Baby’s brain damage risk should have been detected, judge rules

Water on the brain which caused brain damage to a young baby would have been detected if a public health nurse during regular check ups had taken appropriate action, a High Court judge has found.

Damages in the case, brought on behalf of Ava Kiernan against the HSE, will be decided after a further hearing.

Mr Justice Kevin Cross found failure by the public health nurse to record the concerns of the mother of baby Ava Kiernan; to properly record the baby's head circumference at 46.5cm; and to have the child recalled within weeks for further examination.

“These represent a failure of the public health nurse such as no public health nurse of equal speciality, status or skill would be guilty of if acting with ordinary care,” the judge said.

He ruled the failures were “materially causative” of the child’s present condition. Had appropriate action been taken by the public health nurse, the child would not have suffered significant neurological damage, he ruled.

Ava, now aged seven, had through her mother Ruth Kiernan, Cillcarbin, Duleek, Co Meath, sued the HSE over alleged negligence.

It was alleged the child’s serious neurological symptoms were attributable to hydrocephalus — water on the brain — and there was failure to detect that condition prior to its causing significant damage.

The HSE denied the claims but said there was an incorrect head cicumference measurement recorded on September 8th, 2008.

Mr Justice Cross found the HSE liable in relation to two check ups carried out. He found no liability concerning a check-up when the baby was three months old.

The public health nurse was not identified and was unfit to attend court or give evidence, the court heard.

In his ruling, Mr Justice Cross said, if the baby had been recalled four weeks or so after an April 2008 check up, further head circumference increases would have been found and she would have been referred to a doctor and specialist and the necessary scans would have revealed the developing problem.

Had the baby been recalled and referred on, her condition would have been detected prior to any significant damage having occurred, he said. The remedial action of a shunt would have prevented the significant neurological damage that ultimately occurred, he found.