As we near the end of 2025 we look back and reflect, and we are pleased to advise that there have been some very positive developments in the management of clinical negligence claims.
Practice Directions
2025 saw the introduction of two new, and very welcome, Practice Directions (HC131 & HC132), which came into effect on 28 April 2025.
HC132 introduced a ‘Clinical Negligence List’ which allows for clinical negligence cases to be managed by judges who have specific expertise in clinical negligence. This is a welcome development and it is anticipated that it will assist all parties in progressing clinical negligence claims efficiently, speeding up the resolution and determination of claims. While we do not have a separate court for clinical negligence claims, a dedicated list is a significant step forward.
HC131 provides practical guidance and criteria on the procedural steps all parties in litigation must take before a hearing date can be fixed for trial in the new ‘Clinical Negligence List’. Again, its purpose is to improve efficiency, and is also a welcome addition.
Implementation Plan for the Recommendations of the Interdepartmental Working Group on the Rising Cost of Health-Related Claims
On 16 October 2025 the Department of Health published its Implementation Plan on health-related claims. Building on the recommendations of the Working Group Report issued in 2024 its objectives include open disclosure, patient safety, litigation reduction and court reform. There is real emphasis on the need to make litigation more efficient, less costly and less adversarial.
Some reforms are already in place. The Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023 has commenced, placing openness at the heart of the response to adverse events. The High Court has also introduced new practice directions in clinical negligence cases (see above) to improve efficiency.
Looking ahead, one of the Plan’s most closely watched commitments relates to the introduction of Pre-Action Protocols (‘PAPs’). Draft regulations for PAPs are expected by the end of 2025. These would require parties to exchange information and expert evidence at an early stage, encouraging earlier resolution and reducing the need for prolonged proceedings. If delivered, these reforms would transform how clinical claims are managed.
Cases
2025 has also seen some very encouraging judgments in clinical negligence cases.
Tynan v Bon Secours [2025] IEHC 81 involved a case where the treating team’s recollection of the surgery conflicted with the patient‘s recollection, but the Court favoured the treating team’s account. The plaintiff alleged she experienced excruciating pain and anxiety during a cardiac procedure. She alleged that she had been crying intensely and shouting due to the excruciating pain she was experiencing, but she was ignored. She also alleged that the treating team’s notes were incomplete. The treating team’s evidence was that there had been only one instance where the patient voiced discomfort and that additional levels of anaesthetic and fentanyl were administered at that point.
Mr Justice Paul Coffey (at paragraph 125) stated that ‘[p]roper medical and nursing practice requires that significant or concerning events, including pain or emotional distress, are documented’. He went on to say that the plaintiff’s allegation that there was a persistent and total failure to record any of her ongoing complaints of severe pain was ‘inherently implausible, as it implies a deliberate, if not concerted, ongoing failure by all team members over the course of the 54-minute procedure to perform a simple, straightforward but fundamental duty’. Importantly, this was not a case where there were few or no notes, rather there had been regular and diligent recording of all the plaintiff’s vital signs throughout the procedure, which suggested that expressions of pain or crying would have been recorded, had they occurred.
In all the circumstances, the Court dismissed the patient’s claim.
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In Gimenez Perez v Coombe [2025] IEHC 396 Ms Perez suffered from bleeding and collapsed at home two and a half weeks after giving birth. She alleged, amongst other things, that there had been a failure to diagnose and treat her post-partum haemorrhage caused by incomplete delivery of the placenta, preventing her uterus from contracting and stemming bleeding from the uterine wall. The notes documented that the placenta was checked by the midwife after delivery and that it ‘appears complete’. Ms Perez also criticised her subsequent management at another hospital after her collapse at home.
In deciding the case, Ms Justice Egan reiterated that the standard of care was to be determined on the basis of the ‘Dunne principles’, and that (i) the Court must identify as a matter of fact what would an ordinary competent professional of the type and skill of the individual concerned have done, and (ii) then consider whether the defendants had complied with that standard.
Ultimately, the Court held that there had been no clinical negligence on the part of the defendants, and dismissed the plaintiff’s case.
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In addition, 2025 saw a very welcome judgment in a case involving occupiers’ liability.
Kandaurova v Circle K [2025] IECA 13 related to a trip and fall injury, which occurred on the forecourt of the defendant’s fuel station. Ms Kandaurova was driving to work and stopped for a coffee at the station at around 7am. She was five months pregnant at the time. While returning to her car, she tripped over a raised kerb or ‘nib pavement’ and fell forward onto the ground.
Mr Justice Noonan opened with the words:-
Life is full of dangers which may cause injury if not avoided. Small children develop by encountering and learning to avoid things that can be fallen off, bumped into, tripped over or knocked down. In the common law of occupiers’ liability, ordinary everyday dangers are described as “usual” and as such, do not attract liability.
The Court held that there was no evidence that the nib pavement constituted an ‘unusual’ danger, and that it was clear that the plaintiff could not have been taking reasonable care for her own safety in failing to see the kerb over which she fell. The plaintiff’s case was dismissed and costs were awarded against her.
Challenge Medico-Legal Updates
by Josephine Breen, Solicitor/Medico-Legal Advisor
Josephine has extensive experience in the area of medical negligence defence litigation and health law generally. She has managed and resolved a wide range of healthcare related claims and complaints on behalf of individual healthcare practitioners and healthcare organisations. She has advised on many and varied healthcare-related issues including capacity to consent to medical treatment; confidentiality and disclosure of personal information; public health issues and mental health issues. She has also attended at Coroners Court and Medical Council hearings.
Josephine has been admitted as solicitor in two jurisdictions, having been admitted as a solicitor in the Republic of Ireland in 1998 and as a lawyer in the Supreme Court of Western Australia in 2013.
In Western Australia Josephine worked as a Medico-Legal Case Manager (Solicitor) with MDA National, a leading Australia-wide Medical Defence Organisation. Before that Josephine was a Solicitor with the Department of Health (Western Australia) in their Legal & Legislative Services Unit.
In Ireland, Josephine worked for eight years as a Solicitor/Clinical Claims Manager in the specialist clinical litigation section of the State Claims Agency (Clinical Indemnity Scheme). Prior to that Josephine was a Solicitor and Medico-Legal Advisor with St. Paul Ireland Insurance which insured approximately 4,000 non-consultant hospital doctors.