Understanding the Statute of Limitations in Medical Negligence Litigation in Ireland

What is the Statute of Limitations?
The statute of limitations sets a deadline for filing a lawsuit. In Ireland, the statute of limitations for medical negligence claims is generally two years less one day from the date of the incident or the date when the injury was discovered, known as the "date of knowledge".

Section 2 of the Statute of Limitations (Amendment) Act 1991 governs the timeframe within which an injured person (the plaintiff) must commence legal proceedings. The statute aims to balance the need for justice for those with undiscovered injuries, and the necessity of ensuring actions are initiated within a reasonable period.

Date of Knowledge
The "date of knowledge" is a crucial concept in medical negligence cases. It refers to the point in time when the injured person becomes aware, or ought reasonably to have become aware, of the following:

•    The injury or harm they have suffered;
•    The fact that the injury was significant;
•    The identity of the party responsible for the injury;
•    The connection between the injury and the alleged negligence. This includes knowing the factual basis of the negligence.

Reasonable Inquiry: The court must consider whether the plaintiff could reasonably have been expected to acquire knowledge of the negligence through inquiry. 

Expert Reports: Reliance on expert reports obtained after the limitation period has expired, does not extend the limitation period if the plaintiff had prior knowledge of critical facts. The plaintiff's awareness of significant injury and its potential causes, as evidenced by their interactions with medical professionals, may be deemed sufficient for the purpose of determining the date of discovery.

How do I know if I am out of time to start a case?
If you suspect that you have been injured due to negligence, you must act promptly in seeking medical records and expert opinions to establish the date of knowledge and ensure that you are not barred by statute. Consult with one of our expert medical negligence solicitors as soon as you suspect medical negligence. They can help you determine your date of knowledge and ensure that you file your claim within the statutory period.

Recent Case Law
•    Monaghan v Molony [2024] IEHC 287
The plaintiff sustained an injury on 21st May 2015, when he had to jump over a wall to escape from a cow. Following the incident, he visited his GP, the defendant, who diagnosed a tear in his pectoralis major muscle. The plaintiff alleged negligence, nuisance, and breach of duty by the defendant, primarily for failing to refer him for an MRI and an orthopaedic assessment in May 2015, which he claimed resulted in adverse consequences.

The plaintiff issued a personal injury summons on 21st May 2018, and later amended it in July 2022 to include details of his visits to a physiotherapist and an orthopaedic surgeon. The defendant argued that the original summons was issued outside the statutory time limit, rendering the claim statute barred.

Justice Marguerite Bolger delivered the judgment on 13th May 2024. The High Court found that the plaintiff had knowledge of his injury and its causes within the statutory period prescribed by section 2 of the Statute of Limitations (Amendment) Act 1991. Consequently, the court dismissed the plaintiff's claim.

•    O'Sullivan v Ireland [2019] IESC 33
The plaintiff, Mr. O'Sullivan, contracted Methicillin-resistant Staphylococcus aureus (MRSA) during an operation at the Bon Secours Hospital in Cork in September 2005. The infection led to severe complications, and Mr. O'Sullivan sought to hold the hospital liable for negligence.

The plaintiff issued a plenary summons on August 19, 2008, more than two years after the alleged injury. The defendant argued that the claim was statute-barred under the 1991 Act. However, the plaintiff contended that he only became aware of the injury's connection to the hospital's negligence in February 2007, when he consulted an expert.

The High Court ruled in favour of the plaintiff, finding that he did not delay unreasonably in seeking expert advice and that the date of knowledge was within the statutory period. The Court of Appeal, with one dissenting judgment, upheld this decision. The defendant then appealed to the Supreme Court.

The Supreme Court, in a judgment delivered by Charleton J, upheld the decisions of the High Court and the majority in the Court of Appeal. Charleton J noted that the plaintiff's knowledge of the injury's connection to the hospital's negligence came in February 2007, within two years of issuing the plenary summons in August 2008. This date of knowledge was crucial in determining the commencement of the limitation period. The court found that the plaintiff did not delay unreasonably in seeking expert advice.

•    Green v. Hardiman ([2019] IESC 51)
The plaintiff underwent abdominal surgery at Tallaght Hospital on December 11, 2007, to address issues with his colon and bladder caused by a colovesical fistula. During the surgery, the plaintiff's small bowel was accidentally torn, leading to severe post-operative complications, including infection, wound sepsis, peritonitis, and a ventral hernia. The plaintiff underwent multiple surgeries to address these complications.

The plaintiff issued a Personal Injury Summons on August 7, 2012, outside the two-year limitation period. The defendant argued that the claim was statute-barred, while the plaintiff relied on the "date of knowledge" provision.

In the High Court, the trial judge ruled against the defendant's limitation defence, finding that the plaintiff's proceedings were commenced within two years from the date he first had the requisite knowledge. The judge concluded that the plaintiff did not have sufficient knowledge of the negligence until he received an expert report from a Professor K on 20th May 2012. This report was the first time the plaintiff became aware that the failure to perform a CT scan on December 14, 2007, constituted negligence.

The defendant appealed the High Court's decision, but the Court of Appeal upheld the ruling. The Court of Appeal agreed that the plaintiff could not have known about the omission to perform the CT scan until he received his medical records and the expert report. 

The Supreme Court, concurring with the two lower courts, dismissed the appeal, holding that the plaintiff's action was not statute barred. The court emphasised the importance of considering the plaintiff's knowledge of the injury and the circumstances surrounding the acquisition of such knowledge when determining the limitation period for bringing this type of action.

Proposed Changes
There is a proposed provision in the Legal Services Regulation Act 2015 that, once commenced, will extend the time period within which to issue proceedings claiming medical negligence from two years to three years. This three-year period will run from the date on which the cause of action accrues or from the date of knowledge (if later) of the injured person.

Written by: Johan Verbruggen