SIGNIFICANT brain damage to a baby could have been avoided if a symptom had been spotted and acted on, a judge said.
Hydrocephalus - water on the brain - would have been detected in Ava Kiernan if a public nurse had, during regular check ups, taken appropriate action, Mr Justice Kevin Cross said in the High Court.
There was a a failure on the part of the nurse to record the concerns of Ava's mother and to properly record the baby's head circumference, he said.
There was also a failure to have the child recalled after a few weeks for a further examination.
The failures, the judge said, were "materially causative" of Ava's present condition in that if appropriate action had been taken by the nurse, Ava would not have suffered the significant neurological damage.
The judge was giving his ruling in relation to liability in the case of Ava (now 7) who, through her mother Ruth Kiernan of Cillcarbin, Duleek, Co Meath, who sued the HSE for negligence.
It was claimed serious neurological symptoms which were attributable to hydrocephalus were caused by the failure to detect the condition prior to it causing significant damage to the child.
The HSE had denied the claims but said there was an incorrect head circumference measurement recorded on September 8, 2008.
Mr Justice Cross found the HSE liable in relation to two check ups but not a check up when the baby was three months old.
The public health nurse, who was only referred to as "R", was unfit to attend court, the judge was told.
Mr Justice Cross said had Ava been recalled four weeks or so after an April 2008 check up, further head circumference increases would have been found.
She would have been referred to a doctor and on to a specialist and the necessary scans would have revealed the developing problem.
There was a failure on the part of the public health nurse to record the mother's concerns, to properly record the head circumference at 46.5cm, and a failure to have the child recalled in a few weeks for a further examination.
Damages in the case will be decided after a further hearing.