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In this closed claim case study, Emmajane O’Halloran, Solicitor and Clinical Claims Manager, outlines the details of a case relating to postpartum haemorrhage with a second degree perineal tear in a regional hospital.

A plaintiff sued a regional hospital alleging that the hospital failed to take sufficient steps to stop a significant postpartum haemorrhage on time. The haemorrhage occurred following the birth of the plaintiff’s baby.

Details of case

Various initial steps were taken to stem the bleeding including suturing and vaginal packing but those steps were unsuccessful. The plaintiff was moved to theatre and was estimated to have lost approximately 1.5 litres of blood. The repair was a difficult procedure which lasted almost two hours and the operative findings were a large perineal haematoma, second-degree perineal tear, well-contracted uterus and a right paravaginal tear.

The plaintiff’s claim was that, as a result of events, she had suffered an unnecessarily traumatic experience, had required an extensive blood transfusion and was left extremely traumatised and suffering a significant ongoing psychological injury.

The plaintiff’s expert was not critical of the steps taken by the defendants once the bleeding and tear were identified, but was critical of the speed at which those steps were undertaken. The plaintiff’s expert gave evidence that the plaintiff should have been moved to the operating theatre 36 minutes earlier than had occurred and, if the plaintiff had been moved earlier, the blood loss would have been less and the trauma was likely to have been less as well.

Outcome of the case

The Court accepted that the plaintiff was a completely genuine witness who gave her evidence truthfully and there was no doubt that her life had been significantly damaged by the events. The Court also accepted that the plaintiff met the criteria for posttraumatic stress disorder and her distress continued.

In addressing liability and applying the test set out in Dunne v The National Maternity Hospital & Another [1989] IR 91, the Court accepted the evidence of the defendants’ expert that the treatment provided to the plaintiff was acceptable and could not conclude that the defendants were in any way negligent.

The Court held that the hospital had followed approved practice at the time and the plaintiff had not demonstrated that the practice had inherent defects, which ought to have been obvious to any person giving the matter due consideration.

The Judge believed that if the plaintiff had been taken to theatre sooner she would have suffered less blood loss and probably less psychiatric trauma, however, the Judge indicated that this was speculative given the finding that the hospital was not negligent.

The plaintiff had therefore failed in her claim which was accordingly dismissed.

NB At the time of writing this case was under appeal.

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