€22.5m settlement for boy with brain damage

beerguts

beerguts wrote: »

This isn't going to be a popular opinion but I feel this is a very excessive settlement award. The boy was not diagnosed with meningitis after birth and now has brain damage due to the medical negligence.I have no issue with compensation to cover the care for the lad over the course of his life but that could never amount to over €22 million euro.

Is their any safeguards to the state in this award that if he was to die early in life that the sum remaining would be reclaimed by the state. I don't think the parents should be entitled to any large sum that remained in this senario.



https://www.rte.ie/news/courts/2020/0917/1165723-settlement/

The quality of life lost not just by him but his parents as well.

I would certainly want my kids healthy than rich and brain damaged

boombang

simongurnick wrote: »

Settlement payments aren't coming from hospital budgets. They have insurance policies against this and very often the settlement isnt paid lump sum, but spread over years in installments

I don't think it makes a difference either way, as the costs are massive, lump sum or spread out, but it's my understanding that the HSE doesn't buy insurance as it's large enough to aggregate the costs.

I read recently that something like €2bn of the health spend is on compensation.

I think it's out of control.

Infini

It might sound cruel but if someone has such severe damage to the brain that they'll never have any sort of quality of life or being able to actually live only exist, Death would be a better option. We can compensate for many physical thing's or even replace defective organs and limbs but when it comes to matters surrounding the brain if the damage is severe enough to the point one's perception of the world around them is severely limited and they cant even communitate properly it's honestly not even worth staying alive for. Wouldn't wish what this kid is suffering on anybody tbh it's just a neverending lifetime of hell with death being the only release from it at the very end. The payment might seem excessive but to be honest it's to cover him for the rest of his life, we really shouldn't need these kinds of payments though if someone ends up like this they deserve to have their full needs covered instead.

ohnonotgmail

boombang wrote: »

I don't think it makes a difference either way, as the costs are massive, lump sum or spread out, but it's my understanding that the HSE doesn't buy insurance as it's large enough to aggregate the costs.

I read recently that something like €2bn of the health spend is on compensation.

I think it's out of control.

that is irrelevant to this kid. Lifelong fulltime care for what could be decades is VERY expensive.

ohnonotgmail

Infini wrote: »

It might sound cruel but if someone has such severe damage to the brain that they'll never have any sort of quality of life or being able to actually live only exist, Death would be a better option. We can compensate for many physical thing's or even replace defective organs and limbs but when it comes to matters surrounding the brain if the damage is severe enough to the point one's perception of the world around them is severely limited and they cant even communitate properly it's honestly not even worth staying alive for. Wouldn't wish what this kid is suffering on anybody tbh it's just a neverending lifetime of hell with death being the only release from it at the very end. The payment might seem excessive but to be honest it's to cover him for the rest of his life, we really shouldn't need these kinds of payments though if someone ends up like this they deserve to have their full needs covered instead.

they will have their full needs covered. and they can do it without having to rely on the HSE who would never provide the level of care that this child needs.

Peregrinus

boombang wrote: »

I understand this sentiment, but there's going to be €22.5m worth of care taken away from other patients to look after this unlucky lad.

I know. But why should their care needs be prioritised over his care needs?

You could be absolutely brutal about this, and reason as follows:

1. Avoiding medical accidents costs money. When you have very complex systems (and hospitals are very complex systems) operating at the limit of their capacity - all equipment being use as intensively as possible, staff being as busy as possible, etc - that's when accidents are most likely to happen and when they are most difficult to recover from, because there is so little slack, so little spare time or resources in the system; everything and everyone is under maximum pressure all the time. This is a truism of organisation studies; you're not going to change it.

2. Medical accidents can be very expensive, as this case shows.

3. If you want to minimise medical accidents, and thus minimise that expense, what you have to do is operate systems below capacity. Either use the current resources (both physical resources and staff) less intensively and accept a lesser output, or put more resources into the system and use them less intensively to obtain the same output as at present. You'll then have a more resilient system with fewer accidents.

4. But you'll have a less efficient system; you're getting less healthcare outcomes for your euro.

5. In theory, there's a "sweet spot" - an optimum level of medical accidents such that, although it costs you a lot of money to pay for those medical accidents, it would cost you more money to reduce pressure across in the system to avoid them.

You can see why I call this brutal - it suggests that there's an acceptable, even a desirable level of medical accidents which maximises the efficiency of healthcare expenditure.

Most of us revolt against that calculation. Effiency of healthcare expenditure is important, but it's not the only important consideration, or even the most important consideration. Not actively harming patients is a pretty basic requirement for healthcare, and ought to be pursued even if it reduces the efficiency of healthcare overall.

If you accept that, then there's no case for not property recognised the costs of medical accidents, since that reduces the incentive to avoid medical accidents and, if you reduce the incentive to avoid them, more of them will happen.

s1ippy

Infini wrote: »

It might sound cruel but if someone has such severe damage to the brain that they'll never have any sort of quality of life or being able to actually live only exist, Death would be a better option. We can compensate for many physical thing's or even replace defective organs and limbs but when it comes to matters surrounding the brain if the damage is severe enough to the point one's perception of the world around them is severely limited and they cant even communitate properly it's honestly not even worth staying alive for. Wouldn't wish what this kid is suffering on anybody tbh it's just a neverending lifetime of hell with death being the only release from it at the very end. The payment might seem excessive but to be honest it's to cover him for the rest of his life, we really shouldn't need these kinds of payments though if someone ends up like this they deserve to have their full needs covered instead.

People with brain damage lead fulfulling and happy lives. They have emotions, likes and wants the same as you do. Their ability to communicate is limited, granted, but so is a pet's. Do you think we should kill all pets as well because it's inconvenient to care for them and you can't ask them how they're getting on? What if you or your child were in a car accident tomorrow and came out with most of your faculties, if the other driver was found to be responsible do you think it should be a case of him saying "I can't afford to pay for his care and he's got brain damage so he won't even enjoy being alive" and that's that, plug pulled?

It's fairly rich of you to presume that you can make a determination about somebody else's life experiences when you so clearly have such limited perception in your own.

BattleCorp

beerguts wrote: »

This isn't going to be a popular opinion but I feel this is a very excessive settlement award. The boy was not diagnosed with meningitis after birth and now has brain damage due to the medical negligence.I have no issue with compensation to cover the care for the lad over the course of his life but that could never amount to over €22 million euro.

Is their any safeguards to the state in this award that if he was to die early in life that the sum remaining would be reclaimed by the state. I don't think the parents should be entitled to any large sum that remained in this senario.



https://www.rte.ie/news/courts/2020/0917/1165723-settlement/

I don't mean to be disrespectful but I don't think you realise how much care this kid will need for the rest of his life nor the cost of providing such care.

Infini

s1ippy wrote: »

People with brain damage lead fulfulling and happy lives. They have emotions, likes and wants the same as you do. Their ability to communicate is limited, granted, but so is a pet's. Do you think we should kill all pets as well because it's inconvenient to care for them and you can't ask them how they're getting on? What if you or your child were in a car accident tomorrow and came out with most of your faculties, if the other driver was found to be responsible do you think it should be a case of him saying "I can't afford to pay for his care and he's got brain damage so he won't even enjoy being alive" and that's that, plug pulled?

It's fairly rich of you to presume that you can make a determination about somebody else's life experiences when you so clearly have such limited perception in your own.

You seem to have completely missed the point entirely, my point isnt about simple communication it's was about being able to percieve the reality of the world around you, the actual ability to act and live and witness the world. The damage the kid has suffered includes Cerebral palsy, mobility and neurolgical damage. The severe kind of damage the kid has suffered is of such cruelty I would consider it torture in a sense as there's no chance of being able to live any true sort of life only existing in a permenant state of limbo. Cerebral Palsy is also progressive and it gets gradually worse over time and can be severely dehabilitating in later stages.

It would be like having your sight and hearing severely curtailed to the point it's difficult to even understand, being barely able to comprehend ones surroundings, being unable to do the simplest thing's like go to the bathroom or shower on your own, lacking any kind of independence or dignity and even being able to do anything on your own without constant assistance either from ones parents till they die or a medical helper. There's no release except death, there's no way to improve or repair the damage, your left unable to do anything until either your body fails or one dies of natural causes.

If I ever suffered that kind of injury to my Brain that left me unable to live I wouldnt want to exist like that, would be better to be put out of my misery than exist in a permenant state of limbo with no way of improving or living any sort of life. It's a bit rich to come assuming I'm making assumptions when I'm perfectly aware of the kind of suffering one can be put through when one suffers damage to their brain, believe me theres plenty out there who would actually share my view, once the damage to one's brain reaches such a point it's no longer worth living it's just torturous and meaningless existence until the end.

eviltwin

Geuze wrote: »

Surely the HSE will be paying for social care anyways?

Ah come on you can't be that naive. HSE will pay for only the most basic of care and sometimes not even that.

lawred2

beerguts wrote: »

This isn't going to be a popular opinion but I feel this is a very excessive settlement award. The boy was not diagnosed with meningitis after birth and now has brain damage due to the medical negligence.I have no issue with compensation to cover the care for the lad over the course of his life but that could never amount to over €22 million euro.

Is their any safeguards to the state in this award that if he was to die early in life that the sum remaining would be reclaimed by the state. I don't think the parents should be entitled to any large sum that remained in this senario.



https://www.rte.ie/news/courts/2020/0917/1165723-settlement/

jesus

you think it's party time for them now?

Strumms

Infini wrote: »

You seem to have completely missed the point entirely, my point isnt about simple communication it's was about being able to percieve the reality of the world around you, the actual ability to act and live and witness the world. The damage the kid has suffered includes Cerebral palsy, mobility and neurolgical damage. The severe kind of damage the kid has suffered is of such cruelty I would consider it torture in a sense as there's no chance of being able to live any true sort of life only existing in a permenant state of limbo. Cerebral Palsy is also progressive and it gets gradually worse over time and can be severely dehabilitating in later stages.

It would be like having your sight and hearing severely curtailed to the point it's difficult to even understand, being barely able to comprehend ones surroundings, being unable to do the simplest thing's like go to the bathroom or shower on your own, lacking any kind of independence or dignity and even being able to do anything on your own without constant assistance either from ones parents till they die or a medical helper. There's no release except death, there's no way to improve or repair the damage, your left unable to do anything until either your body fails or one dies of natural causes.

If I ever suffered that kind of injury to my Brain that left me unable to live I wouldnt want to exist like that, would be better to be put out of my misery than exist in a permenant state of limbo with no way of improving or living any sort of life. It's a bit rich to come assuming I'm making assumptions when I'm perfectly aware of the kind of suffering one can be put through when one suffers damage to their brain, believe me theres plenty out there who would actually share my view, once the damage to one's brain reaches such a point it's no longer worth living it's just torturous and meaningless existence until the end.

Because YOU consider it torture doesn’t mean they or anybody else does. Get yourself in contact with the organization ‘headway’ in blackball place. They will show you just how out of touch with reality you are. Take it from me.

EndaHonesty

boombang wrote: »

I understand this sentiment, but there's going to be €22.5m worth of care taken away from other patients to look after this unlucky lad.

The money does not come out of the HSE budget so no care will be taken away from anyone.

The money comes out of the national reserve fund...

Nermal

EndaHonesty wrote: »

The money does not come out of the HSE budget so no care will be taken away from anyone.

The money comes out of the national reserve fund...

And if the national reserve fund didn't have to be funded to pay for it, the HSE budget could be larger.

Payouts from the public system should be capped at a much, much lower level than this and a higher standard of negligence should be proven. If you have a problem with that, go private - you'll see what indemnity really costs then.

Let people choose the level of risk and insurance they're willing to pay for.

Peregrinus

Nermal wrote: »

And if the national reserve fund didn't have to be funded to pay for it, the HSE budget could be larger.

Nermal wrote: »

Payouts from the public system should be capped at a much, much lower level than this and a higher standard of negligence should be proven. If you have a problem with that, go private - you'll see what indemnity really costs then.

Let people choose the level of risk and insurance they're willing to pay for.

I don't really think we want to operate a public health system in which doctors are held to lower professional standards than would otherwise apply.

On the matter of choice, if you go private there's nothing to stop you contracting with a provider on the basis that the provider has a reduced standard of care to you and a correspondingly reduced liablity, so people who want that can have it. The choice is already there. But I can't see any argument for imposing such a rule on people who use the public health service. That's not choice; that's just depriving people of the rights that other people enjoy by default.

Nor is it clear why we would single out the victims of medical accidents for this vindictive treatment. Why don't we just impose a rule that the HSE does not owe the normal obligations to, say, cancer patients? Couldn't cancer patients go private if they want the full service?

hullaballoo

I don't think this gets much attention but the absolute maximum that can be paid in this country for general damages - that is the pain, suffering, inconvenience and loss of a normal life as a result of injuries - is €450,000.

Every penny over and above that in any award is for out-of-pocket expenses past and future. Other people have done the maths that show €22.5 million looks like a big number until you divide it into hours in years for average life expectancy etc.

Being honest, most people who understand money would baulk at the idea of receiving a one time only payment of €22.5 million today and never getting anything else for the rest of your life, not because €22.5 million is not a lot of money today but because we have no idea what value €22.5 million will have in 20, 30, 40+ years. All we can really reasonably say about it is that it is highly likely to be worth less than it is worth today. How much less is not a question we can answer with any certainty even with the relatively stable long term economic outlook we have as EU members.

So two big takeaways for me in this thread are 1. I would take my (almost) fully intact body over any amount of money and 2. the idea of a "large payout" is relative to place and time.

s1ippy

The ward of court system is responsible for incurring a return on investment on the sum of money over the course of its use, so there's no fear of it running out. I suspect that the entire thing is actually a hugely profitable endeavour for the state, given the enormous sums involved.

Knine

Geuze wrote: »

Another point - given that social care is available from the HSE, financed by taxes, why the need for the award?

I think I know the answer, but would like it confirmed.


It is that Judges have agreed that private care is allowed in the award, so the award must be big enough to pay for private social care.

Really? Clearly you are not a Carer for someone with a severe disability. There is little to no help or respite. In this pandemic Carers have largely been forgotten. Caring is also 24/7

hullaballoo

s1ippy wrote: »

The ward of court system is responsible for incurring a return on investment on the sum of money over the course of its use, so there's no fear of it running out. I suspect that the entire thing is actually a hugely profitable endeavour for the state, given the enormous sums involved.

It's all publicly available information so supect no more: https://www.courts.ie/acc/alfresco/e184b845-c657-4a75-ac34-13be650c0f04/Accountant%20Report%202019.pdf/pdf

That's the most recent financial report I found. Admittedly it was not easy to find on the courts.ie website but it was one of the first results on google for "accountant of the courts of justice financial statements 2019".

Munstergirl854

Just out of curiosity, what chunk of that would the legal team receive?

Munstergirl854

Munstergirl854 wrote: »

Just out of curiosity, what chunk of that would the legal team receive?

Paid by the other side usually.

Even though it's an eye watering amount, there wouldn't be much fight in it and the court date is only really needed to fix a price.

Geuze

lawrencesummers wrote: »

Does that 22 million come out of the medical budget this year?

How many cut backs will there be this year because of that money not being available, or how much better a health system would it be with an additional 22 million. How many nurses and doctors does 22 million pay for?

A part of the NTMA called the State Claims Agency deals with these claims.

https://www.ntma.ie/business-areas/state-claims-agency

https://stateclaims.ie/

About Our Work

The NTMA is known as the State Claims Agency (SCA) when managing personal injury and property damage claims against the State and State authorities, as delegated to it, and in providing related risk management services. As the SCA, the NTMA also manages claims for legal costs against the State and State authorities, as delegated to it, however so incurred.

The SCA has three core areas of work:

Claims Management

Risk Management

Legal Costs Management

Geuze

lawrencesummers wrote: »

Does that 22 million come out of the medical budget this year?

How many cut backs will there be this year because of that money not being available, or how much better a health system would it be with an additional 22 million. How many nurses and doctors does 22 million pay for?

How many settlements were made 8 years ago that reduced the ability of the HSE to be adequately staffed when that child was born?

See p40 of NTMA annual report:

https://www.ntma.ie/uploads/publication-articles/NTMA-Annual-Report-2018.pdf

Yellow_Fern

lawred2 wrote: »

jesus

you think it's party time for them now?

I think people just want an understand of why the sum is so large and what it is supposed to pay for. It is important to note that pay outs like these are why private ob/gyns have to pay annual insurance of hundreds of thousands which means women have to pay more to maintain their health, if they can even get it as specialists may enter other less risky areas. I am not implying the figure is too high, I just like to know more.

Peregrinus

It's to pay for everything that child will need for the rest of his expected life. It's not just a lifetime's medical care, physical therapy, 24-hour attendants, special education, etc, but also all the "normal" things like housing, food, clothing, etc, because he will never work and will not be able to pay for them himself. It'll also cover, e.g., the lifetime loss of earnings of either or both of his parents, if they are going to care for him in priority to working. (I don't know whether they are or not in this case, but that would be common).

There will also be an element of "general damages" to compensate him for the diminution in his quality of life resulting from his incapacity. There are guidelines for awards of this kind, which I'm afraid I'm not up to date on; other posters may know more. But for a profound and lifeling disability incurred at an early age, he would be awarded pretty close to the top of the scale. But that will be a minor part of the overall 22.5 million award.

ohnonotgmail

Peregrinus wrote: »

It's to pay for everything that child will need for the rest of his expected life. It's not just a lifetime's medical care, physical therapy, 24-hour attendants, special education, etc, but also all the "normal" things like housing, food, clothing, etc, because he will never work and will not be able to pay for them himself. It'll also cover, e.g., the lifetime loss of earnings of either or both of his parents, if they are going to care for him in priority to working. (I don't know whether they are or not in this case, but that would be common).

There will also be an element of "general damages" to compensate him for the diminution in his quality of life resulting from his incapacity. There are guidelines for awards of this kind, which I'm afraid I'm not up to date on; other posters may know more. But for a profound and lifeling disability incurred at an early age, he would be awarded pretty close to the top of the scale. But that will be a minor part of the overall 22.5 million award.

hullaballoo mentioned that general damages are capped at 450,000

Nermal

Peregrinus wrote: »

But I can't see any argument for imposing such a rule on people who use the public health service.

The argument is simply about resources, on which fanciful notions of 'rights' actually depend. We cannot afford a health service if the legal system delivers this type of result. The public health system is obliged to treat all patients. Because it has to play the game, it has to be allowed to set the rules.

Consider what would happen if a drug became available that would cure this person, but cost say €4M. The HSE would, under its own rules, not be able to purchase it - it cannot pay more than €40,000 per quality-adjusted life year for any medical intervention.

One arm of the state values life at €40,000 per year, the other appears to value it at well over a quarter of a million. Not realistic, not consistent, not affordable.

ohnonotgmail

Nermal wrote: »

The argument is simply about resources, on which fanciful notions of 'rights' actually depend. We cannot afford a health service if the legal system delivers this type of result. The public health system is obliged to treat all patients. Because it has to play the game, it has to be allowed to set the rules.

Consider what would happen if a drug became available that would cure this person, but cost say €4M. The HSE would, under its own rules, not be able to purchase it - it cannot pay more than €40,000 per quality-adjusted life year for any medical intervention.

One arm of the state values life at €40,000 per year, the other appears to value it at well over a quarter of a million. Not realistic, not consistent, not affordable.

who has put a value of a life at 250,000 a year?

Nermal

ohnonotgmail wrote: »

who has put a value of a life at 250,000 a year?

It's implied by the amount awarded by the courts and average life expectancy.

Feisar

The word compensation is completely the wrong word here. €22 million? You'd as well unload a pile of manure at their door in terms of what €22M means when it comes to compensating. It is not like a object was destroyed and here's the monetary value of it. One cannot compensate for wrecking someones life and also their parents lives. I have a toddler running around here and I could not attempt to put a value on his health. As for the parents "netting" a couple of million should the lad not live very long??? People must lack an understanding of the parent/child bond. We are talking about people who would gladly give the lad their last pint of blood if it would cure him.