A Dublin woman who sustained a rectal tear during the birth of her third child at the National Maternity Hospital, and who, as a result, may have to wear a colostomy bag for the rest of her life, has secured €255,000 damages at the High Court.
After finding there was a breakdown of the hospital's management regime at the time of the injury, Mr Justice Abbott yesterday directed that the hospital in Holles Street, Dublin, pay the damages to Ms Margaret Kelly.
He noted that Ms Kelly (34), Suncroft Drive, Blessington Road, Tallaght, will probably have to use a colostomy bag for the rest of her life because of incontinence.
The judge said Ms Kelly was admitted to the hospital on July 8th, 1994. Records showed she had an uncomplicated first and second stage of labour before her perineum (the area of skin between the vagina and anus) was ruptured and torn. While the tear had been repaired, it caused incontinence and Ms Kelly had had to have a colostomy in 2000.
The judge said that the practice in a number of Dublin maternity hospitals - at Holles Street, the Coombe and Mount Carmel - of restricting the use of episiotomy (making an incision into the perineum) was effective in keeping "third degree" tears down to a level in line with international comparisons.
In Ms Kelly's case, a student midwife had told Ms Kelly to push at the first stage and this command was not altered appropriately at the second stage, either by the student or midwife, so that the care of the midwifery regime was not established so as to ensure Ms Kelly was at least risk of an explosive, uncontrolled delivery, giving rise to a perineal tear.
Among the reasons why he accepted Ms Kelly's evidence was credible was the lack of discretionary notes and comments in the hospital records in relation to the state of the perineum.