Tragic death of young woman in hospital led to judicial review proceedings

In n December 2024, the High Court delivered its ruling on an application for leave to judicially review a decision of the Preliminary Proceedings Committee (‘PPC’) of the Medical Council.

When the case came on for hearing, the Court was told of the tragic background to the case. The death of a young woman in hospital led to an investigation into the circumstances of her death. Her family, who were the Applicants in the case, had serious reservations about the events surrounding her death, and had raised ‘substantial issues about the fairness of the subsequent investigation into her medical care’.

The principal grounds for the application were in respect of the procedures adopted by the PPC in reaching a decision regarding the alleged negligence of a treating doctor on the night of the young woman’s death.

The Applicants claimed that the Medical Council and the PPC (the Respondents in the case) did not accept submissions from them in respect of alleged failures of care, and did not consider a medical report prepared by an expert retained on their behalf.

There was also an allegation of objective bias in respect of one member of the PPC who had served with the treating doctor in a different context for a sufficient period of time ‘to raise concerns about the issue of objective bias in respect of their professional relationship’.

When the Respondents were put on notice of the application, they met the application by conceding that specific orders consistent with the statement of grounds prepared on behalf of the Applicants could be made: they conceded the point in respect of the objective bias issue, and agreed that the matter could be remitted to a differently constituted PPC; they confirmed in correspondence that submissions could be made on behalf of the Applicants to that Committee.

The letter offering this compromise specifically noted that the offer included the making of submissions in respect of the medical expert report, which the family had argued was not considered in the impugned decision.

The Applicants objected to the Respondents’ proposal and asked that the issue be listed for hearing in the High Court.

It was submitted that this was a case in which the family had concerns about the Respondents’ investigation and procedures and that they wanted a High Court hearing to determine the matters raised.  It was argued that there were ‘live issues in respect of the parameters of the PPC hearing and the family’s rights’.

Giving her judgment in the case, Ms Justice Gearty said that while there might have been arguable grounds for the present application when it was first made, there was no authority to support the proposition that if one party substantially concedes the case, the Court is nonetheless required to embark on a hearing on the basis that the parties are entitled to know the Court’s view.

While she was ‘sympathetic’ to the present Applicants and understood why their instructions were to seek a full High Court hearing, this represented a misguided view as to what could be achieved. As a matter of law, the most substantial part of any relief that they could obtain in the High Court was now being offered to them in the form of a full rehearing before a differently constituted PPC.

Most significantly, they had now been reassured that the expert medical report, which opened the question of potential negligence, would be considered by that newly constituted PPC. Any objection to this matter being remitted to a newly constituted PPC, could only be based on a misunderstanding of the role of the courts.

The most effective relief that a judge in the case could offer to the parties was to remit the case to the decision-maker. The PPC is the body that would ultimately assess the case, whether or not there was a High Court hearing. Any mistrust on the Applicants’ part could not be addressed by removing the decision from a body that is, under law, charged with making the decision. Were there to be any lack of fair procedures in the new decision, this would be a matter for the Applicants to consider at that time.

The Court granted certiorari quashing the original decision of the PPC on the basis conceded by the Respondents and remitted the case for re-hearing before a newly constituted PPC.

Reference: [2024] IEHC 734