The High Court has approved a €200,000 settlement for a girl who was alleged to have suffered “very significant” harm as a result of the care she received from south Kerry Child and Adolescent Mental Health Services (CAMHS).
The girl, now aged 16, alleged she was inappropriately prescribed antipsychotic medications that exposed her to the onset of bulimia nervosa and a foreseeable risk of injury. The court heard she developed a self-harm “habit” and attempted suicide at the age of 13.
The €200,000 settlement against the HSE is the largest of any sanctioned by the court over south Kerry CAMHS treatment that formed part of a review of some 1,300 patient care files.
The 2022 Maskey report, commissioned by the HSE on foot of concerns raised in September 2020 about clinical practice, found that 240 young people did not receive an appropriate standard of care and 46 suffered significant harm.
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The High Court heard on Friday that this plaintiff was referred to the HSE-run south Kerry service five years ago, when she was 12, on account of her panic attacks, stress, anxiety and self-harming behaviours.
She was prescribed the antidepressant Setraline and the antipsychotic Risperidone, the latter of which was later replaced by two antipsychotic drugs: Quetiapine and Aripiprazole, her senior counsel, John Gordon, told the court.
He said the girl’s health “deteriorated rapidly” as a result of the medication changes and she suffered “very significant injuries”. Although his client was on the drugs for a “relatively short” period, he said the “damage was enormous”.
She became more anxious and stressed, extremely tired, gained some 20kg in weight and developed a habit of self-harm, he said. She suffered bullying as a result of her weight gain and developed bulimia, for which she is still receiving treatment, said Mr Gordon, who was instructed by Coleman Legal solicitors.
In her legal papers, the girl said her mother brought her to a hospital emergency department in September 2020 where a psychiatrist reviewed her treatment plan and ceased her prescription for the Aripiprazole antipsychotic.
Suing through her mother, she claimed the HSE apologised for the deficits in the standard of care and acknowledged harm was caused to her although, due to the inadequate monitoring of her case, the extent of harm could not be evaluated.
It was alleged that the HSE was guilty of negligence and breach of duty in prescribing Risperidone, which, she claimed, is not recognised for treating panic disorder in adolescents. There were also failings in continuing to prescribe the drug, and increasing the dosage, after her GP communicated elevated levels of prolactin, which is the hormone responsible for lactation and breast development, she claimed.
She also alleged negligence in prescribing two antipsychotic drugs at the same time and in allegedly failing to document the rationale for this. Although she self-harmed before attending the service, it is alleged that this became much more serious afterwards, partly due to the girl’s mood and partly due to her weight gain. She said her mood and energy levels improved after she ceased taking Aripiprazole.
She was later diagnosed with obsessive compulsive disorder and has received counselling and cognitive behavioural therapy. She is awaiting referral to a local eating disorder clinic.
Mr Justice Paul Coffey approved the settlement in what he said was a “very distressing case”. Speaking to the girl and her mother in court, he said the teenager has “suffered enormously” and he is glad to hear she is receiving the care she is entitled to.
The High Court has approved several other settlements for children under a State compensation scheme set up for patients affected by the south Kerry CAMHS failings. The €200,000 settlement is the largest to date.
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