Ava Kiernan

The High Court has recently found in favour of Ava Kiernan, who through her mother sued the Health Service Executive, for severe neurological injuries which she has suffered as a result of the negligence of a public health nurse.
Augustus Cullen Law acted on behalf of Ava Kiernan and her parents in a medical negligence action against the Health Service Executive.  Ava was born perfectly healthy however unfortunately she went on to suffer from a condition called hydrocephalus (a condition colloquially referred to as water on the brain). Within the brain there are chambers which produce a fluid known as cerebral spinal fluid. If the ventricles of the brain are unable to absorb this fluid, the ventricles will enlarge.  Where there is an inability to absorb the cerebral spinal fluid, a communicating hydrocephalus arise as occurred in Ava’s case.  As the ventricles enlarge, adjacent brain tissue is compressed with the result that there is an increase in the intracranial pressure. If the increase is left untreated then significant and irreversible brain damage occurs. Neither the Plaintiff’s nor the Defendant’s experts were able to definitely same what was the cause of the hydrocephalus. However, the Plaintiff’s case was that there was a failure on the part of Ava’s public health nurse to note and to act upon Ava’s increasing head circumstance measurements and to heed the parental concerns.

The Public Health Nurse plotted Ava’s head circumference measurements on a head centile chart and it was the Plaintiff’s case that a baby’s head circumstance measurements should track a centile line. However in Ava’s case her head circumference measurements crossed over the centile lines. The Plaintiff’s experts argued that if at the nine month check-up the Public Health Nurse had correctly measured and plotted Ava’s head circumference and had acted on Ava’s mother’s concern in relation to Ava’s inability to hold up her bottle, then Ava should have been, at least recalled within four weeks and / or referred to a Paediatrician who would have undertaken an ultrasound examination and that such an examination would have identified the condition. The Plaintiff’s experts argued that a remedial shunt would then have been inserted and the majority of the subsequent brain damage would have been prevented.  Unfortunately the Public Health Nurse did not do either of these. Ava’s mother returned to the Public Health clinic while Ava was 14 months and in relation to this visit the Defendants admitted negligence, however they denied that any further damage was caused by this negligence. After 12 days of hearing, Mr. Justice Cross reserved his Judgment. His judgment was delivered last week and he held that the Public Health Nurse was negligent in relation to both visits (i.e. the visit at 9 months and the visit at 14 months). He found that the failure of a public health nurse to record parental concerns, to correctly record and plot Ava’s head circumference measurements and to recall her within four weeks for further assessment were materially causative of Ava’s injuries.  In addition he found that in relation to the 14 month visit he found that the Plaintiff did suffer 'legally significant damage as a result of that negligence'.

It was agreed between the parties that the liability aspect of the matter would be determined first, therefore the matter of appropriate compensation for Ava will be dealt with at a later date. 





09 March 2015

    Gillian and all at Augustus Cullen Law, A million thanks for a great job done. Justice for our son at last!!

    Catherine, Liam & William

    Dear Michael, A great result was achieved because of your efforts and we were truly blessed to have you on our side.

    Kathleen, Medical Negligence Client

    Dear Joice…you are and have been very professional, sympathetic and dignified in all of your dealings with us and I put that down to one simple fact. You listened.

    James, Medical Negligence Client

    Geraldine, Thank you most sincerely for all your hard work and commitment to these children.

    Freda McKittrick, Head of Barnardos Beacon Guardian Ad Litem service

    Neil is an absolute gentleman to deal with – kind, tactful and very efficient. We could not praise him highly enough. He brought us through a horrible time.

    Sean, Medical Negligence Client

    Many thanks again for a job well done. We really appreciate all your hard work and practical advice.

    Corporate client in a commercial litigation matter

    Dear Jamie, You and your team in ACL were so professional, diligent and prompt. I have recommended you and the firm, and will continue to do so

    Lorraine McCarthy

    Gus Cullen and the firm’s approach to addressing the key issues was professional, yet personal, efficient yet attentive.


    The process is a difficult one and when you deal with people who are so professional and yet genuine/real people, it makes it so much easier... so thanks a million.


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