The widow of a man who died of a brain haemorrhage yesterday succeeded in overturning a High Court decision which dismissed her action for alleged negligence against the Mid Western Health Board and a doctor. Mrs Carmel Collins claimed the defendants failed to diagnose her husband's condition.
Mrs Collins (45), of Glenanaar Avenue, Woodview, Limerick, sued the health board and Dr Ray O'Connor, of Kilbrannish Park, Woodview Park, Limerick, both of whom denied negligence.
Her husband, James (42), a blocklayer, died eight years ago. He had attended Dr O'Connor and was treated at Limerick Regional Hospital. On March 22nd-23rd, 1991, he was found to have an aneurysm and was transferred to Cork Regional Hospital, where he died three days later.
The High Court found Mrs Collins had failed to establish negligence on the part of the defendants and dismissed her claims.
The Supreme Court yesterday overturned that decision and directed that the action be sent back to the High Court to decide whether loss had flowed from the breaches of duty of the health board and Dr O'Connor, or either of them, and if so, the extent of the loss.
Giving judgment, Mr Justice Barron said Mr Collins was taken ill at work on February 20th, 1991. Mrs Collins rang Dr O'Connor and told him: "Jim has a very bad headache. He does not usually go to the doctor. He must be very bad." Dr O'Connor found Mr Collins was complaining of a head cold.
On February 23rd, Mrs Collins, disturbed that her husband, who had stayed in bed, was getting no better, rang the doctor. She asked if there was nothing he could prescribe. Dr O'Connor said: "No, not for viral flu. It has to take its course. It may take four to five days."
On February 25th Mrs Collins rang again and said: "Jim is very bad." Dr O'Connor visited and took the view Mr Collins was probably suffering from headaches caused by sinus congestion. On March 18th Mr Collins saw the family doctor, who decided he needed a CT scan.
He was seen by a senior house officer at Limerick Regional Hospital, who decided he needed further examination, made an appointment for him to see a specialist and sent him home. On March 22nd he was brought back to the hospital and was diagnosed as having a brain haemorrhage.
Mr Justice Barron said the conflict narrowed itself to whether Dr O'Connor should have been obliged to go outside what he discovered from the patient. The telephone calls should not have been ignored. Dr O'Connor was not expected to make the correct diagnosis but he was expected to know when his patient should be referred to a specialist. The failure to follow up what Mrs Collins said in three telephone calls was negligence.
The case against Limerick Regional Hospital was that the house officer should have admitted Mr Collins. He was aware the family GP had formed the opinion Mr Collins should be referred for expert opinion. He decided Mr Collins required further examination but it did not seem there was a matter of extreme urgency.
Mr Justice Barron said any system giving absolute authority to a junior doctor was inadvisable. By its very nature the position was one where the holder was learning his profession.
He did not wish to impose greater liability on hospitals than was necessary, the judge said. House officers should not be required to look over their shoulders on every occasion a patient was brought to casualty. An absolute authority was inadvisable.
It was a matter for the hospital authorities to indicate a scheme to provide under what circumstances a house officer would be required to seek advice from a senior.
It seemed the problem arose from the system which gave the house officer an absolute authority to refuse admission. All the indications were that the house officer ought to have referred Mr Collins to the medical team having regard to the letter from the family GP. Perhaps the house officer felt bound by the system, in which case it was the authors of the system who must take the blame, Mr Justice Barron said. In either case, there was a breach of duty of care for which the health board was liable.