| Philp v Ryan | |
|---|---|
| Court | Supreme Court of Ireland |
| Full case name | Philp v Ryan & Anor |
| Decided | 17 December 2004 |
| Case history | |
| Appealed from | Philp v Ryan [2004] IEHC 77 |
| Case opinions | |
| Decision by | Fennelly J |
Philp v Ryan & Anor [2004] IESC 105 is an Irish tort law case concerning the actionability of the 'loss of chance' doctrine in medical negligence. [1] Contrary to the position in England and Wales consolidated in Gregg v Scott, the Supreme Court of Ireland awarded compensation to the plaintiff for their loss of life expectancy caused by the defendant's negligence, despite the lack of proof on the balance of probabilities that Mr Philp would have otherwise recovered.
The plaintiff, David Philp, was referred to Bon Secours Hospital in Cork by his general practitioner, after complaining of abdominal pain. There, the defendant negligently failed to diagnose Mr Philp with prostate cancer, and instead began treatment for prostatitis. Consequently, by the time the correct diagnosis was made 8 months later, the cancer had advanced, although it was unclear to what extent the progression was affected by the delayed treatment.
Under Fennelly J's discussion of the loss of chance doctrine in the Supreme Court, the question was whether Mr Philp could establish factual causation between his lost chance of recovery and the defendant's negligence. In short, 'but for' the defendant's negligence, was there a greater than 50% chance that Mr Philp would have recovered. In this case, the lost chance related to loss of life expectancy, meaning the court compared possible life expectancy before and after the negligent act. A similar approach was taken by the minority in Gregg v Scott, who found it inappropriate to regard the plaintiff's lost chance as their lost chance of recovery when dealing with a pre-existing condition that was always going to be terminable or otherwise incurable. [2]
In the High Court, Mr Philp was awarded €45,000 to compensate for the psychological distress he suffered as a result of his negligently delayed diagnosis and treatment. This was later increased to €100,000 by the Supreme Court. At first instance, the trial judge observed medical expertise presented by Mr Denis Murphy, a consultant Urologist, who stated in his report that "it is not clear that the delay in initiating treatment was detrimental to Mr Philp's progress." [3] There was no evidence presented of the plaintiff's initial chances of survival, which is anomalous with the majority of loss of a chance case law. [4] [2] The trial judge, Peart J, considered it inappropriate to suggest that delayed treatment had no effect on Mr Philp's recovery prospects, despite the lack of statistical evidence:
Consequently, Fennelly J, who presented the leading judgement in the Supreme Court, concluded that Mr Philp should be awarded damages in recognition of his lost chance, which he equated with an "increased risk of shorter life expectancy:" [1]
In agreement with Fennelly J, McCracken J further quantified the plaintiff's entitlement to aggravated damages to compensate for mental distress caused by the defendant. He awarded Mr Philp €50,000 in addition to the €45,000 found at first instance. The total damages awarded increased to €100,000 in recognition of Mr Philp's possible lost chance of a longer life expectancy, for which he was awarded €5,000.