.
He found the hospital guilty of negligence in having failed to have a skilled person in the ICU or immediately available in the hospital. He also found that because of Prof Walsh's overall responsibility for the patient, he must be held legally responsible for the failure of the hospital to provide the appropriate care in the ICU in the events that arose.
Under those circumstances, he also found Prof Walsh negligent.
The judge said that, on the balance of probabilities and the evidence, that had a person appropriately trained within the ICU or the hospital been present, then the deceased would not have died.
The judge said Mr Gottestein had been admitted to the hospital under Prof Walsh. There was no criticism of him or the staff regarding the carrying out of the operation. After the operation, at the direction of an anaesthetist, Mr Gottestein was taken to the ICU for initial care.
With regard to Prof Walsh, the judge said it was clear that the operation was done skilfully. He was working in an environment where there did not appear to be specialist ENT wards for dealing with post-operative treatment. The system was that the anaesthetist directed who should go to the ICU. In this case, Prof Walsh did not appear to have had any authority in the staffing or organisation of the ICU. This was something the judge found peculiar, as the professor knew, or ought to have known, that there would be nobody in the ICU with the appropriate skills to deal with this eventuality.
He said submissions in relation to damages and costs would be heard in the new year.