An eight-year-old twin boy suffers cerebral palsy due to negligence in the circumstances of his birth at Wexford General Hospital, the High Court was told yesterday.
Gary Kavanagh sometimes cries because he sees in his twin brother, Ian, who is healthy, all he could and should have been, the court heard.
It is alleged there was a failure to diagnose that Ms Patricia Kavanagh was carrying twins until their premature birth.
Ian Kavanagh, who was the first born, is now in very good health, but Gary, born shortly afterwards, suffers cerebral palsy and has other difficulties, although he is "an extremely gifted and cheerful young boy", Mr Justice O'Donovan was told.
Gary Kavanagh, through his mother, of Curracloe, near Wexford town, is suing a consultant obstetrician, Dr Harry Murphy, and the South Eastern Health Board, who deny allegations of negligence.
Opening the action yesterday, Mr Denis McCullough SC said the twins were Ms Kavanagh's first pregnancy. She was aged 29 at the time and attended Dr Murphy for antenatal care. Her estimated date of delivery was March 15th, 1991. She felt she was "rather big".
She arranged with Dr Murphy to have an ultra-sound scan on December 8th, 1990. It was not diagnosed at that stage that she was expecting twins. She saw Dr Murphy again on January 5th, 1991, and it was again not diagnosed she was expecting twins.
Early on January 9th, 1991, Ms Kavanagh felt she was going into labour. She was just over 31 weeks pregnant at the time. She called to her GP, who felt she could not be going into labour and thought she had a kidney infection.
Mr McCullough said Ms Kavanagh went home, but in the afternoon she went into labour, and her husband drove her to Wexford General Hospital. The first twin, Ian, was delivered by Dr Murphy at 2.15 p.m. Ian was in fairly poor condition.
One of the nurses realised there was a second baby waiting to be delivered. This was the first time it had been diagnosed that Ms Kavanagh was expecting twins, counsel said. Gary was delivered shortly afterwards and was in good condition.
There was no neonatal unit or consultant paediatrician in the hospital, but Waterford Regional Hospital had both. Ian was transferred to Waterford by ambulance. He got good care and made a very good recovery. He was now healthy with no ill effects.
It was decided to keep Gary in the hospital where he was born, but he should not have been detained there, counsel said. Premature babies had a high risk of respiratory distress, and this was particularly the case in multiple-birth situations.
The day after his birth Gary had difficulty breathing and was "grunting" as if in distress. Nursing notes would say his colour was off, he was showing signs of turning blue, was jaundiced and was slow to recover. He was at that stage in a very serious condition.
His respiratory distress was as a result of a significant deprivation of oxygen, Mr McCullough said. It must have been obvious that he required expert, immediate attention, including the services of a paediatrician, and should have been transferred to Waterford. But it was not until some time after 1.25 p.m. that such a decision was taken. It was the contention of the plaintiff that the decision was, at that stage, far too late.
On March 3rd, 1991, Gary was discharged from hospital. He showed slow neurodevelopment processing over the next two years. In April 1993 he was diagnosed as suffering from cerebral palsy of the spastic dyplegia-type, which primarily affects the lower limbs.
The hearing is expected to last three weeks.