Mary Healy v Brendan Buckley and the Bon Secours Hospital and the Bon Secours Health System

CourtSupreme Court
JudgeDenham C.J.,Laffoy J.,Charleton J.
Judgment Date08 March 2016
Neutral Citation[2016] IESCDET 18
Date08 March 2016





[2016] IESCDET 18

Denham C.J.

Laffoy J.

Charleton J.



RESULT: The Court does not grant leave to appeal to the Court from the Court of Appeal.
The application for leave

This determination relates to an application for leave to appeal to the Supreme Court from a judgment delivered on 17th November, 2015 and the order made on 17th November, 2015 and perfected on 24th November, 2015 of the Court of Appeal. The applicant/appellant, Mary Healy, hereinafter referred to as ‘Mrs. Healy’ seeks leave to appeal to this Court from the said judgment and order. The first named defendant/respondent, Brendan Buckley, is hereinafter referred to as ‘Dr. Buckley’. The other defendants/respondents are referred to as ‘the Hospital’. Dr. Buckley and the Hospital, who are hereinafter collectively referred to as ‘the Respondents’, oppose the application for leave.


The jurisdiction of the Supreme Court to hear appeals is set out in the Constitution.


Article 34 of the Constitution provides for the public administration of justice; describes the courts established by the Constitution, and those which may be established by law; provides for the full and original jurisdiction of the High Court; establishes the Court of Appeal under Article 34.2; and sets out the appellate jurisdiction under Article 34.4.1°. This states:

‘1° The Court of Appeal shall –

(i) save as otherwise provided by this Article,

(ii) with such exceptions and subject to such regulations as may be prescribed by law, have appellate jurisdiction from all decisions of the High Court, and also shall have appellate jurisdiction from such decisions of other courts as may be prescribed by law.’


Article 34.4.3° of the Constitution also provides for the finality of decisions of the Court of Appeal, save for appeals that may be taken to the Supreme Court from its decisions under Article 34.5.3°.


Under Article 34.5.4° it is possible for a decision of the High Court to be directly appealed to the Supreme Court, bypassing the Court of Appeal. This type of appeal is sometimes referred to colloquially as a ‘leap-frog’ appeal.


The Article relevant to this appeal, where the Court of Appeal has already given judgment in a matter, is Article 34.5.3°, which states:

‘The Supreme Court shall, subject to such regulations as may be prescribed by law, have appellate jurisdiction from a decision of the Court of Appeal if the Supreme Court is satisfied that –

(i) the decision involves a matter of general public importance, or

(ii) in the interests of justice it is necessary that there be an appeal to the Supreme Court.’


The decision of the Supreme Court under Article 34.5.6° is, in all cases, ‘final and conclusive’.


Primarily, this Court has now, ‘subject to such regulations as may be prescribed by law’, an appellate jurisdiction from the Court of Appeal. Such jurisdiction may only be exercised provided the Court is satisfied, either that the relevant decision of the Court of Appeal ‘involves a matter of general public importance’, or, alternatively, that it is ‘in the interests of justice’ necessary that there be an appeal to this Court. The constitutional framework established by the 33rd Amendment of the Constitution thus requires, in order for a party to be entitled to appeal to this Court from a decision of the Court of Appeal, that it be demonstrated that either ‘a matter of general public importance’ arises, or that ‘in the interests of justice, it is necessary that there be an appeal’ to this Court.


The statutory framework for the exercise of the right of appeal to this Court for such leave is to be found in the Court of Appeal Act 2014 and, in particular, the provisions of s. 44 of that Act, which inserts a new s. 7 into the Courts (Supplemental Provisions) Act 1961.


The Rules of Court are set out in the amended Order 58 of the Rules of the Superior Courts.


The Constitution has retained the entitlement of one appeal as a right, subject to express exclusions or regulation by statute, from the High Court to the Court of Appeal. What is sought here is a second appeal. The jurisdiction to bring an appeal to this Court is confined principally to cases where, as a result of the determination of the Court of Appeal, the decision of that Court is such that the issues raised on a proposed appeal would involve a matter of general public importance, or would be such that it is in the interests of justice that there be a further appeal to this Court.

Factual and procedural background

The Respondents in their notice in response to Mrs. Healy's application dispute the outline of the information about the decision that it is sought to appeal set out in Section 4 of Mrs. Healy's application for leave and, in particular, the portion thereof headed ‘Concise Statement of Facts’ found in the High Court, asserting that the narrative does not represent an accurate account of the facts proved in evidence. In the light of that dispute, the summary of the factual and procedural background which follows, is based on the judgments and orders of the High Court and the Court of Appeal which are before this Court.


The action brought by Mrs. Healy in the High Court was an action for damages for medical negligence and breach of duty against Dr. Buckley and the Hospital, which was initiated in 2004. The action was based on alleged negligence by Dr. Buckley, a consultant endocrinologist at the Hospital, and by the Hospital in the period between September 2000 and March 2001.


In February 1982, Mrs. Healy, who was born in 1946, was found to have a large pituitary tumour. Over the years from 1982 to September 1995, Mrs. Healy was treated and reviewed in the Hospital by various clinicians. She came under the care of Dr. Buckley in the Hospital in September 1995 and he treated her thereafter until around March 2001.


The treatment of Mrs. Healy by Dr. Buckley which is at the core of her action resulted from a full endocrine review carried out on Mrs. Healy in mid-August 2000, on the recommendation of Dr. Buckley, in the Hospital, including an MRI scan which was carried out in Cork University Hospital. The results of the various tests carried out are outlined in the judgment of the High Court delivered by O'Neill J. (the trial judge) in the High Court proceedings. Mrs. Healy ascertained the results of the tests in the course of a telephone conversation with Dr. Buckley on 5th September, 2005, when she learned that the MRI scan revealed that she still had a large pituitary tumour and that an IGF-I test revealed that her hormone level was very significantly elevated. Dr. Buckley recommended to Mrs. Healy that she be treated with a drug, Sandostatin LAR, which had relatively recently become available. Dr. Buckley sent a prescription for the drug to Mrs. Healy and he communicated with her general practitioner that he had done so and advised that she would need to be injected with the drug every four weeks.


Soon after the administration of the first injection in early September 2000, Mrs. Healy began to experience distressing vomiting and diarrhoea. She contacted Dr. Buckley who saw her in his office on 18th September, 2000. In consequence of that consultation, Dr. Buckley altered the dosage of the drug to reduce it by half and he furnished a prescription addressed to the chemist nominated by Mrs. Healy. Mrs. Healy had the second injection at the lower dose at the beginning of October 2000 and a third approximately four weeks later and a fourth at the end of November 2000. By the end of December 2000, as the trial judge recorded, Mrs. Healy had become quite ill and was referred to hospital by her general practitioner and was admitted to the Hospital on 2nd January, 2001.


The trial judge recorded that Mrs. Healy's encounter with Dr. Buckley on that occasion appeared to be very unsatisfactory from the perspective of each and, in particular, that Mrs. Healy reacted very badly to a suggestion by Dr. Buckley that she might be suffering from depression. An ultrasound examination ordered by Dr. Buckley was carried out to test for gallstones, but the result was negative. With Mrs. Healy's consent, Dr. Buckley held a lengthy discussion with her husband and her sister on 4th January, 2001, before her discharge from the Hospital, at which the advisability of continuing with the Sandostatin LAR injections was discussed, Mrs. Healy not having taken the fifth injection which was due at the beginning of January 2001. After Mrs. Healy was discharged, Dr. Buckley wrote to her general practitioner outlining her complaints and the result of the examination and other investigations which had been carried out. In that letter Dr. Buckley suggested that the Sandostatin LAR drug should not be administered for another four weeks but that its recommencement should be considered around the beginning of February. While Mrs. Healy was in the Hospital, routine blood tests were carried out, which revealed that she was severely hypothyroid. Dr. Buckley also gave details of a prescription for Thyroxine, which he had posted to her. On the same day Dr. Buckley wrote to Mrs. Healy outlining the position to her and outlining what he had told her general practitioner.


As Mrs. Healy's general practitioner was unwilling to administer any further injections of Sandostatin LAR to her, she sourced a nurse who was known to her, who gave her the last two injections, one at the beginning of February 2001 and the final one at the beginning of March...

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