Wednesday 18 July 2018

Woman who alleges unjustified symphysiotomy was performed on her didn't know for decades what procedure was carried out

The Four Courts, Dublin
The Four Courts, Dublin newsdesk

A woman who alleges an unjustified symphysiotomy was performed on her at a Dublin hospital 12 days before her first baby was born in 1963 did not know for decades exactly what procedure was carried out on her, the Court of Appeal has been told.

The three judge court today reserved judgment on the woman's appeal against the High Court's finding she had failed to prove the symphysiotomy - which divides the cartilage of the pubic symphsis to facilitate easier delivery - was unjustified.

The now 77-year-old woman appealed the High Court’s dismissal of her claim while the hospital where the procedure was carried out cross-appealed the High Court finding her action did not fall outside the applicable two year time limit.

The delay until autumn 2012 in bringing the case prejudiced the hospital's right to a fair hearing on grounds including that the doctor who performed the procedure, the then master of the hospital, has died, Emily Egan SC, for the hospital, argued.

The woman had sufficient knowledge by February 2010, when a Prime Time programme on symphysioptomy was screened and because she had sought medical records, that a potentially unnecessary symphysiotomy was performed to allow her bring her legal action then, counsel said.

Her medical records were always available to her had she taken reasonable steps, counsel added.

The High Court erred in finding medical records provided to her in August 2011 had filled a missing piece in her "jigsaw" of knowledge, that her date of knowledge was August 2011 and the hospital was not prejudiced by the delay, counsel argued.

While she could not say if this symphysiotomy was discussed with the woman before it was carried out, records showed another woman was offered the procedure by the same master and refused it, counsel said. The death of the master meant she could not pursue this issue.

Cousnel also said, while there had been references during the case to some doctors favouring symphysiotomies out of a "Catholic zeal", there was no such allegation made in relation to this particular symphysiotomy.

In closing arguments on the statute point, Ciaran Craven SC, for the woman, said she was aged 24 at the time of the procedure and was not sophisticated about medical matters, having left school at 15. It was only years later, and after she discussed matters with others following a discussion of symphysiotomy on the Vincent Browne show on TV3, she realised what had happened.

She was told they were going to help her deliver the baby, she wakes up, she’s told the baby is not delivered and the baby arrives days later, he said. “That’s all she knows.”

She saw she had a scar but did not know until years later exactly what procedure was carried out, he said.

It was also significant that the High court had found the woman was a truthful witness, he added.

The woman's case is regarded as a test case relating to certain actions over symphysiotomies.  Some 30 cases have been initiated but it is understood just a small number of those  relate to the type of symphysiotomy performed on the woman, a prophylactic symphysiotomy, one performed without a trial of labour based on a view vaginal delivery is not reasonably possible.

Having heard final arguments on the three day appeal, the court comprising Mr Justice Michael Peart, Ms Justice Mary Irvine and Mr Justice Michael Hanna, said it was reserving judgment.

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