Last week marked a significant milestone in medical negligence law when Mr McNabb secured a substantial six-figure settlement against the HSE, Bon Secours Health Systems Company trading as Bon Secours Hospital Tralee, and consultant Allam Adas. The undisclosed settlement, reached through mediation and ruled upon at the High Court in Dublin, has sparked urgent calls for healthcare reform and greater accountability in diagnostic protocols.
The Case That Demands Change
Rachael O’Shaughnessy, Partner at HOMS Assist Solicitors, who led the legal action, is now calling for greater accountability and urgent reform in diagnostic protocols following the successful resolution of Mr McNabb’s case. Her advocacy extends beyond the courtroom outcome to address systemic issues that continue to affect patients and their families across Ireland’s healthcare system.
The case represents more than a legal resolution—it serves as a catalyst for examining how the healthcare system responds to medical negligence and the emotional needs of patients who have suffered harm..
The Missing Apology That Speaks Volumes
Perhaps the most telling aspect of this case was what didn’t happen during the mediation process. Despite the successful settlement, no apology was offered to Mr McNabb and his family—a detail that has profound implications for how healthcare institutions approach patient care and accountability.
“On the day of the mediation we requested an apology and didn’t get one and that upset me more than anything,”
said Rose McNabb, highlighting the emotional impact that extends far beyond financial compensation.
This absence of acknowledgment reflects a broader pattern within Ireland’s healthcare system, where institutions may settle cases without taking responsibility for the human cost of their actions.
New Legislation Offers Hope for Change
The timing of this case coincides with significant legislative developments in Irish healthcare law. The Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023, which came into effect in September 2024, mandates open disclosure of certain serious adverse events in healthcare settings.
Crucially, this legislation allows healthcare providers to offer apologies without these expressions of regret constituting an admission of liability. This represents a fundamental shift in how healthcare institutions can approach patient communication following adverse events.
Ms O’Shaughnessy noted the irony that while Tony’s case predated this legislation, the defendants should have recognised the importance of acknowledging what occurred.
“Although Tony’s case did not fall under the terms of the act, he should have been given an apology for what the Defendants did accept in terms of what occurred to him,”
she explained.
The Broader Pattern of Institutional Resistance
The McNabb case illuminates a troubling trend in how healthcare institutions handle medical negligence claims. According to Ms O’Shaughnessy, defendants continue to fight such cases vigorously but remain unwilling to provide apologies even when cases are won or settled.
This approach fails to recognise the fundamental human need for acknowledgment and understanding during times of vulnerability. Patients and their families often seek more than financial compensation—they want recognition of their suffering and assurance that lessons will be learned to prevent similar incidents.
“They [the plaintiffs] have gone through the difficulties of the case when they are in such ill-health at a most vulnerable time in their lives and they don’t get any form of apology,”
Ms O’Shaughnessy observed.
“Defendants in cases like these should think about what is important to the patient and the family.”
Listen to the full interview:
Accelerating Justice for Vulnerable Patients
Beyond the emotional considerations, the McNabb case also highlights positive developments in how medical negligence cases progress through Ireland’s court system. Ms O’Shaughnessy noted that such cases are now moving through the courts more quickly—a vital improvement given the often deteriorating health of plaintiffs.
This acceleration of justice serves multiple purposes:
- It provides timely resolution for patients who may have limited time
- It reduces the prolonged stress and uncertainty for families
- It allows for quicker implementation of any necessary healthcare improvements
The speed of resolution becomes particularly crucial when considering that many medical negligence cases involve patients with serious ongoing health conditions who cannot afford lengthy legal proceedings.
The Patient’s Perspective on System Change
Mr McNabb’s motivation for pursuing this case extended beyond personal compensation. According to Ms O’Shaughnessy, he took the case to
“highlight”
that medical errors do occur and to encourage other patients to persist with questions when something doesn’t feel right about their healthcare.
This patient advocacy represents a crucial element of healthcare improvement. When patients feel empowered to question their care and seek accountability, it creates pressure for systemic improvements that benefit everyone.
The case serves as a reminder that patients have both the right and responsibility to advocate for their own care, particularly when they have concerns about diagnosis or treatment protocols.
Professional Recognition and Patient Advocacy
Ms O’Shaughnessy’s description of Mr McNabb as
“a gentleman in the truest sense of the word”
reflects the dignity with which he approached this challenging situation. Her team’s pleasure in achieving “a good outcome like this” demonstrates the professional satisfaction that comes from successfully advocating for patients who have suffered harm.
This professional perspective highlights the importance of skilled legal representation in medical negligence cases. Experienced solicitors understand not only the legal complexities but also the emotional needs of clients during vulnerable periods.
Implications for Healthcare Policy
The McNabb case arrives at a critical moment for Irish healthcare policy. With the new Patient Safety Act in place and growing public awareness of medical negligence issues, there is an opportunity to reshape how healthcare institutions approach patient care and accountability.
Key policy considerations include:
- Implementing comprehensive open disclosure practices
- Training healthcare staff in empathetic communication following adverse events
- Establishing clear protocols for acknowledging harm without admitting legal liability
- Creating patient advocacy mechanisms within healthcare institutions
The Role of Legal Advocacy in System Change
Cases like Mr McNabb’s demonstrate the vital role that legal advocacy plays in driving healthcare improvements. When solicitors like Ms O’Shaughnessy successfully represent patients, they not only secure individual justice but also contribute to broader systemic changes.
Legal pressure creates incentives for healthcare institutions to examine their practices, implement safety improvements, and develop more compassionate approaches to patient communication. This creates a positive feedback loop where individual cases contribute to system-wide improvements.
Looking Forward: A Call for Institutional Empathy
The McNabb case ultimately represents a call for greater empathy within Ireland’s healthcare system. While medical professionals generally provide excellent care, when things go wrong, the response must acknowledge the human impact of these failures.
Ms O’Shaughnessy’s advocacy for apologies and acknowledgment reflects a deeper understanding of what patients and families need during times of crisis. Financial compensation, while important, cannot fully address the emotional harm caused by medical negligence without some form of recognition and accountability.
Building a More Accountable Healthcare System
The path forward requires healthcare institutions to embrace both the legal requirements of the new Patient Safety Act and the spirit of genuine patient care that should underpin all medical practice. This means:
- Providing timely and honest disclosure when things go wrong
- Offering genuine apologies and acknowledgment of harm
- Implementing systematic improvements to prevent similar incidents
- Supporting patients and families through the aftermath of adverse events
The McNabb case serves as both a warning and an opportunity for Ireland’s healthcare system. It demonstrates the consequences of inadequate diagnostic protocols while pointing toward a more accountable and compassionate approach to patient care.
As more cases progress through the courts and new legislation takes effect, the hope is that healthcare institutions will recognise that true healing requires more than medical treatment—it requires acknowledgment, accountability, and a commitment to continuous improvement.
For patients and families affected by medical negligence, the McNabb case offers both vindication and hope. It shows that justice is possible and that skilled legal advocacy can drive meaningful change in how healthcare institutions approach patient care and accountability.
The settlement may be concluded, but the broader conversation about healthcare reform and patient dignity is just beginning. Through continued advocacy and systemic pressure, cases like Mr McNabb’s can contribute to a healthcare system that truly serves the needs of all patients with both competence and compassion.
