A 12-year-old boy who was left paralysed due to mismanagement of his meningitis at Wexford General Hospital has settled his action against the HSE with an interim payout of €3.7 million.
The High Court heard Matthew McGrath requires 24-hour care following events at the hospital on May 27th, 2004, when he was 17 months old.
The HSE sent a letter dated April 13th, 2015, to Matthew’s parents, Alan and Cathy McGrath, from Gorey, Co Wexford, offering “sincere apologies” to them and their son.
“The hospital extends, unreservedly, its unequivocal and heartfelt apology for the shortcomings in the care provided and for the suffering and distress caused,” added the letter.
The McGraths had been seeking damages “for personal injury, loss and damage” caused by “negligence and breach of duty” at the hospital.
The settlement amounted to €3,731,500 for the next five years of care and will be reviewed again at that time.
The court heard the boy had been suffering from Haemophilus Influenza Type B, which can lead to meningitis.
Mr Justice Kevin Cross was told there was a delay in treating the condition, and in particular with the administration of antibiotics and fluids.
Desmond O’Neill, SC, told the court that but for the delay Matthew “could have been spared” the devastating injuries he suffered.
Also of significance was the decision to carry out a lumbar puncture, or spinal tap, which caused Matthew to “suffer and sustain personal injury, loss, damage, expense, and inconvenience”.
Matthew, began vomiting on May 26th, 2004. His mother brought him to an out-of-hours GP who referred him to Wexford General Hospital with a letter indicating he was “quite drowsy, [and to] please assess urgently”.
After assessment in the emergency department at 12.15am, it was noted Matthew was “listless, drowsy [and] pale”. Subsequent assessments noted no signs of meningitis and a diagnosis of an upper respiratory tract infection or urinary tract infection was made.
At 2.45am, Matthew was assessed by a nurse and found to have a “significantly elevated” pulse rate and a “very significantly elevated” respiratory rate. His skin was also “yellowish”. At 4am, nursing staff noted “panting type breaths” and a “blotchy red rash under skin and neck”.
At 7.30am, it was noted he was “a little less lethargic and the yellow colour was less”. At 11.30am, he was seen by a consultant who queried viral meningitis and recommended a lumbar puncture. At about noon, nurses noted Matthew did not want to be handled and had a “very weak cry”. He also had shallow panting. These were “clear signs of serious illness”.
At 12.30pm, it was noted Matthew was “quite septic and shocked looking”. Nurses suggested to the doctor to delay the lumbar puncture and give an intravenous antibiotic, but the doctor decided to proceed with the lumbar puncture “in spite of the nurse’s concerns”.
After the lumbar puncture, Matthew appeared “mottled and pale” and developed a bluish discolouration of the skin. He stopped breathing and ventilation was required. An anaesthetist and cardiac arrest team were summoned, and intubation was performed.
Mr O’Neill told the court the lumbar puncture caused a collapse in the brain and compromised the spinal cord.
The following day, Matthew was transferred to Our Lady’s Children’s Hospital, Crumlin, where he underwent treatment for meningitis.
Matthew remains ventilation-dependent, and severe neurological injury resulted in paralysis of all four limbs. He has slightly delayed cognitive function, eats through a tube in his abdomen, expels waste though a colostomy bag, and on occasion requires catheterisation to clear his bladder. His life expectancy has also been reduced.
Mr O’Neill said the normal consequences for such mismanagement would be death. He said Matthew had “survived intellectually” but was “totally dependent on others for his survival”.
Despite his injuries, the court was told Matthew is very cheerful, engaging, and a fully involved member of society insofar as he can be.
“He is now completely paralysed but is a bright, intelligent, cheerful boy who goes to school and follows rugby,” Mr O’Neill said.
Mr Justice Cross said he had “no hesitation” in approving the settlement.
