Plaintiff experiences of the medico-legal environment in Ireland

Abstract

Introduction The recent surge in clinical claims in Ireland has sparked concerns about the unsustainable trajectory of medical negligence litigation. Current evaluations have primarily focused on the financial and temporal aspects of litigation, leaving a gap in understanding the experiences of plaintiffs within the adversarial system. This study aims to fill this gap by critically exploring the experiences of those affected by medical negligence and the ensuing legal process. Methods A qualitative descriptive approach was employed to explore the experiences of plaintiffs following patient safety incidents and their interactions with the legal process. Semi-structured, open-ended interviews were conducted with participants who had been involved in medical negligence litigation in Ireland. Participants were eligible for inclusion if they were aged 18 years or over and were involved in medical negligence litigation in Ireland (as a plaintiff), whether the case was resolved by negotiated settlement, a form of alternative dispute resolution (e.g. mediation), or trial hearing. Maximum variation sampling was used to capture a diverse range of experiences, with sample size determined by the concept of information power. Recruitment was facilitated by the Health Service Executive (HSE) through invitations sent by The National Open Disclosure Office. Interviews were conducted in-person or online, recorded, transcribed, and analysed thematically. Ethical approval was obtained from the Social Research Ethics Committee of University College Cork. Findings This research presents the views and experiences of fifteen participants; eleven participants shared their experiences relating to an adverse event which impacted a family member (one participant spoke about two family members), nine of whom were children (including both minors and adult children), and three were a spouse. Of the twelve individuals discussed, eight were deceased. Five main themes were identified from the analysis: i) Navigating the aftermath of a patient safety event: Communication, Support and Abandonment; ii) The pathway from adverse event to litigation; iii) Experiences of the Legal System; iv) Emotional and Mental Health Impact of Litigation on Plaintiffs; v) Advocating for Change: Participant Recommendations. Discussion This research highlights the profound impact of actions taken after a patient safety event on patients, families, healthcare professionals, and organisations, and the importance of Open Disclosure in meeting ethical obligations and ensuring healthcare accountability. It explores the complex relationships between financial compensation, justice-seeking, and the healthcare and legal systems. The findings contribute significant insights to the discourse on medical negligence in Ireland.