A baby suffered severe injury rendering him grossly permanently disabled in the course of his delivery at Wexford General Hospital five years ago, it was claimed in the High Court yesterday.
Mr Liam Reidy SC claimed Gerard Doyle (5) suffered from cerebral palsy and severe spastic quadriplegia, was mentally retarded and had virtually no consciousness as a result of the negligence of the South Eastern Health Board and Dr Nasim Osmani Subhi, with an address care of Wexford General Hospital.
He claimed both defendants allowed the care of the child at the time of his birth to fall below an acceptable and reasonable standard for current obstetric practice.
Gerard, through his mother Vera, of Clongeen, Foulksmills, Co Wexford, is suing the board and the doctor for damages for severe personal injuries caused or occasioned by the alleged negligence and breach of duty of the defendants or their agents.
Both defendants deny negligence or breach of duty. The action, before Mr Justice Smith, is expected to last some weeks.
Opening the case yesterday, Mr Reidy, with Mr John Gordon SC and Mr John Whelan, for Gerard Doyle, said Gerard has been looked after by his mother since his birth and required 24-hour specialist care. The child had a life expectancy of at least 50 years and would require such care for the rest of his life.
Counsel said the health board operated Wexford General Hospital while Dr Subhi was employed at the time of Gerard Doyle's birth as obstetric registrar at the hospital.
He said Mrs Doyle became pregnant in February 1992 and attended all necessary appointments with her medical team.
Counsel noted Mrs Doyle was four feet 11 inches tall and said she was made aware by her doctors that, because of her height, she might not be able to deliver a full-term birth naturally.
He said Mrs Doyle was admitted to the maternity section of Wexford General Hospital on November 14th, 1992, having experienced the onset of labour. While there, it is claimed, she came under the care of Dr Subhi.
Counsel said while in the hospital Mrs Doyle was attached to a foetal heart monitor.
He claimed the defendants and their servants or agents failed to have proper regard for heart-rate decelerations experienced by the baby and failed to notice those decelerations indicated the need for a Caesarean section to protect the child from intrapartum hypoxia.
Counsel said that, from 3.50 a.m. until Gerard's birth four hours later, the monitor showed decelerations of the heart rate almost on a continuous basis. This was an indicator that the baby was being asphyxiated at the time and nothing was done about it, counsel claimed. The progress of the labour from then on was abnormal, he said.
He said Mrs Doyle was being attended by midwives and was told, from 4 a.m. onwards, to push, although her cervix was not fully dilated. That was "a most inappropriate procedure".
The urging on of Mrs Doyle to push assisted in asphyxiating the child, he claimed. He submitted the midwives should have known that a woman as small as Mrs Doyle might possibly have a problem with natural delivery and should have known, if they were experiencing problems, to stop the procedure.
Mr Reidy said Dr Subhi came in and out during the labour. He said Dr Subhi carried out a number of internal examinations and at one stage "for an inexplicable reason" attempted a forceps delivery.
He said a consultant was called about 5.30 to 6 a.m. on November 15th. For the previous hour, Mrs Doyle had been asking for a Caesarean section, counsel said. Mrs Doyle had felt the pushing was achieving nothing and felt as if the baby was moving up towards her chest, not moving downwards.
A Caesarean section was ultimately carried out, about which his clients had no complaints, and Gerard was born weighing 7lb 13oz at 7.52 am.
After delivery, it was immediately noted the baby was in poor condition, Mr Reidy said. Within an hour of birth, he was showing signs of gross neurological abnormality.
The child's neurological development continued to be grossly abnormal and he had been diagnosed as suffering from severe spastic quadriplegia and mental handicap with microcephaly, counsel said.
The case resumes today.