The High Court approves modular trial of two distinct questions of fact in a medical negligence claim

RDJ's Healthcare Department were recently involved in a successful application for a modular trial in a complex medical negligence action.

Judgment of Ms. Justice Reynolds 5 March 2025 [i]

This Judgment addressed an application by the HSE for a modular trial seeking to first resolve two key factual issues before any other issues are litigated.

Background and Key Issues

The background of the case involves allegations of medical negligence during the Plaintiff’s birth in 2013 which allegedly led to hypoxic ischaemic encephalopathy, developmental delay and autism spectrum disorder.

Initially, the claim focused on the alleged failure to expedite delivery based on the CTG. However, a new expert for the Plaintiff later suggested that the CTG had recorded the maternal rather than the foetal heart rate, thereby entirely shifting the basis of the claim.

In making the application for a modular trial, the Defendant sought to have two factual questions addressed at the outset of the trial:-

1. Whether the Defendant failed to identify that the CTG was recording the maternal heart rate instead of the foetal heart rate;
2. Whether the Defendant breached its duty by not reintubating the Plaintiff as pleaded.

Respective Arguments

The HSE argued that if the CTG issue was resolved in its favour, the allegations of negligence during labour would fail entirely. Similarly, if the decision not to reintubate was found reasonable, the neonatal care claim would fail. The Defendant emphasised the benefits of efficiency of Court time and costs saving in dealing with the matter in this way rather than a split trial on liability or a unitary trial of considerable complexity and time.

The Plaintiff’s representatives contended that the case involved broader medical evidence beyond obstetrics and that a modular approach would oversimplify complex negligence and causation issues.

Legal Principles

The Court considered the legal framework for modular trials, citing caselaw [ii] [iii] which established that, while the default position is a unitary trial, the Court has discretion to order modular proceedings where issues are discrete and their early resolution would streamline litigation. The Court also emphasised that modular trials should not cause unfair prejudice and that it retains flexibility to adjust the process, if required.

In Weavering, it was held that there is an obligation on the Court, in embarking on a modular trial, to ensure that justice can be achieved in proceeding in that manner and, if at any stage, the Court considers otherwise, the Court can take such steps as are necessary to ensure that no injustice is caused. The Supreme Court went on to determine that there may be “a range of practical circumstances” to which the Court should have regard in determining whether there was likely to be a “net benefit” in proceeding with a modular trial and such factors were likely to vary depending on the circumstances of the case in question.

Decision

In finding in favour of the Defendant, Ms. Justice Reynolds ruled that a modular trial would provide clear time and cost savings without causing unfair prejudice to the Plaintiff. Ms. Justice Reynolds found that the two factual questions were discrete and independently determinable making them suitable for modular resolution. If new complexities arose, the Court retained its discretion to adjust the process to prevent any injustice.

Ms Justice Reynolds stated “I am satisfied for the reasons outlined above that the issues identified by the defendant are discrete issues which are “capable of being determined independently of the balance of the trial”. I do not accept the contention that a modular trial would be in any way prejudicial to the plaintiff’s interest and inimical to a fair trial. In my view, the plaintiff has failed to demonstrate any real prejudice in this regard and I am satisfied that the matters raised are not relevant to the determination of the issues, and not intrinsically interconnected as alleged.”

Conclusion

This decision highlights the Court’s commitment to efficient case management, and the reduction of Court time and costs, including in complex medical negligence claims, while balancing fairness and procedural flexibility.

[i] Iarla Thompson (a minor suing by his parents and next friends) v HSE The High Court Record Number 2022/1444P

[ii] Weavering Macro Fixed Income Fund Limited v PNC Global Investment Service (Europe) Ltd [2012] 4 IR 681

[iii] Cork Plastics (Manufacturing) v Ineos Compound UK [2008] IEHC 93