ACL Settle Medical Negligence Action for Failure Diagnose Dislocated Elbow


The Plaintiff was 48 years old when she suffered a fall at her home and was taken to the Accident & Emergency Department of a large Dublin Hospital. She was complaining of pain in her right arm and an x-ray wastaken of her wrist which confirmed that she had suffered a right collesfracture. No examination was carried out of her elbow despite her complaints of pain in this joint and a noted deformity in the appearance of her arm. She was admitted to the hospital and underwentan open reduction to the fracture of her right wrist and the insertionof a K wire. Following the surgery the Plaintiff’s arm was placed inplaster and she was discharged from hospital. She was followed up inthe fracture clinic on two further occasions over the next six weeks but at no stage was an injury to her elbow joint suspected despite hercomplaints of ongoing pain in the area. She was sent for a x-ray of her wrist following the removal of the K-wire and she herself requested that the radiographer take an image of her elbow as she was in so much pain. This scan confirmed the presence of a dislocation of her jointand she later underwent surgery to correct the dislocation. Unfortunately due to the delayed diagnosis of the dislocation the Plaintiff’s elbow joint had been irreparably damaged and as a result the Plaintiff lost a significant range of motion in her arm and she will continue to have significant functional in her arm as a result ofthe stiffness and loss of power in her right arm.

The Plaintiff brought proceedings against the Hospital claiming damages for thefailure to diagnose her dislocated elbow at the time of the accidentleaving her with a significant loss of the use of her arm. Liabilitywas admitted by the Defendant shortly after service of the proceedingsand the matter proceeded as an assessment of damages only. Settlementnegotiations took place two weeks before the case was due to be heardto assess the damages and a settlement in the sum of €230,000 with theadmission of liability and the Plaintiff’s legal costs was agreed whichrepresented the full value of the case.

ACL Settle Medical Negligence Action for Hallux Valgus Surgery


The Plaintiff was a lady in her 50s who was suffering from a long standing history of a bunion on her left foot. She consulted the Defendant, a Consultant Orthopaedic Surgeon and surgery was advised to alleviate thepain and in particular a procedure known as a Wilson’s osteotomy. ThisWilson’s osteotomy was carried out in October 2007 in addition tometatarsal osteotomies of the second and third metatarsals which were also performed. A 26mm screw was used to fix the Wilson’s osteotomy but there was no fixation for the second and third metatarsal osteotomies. Post-operatively the Plaintiff did not notice any improvement rathershe noticed a marked increase in the level of pain and deformity in herleft foot. The Plaintiff attended two further Orthopaedic Surgeons witha view to reconstructive surgery on her foot however further surgeryoffered little relief for her symptoms and the marked deformity in herfoot since the initial surgery.

Expert opinion was sought froman independent UK Orthopaedic Surgeon who criticised the decision to offer the Plaintiff a Wilson’s osteotomy as it was a rather outdated procedure that was no longer routinely used in the UK, but also for the complete failure on the part of the surgeon achieve any sort of satisfactory outcome with the Wilson’s osteotomy and to carry out anyinternal fixation in conjunction with the second and third metatarsal osteotomies. Proceedings were issued against the Consultant Orthopaedic Surgeon who carried out the surgery and a liability for the Plaintiff’s injuries denied. A date for trial was set and settlement negotiations were entered into in the weeks leading up to the date the case was dueto commence and a settlement in the sum of €147,000 without admissionof liability together with the Plaintiff’s legal costs was agreed.

ACL Settle Medical Negligence Action for 4th Degree “Buttonhole” Tear Suffered During Childbirth


The Plaintiff was pregnant with her first child and under the care of the first Defendants who is a Consultant Obstetrician & Gynaecologist and the second Defendant a large maternity hospital in Dublin. The Plaintiff was induced shortly after her due dates due to concerns overher blood pressure. After an extremely lengthy labour she delivered a baby boy by way of rotational forceps (Keilland forceps). During the course of the delivery she suffered a fourth degree perineal tear which the Consultant Obstetrician identified and repaired in theatre inaccordance to best practice. The Plaintiff was discharged from hospital five days after the delivery but attended the emergency department ofthe hospital the very next day complaining of being incontinent offaeces. She was examined by the Registrar on call who also telephoned the Consultant Obstetrician on call and a decision was made to prescribe antibiotics as it was felt she may be suffering from aurinary tract infection.

The Plaintiff continued to suffer from incontinence until she attended her own obstetrician for a post natalcheck seven days later. He admitted her to the hospital and arranged for an examination under anaesthetic by a colorectal colleague which identified an ano-vaginal fistula and breakdown of the primary repair. The Plaintiff was later admitted to hospital and underwent adefunctioning loop sigmoid colostomy which was later converted to anend to end colostomy and flap repair. The Plaintiff underwent areversal of her colostomy six months later. Unfortunately she was plagued by a recurrent ano-vaginal fistula which has required ongoing treatment for the past four years and may require sacral nerve stimulation treatment in the future.

Expert opinion was sought from the UK from both an obstetric and colorectal point of view. The Plaintiff’s case was that although the first defendant had correctly identified that the Plaintiff had suffered a fourth degree tear andrepaired it appropriately in the operating theatre, there was evidence to suggest that he had not identified the full extent of the injury and a small “buttonhole tear” had been missed at the uppermost point of the tear. The opinion of the Plaintiff’s colorectal expert was supportive of this view and that what had occurred was not as a result of a breakdown of a primary repair but the result of a missed injury which caused a breakdown. Liability was contested by the Defendants and the matter was specially fixed for trial. Two days before the case was due to commence settlement negotiations took place and a sum of €150,000.00 in damages was agreed to be paid to the Plaintiff in addition to herlegal costs. This was felt to be a good settlement in light of theissue of liability which was to be hotly contested in the event thecase went to hearing.

04 November 2011

    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

    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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