Meyer by his Tutor Lara Meyer v Western Sydney Local Health District [2023] NSWSC 4031 (1)
Background: James Meyer’s Brain Injury Due to Transplant Infection
The Plaintiff, Mr James Meyer, was a young father of two (2), who suffered a catastrophic brain injury as a consequence of medical negligence whilst a patient at the First Defendant’s Hospital, Western Sydney Local Health District.
The Plaintiff was born with Type 1 Diabetes Mellitus, which in or around 2016 led to an end stage renal disease requiring dialysis.
In or around 1 August 2018, the Plaintiff underwent a ‘successful’ simultaneous pancreas and kidney transplantation after becoming eligible for the procedure only some two (2) years after his renal failure.
However, as discovered in the latter, the deceased donor of the kidney and pancreas was infected by ‘strongyloides stercoralis’, a pathogenic parasitic roundworm which is linked with causing strongyloidiasis.
As a result of the transplantation, the Plaintiff became infected by the parasitic roundworm and the associated disease. Ultimately, the parasite breached the brain’s blood-fluid barrier causing the Plaintiff to go into septic shock and suffer catastrophic brain injury.
As a consequence of the Plaintiff’s injuries, he now suffers from catastrophic physical and psychological injuries which require the assistance of paid carers on a twenty-four (24) hour seven (7) day a week basis.
The Plaintiff brought the claim against Western Sydney Health District (First Defendant), Southern Adelaide Local Health Network Incorporated (Second Defendant) and South Eastern Sydney Local Health District (Third Defendant).
The First and Third Defendants were the New South Wales health authorities responsible for co-ordinating the provision of donor organs for transplant and was responsible for the Westmead Hospital where the transplant was carried out. The Second Defendant was responsible for the active monitoring of the Plaintiff when he returned to his home state, South Australia.
The Defendants did not dispute the nature of the Plaintiff’s injuries. At mediation, the main issues in contention were, whether the Defendants were liable for the medical negligence of its agents for:-
- Firstly, failing to perform a screening on the donor for parasites; and/or
- Secondly, failing to prevent the Plaintiff from reaching septic shock by identifying the exhibited symptoms as a parasite infection.
MEDICAL NEGLIGENCE
The medical guidelines require that prior to the transplantation, the First and Third Defendants were to undertake a screening for potential infections in both the donor and in the recipient. However, the Australian medical guideline as at August 2018 did not require the specific screening for strongyloides stercoralis in the donor.
Nevertheless, the First and Third Defendant conducted a screening for the parasite on the Plaintiff, however failed to do the same on the donor.
The Plaintiff was the first case in Australia to contract the infection from an infected donor organ transplantation. The Defendants argued that due to this remoteness, the Third Defendant’s agents were unable to connect the Plaintiff’s symptomology with an infection by way of parasite.
However, the Court found on the evidence that “the acquired infection was undetected notwithstanding him exhibiting symptoms, which I will simply say now with hindsight were undoubtedly related to the infection.”
THE LAW
Section 5O of the Civil Liability Act 2002 (NSW), prescribes the Standard of Care for Professionals are assessed as:-
- A person practising a profession (a professional) does not incur a liability in negligence arising from the provision of a professional service if it is established that the professional acted in a manner that (at the time of the service was provided) was widely accepted in Australia by peer professional opinion as competent professional practice.
- However, peer professional opinion cannot be relied on for the purposes of this section if the Court considers that the opinion is irrational.
- The fact that there are differing peer professional opinions widely accepted in Australia concerning a matter does not prevent any one or more (or all) of those opinions being relied on for the purposes of this section.
- Peer professional opinion does not have to be universally accepted to be considered widely accepted.
DECISION
The case against the First and Third Defendants, the New South Wales Defendants, was that the health authorities failed to co-ordinate donor organs absent of parasites.
The Plaintiff further alleged against the Second Defendant, the South Australian Defendant, that the health authority failed to detect the presence of the infection and had they done so, when a reasonable medical authority in its position ought to, there was sufficient time for medical intervention which in all likelihood would have successfully cured the infection before its catastrophic consequence.
The parties reached an agreement to settlement at mediation. Given the case is sanctioned and the Plaintiff no longer has legal capacity, the Court was to decide whether the case was concluded at mediation in the best interests of the Plaintiff.
The Court ultimately held that the proposed compromise at mediation, having regard to the nature of the issues and uncertainty of trial, was a settlement in the best interests of the Plaintiff.
