Pulmonary Embolism Misdiagnosis Claims in Ireland: Legal Test, Time Limits, Process

Summary: A pulmonary embolism misdiagnosis claim in Ireland is a clinical negligence action where a missed, wrong, or delayed diagnosis of a blood clot in the lungs caused avoidable harm. The legal test is the Dunne v National Maternity Hospital [1989] IR 91^[1] standard, not the UK Bolam test. The time limit is two years from your date of knowledge under the Statute of Limitations (Amendment) Act 1991, s.2^[3]. Claims bypass the IRB and proceed directly to the High Court. The HSE National Clinical Guideline on VTE, known as Eve's Protocol^[8], took effect on 4 July 2025 and now defines the standard of care.

Contents

Legal test: Dunne principles (1989), reaffirmed in Morrissey v HSE [2020] IESC 6. Stricter than the UK Bolam test.

Time limit: Two years from date of knowledge under Statute of Limitations 1991, s.2.

IRB exemption: Clinical negligence claims bypass the Injuries Resolution Board. PIAB Act 2003, s.3(d).

Standard of care: HSE National Clinical Guideline on VTE (Eve's Protocol), in force 4 July 2025. HSE NCG-VTE.

What is a pulmonary embolism misdiagnosis claim in Ireland?

A pulmonary embolism misdiagnosis claim in Ireland is a clinical negligence action. It arises where a doctor missed, delayed, or wrongly diagnosed a blood clot in the lungs and that diagnostic failure caused you avoidable harm. The harm can be physical, psychological, or financial. Under the Dunne v National Maternity Hospital [1989] IR 91 standard, the test is whether no reasonably competent doctor of the same speciality, acting with ordinary care, would have made the same error.

A pulmonary embolism (PE) is a blood clot that has travelled to the lungs, usually from a deep vein thrombosis (DVT) in the leg. Untreated PE has a mortality rate of up to 30%, falling to roughly 8% with prompt treatment. The figures come from the HSE National Clinical Guideline on VTE (Eve's Protocol) and the European Society of Cardiology guidelines it incorporates. PE is consistently named as one of the most-missed deadly diagnoses in modern emergency medicine.

A wrong diagnosis on its own does not create a legal claim. You also need to show that the error caused you measurable harm and that an independent medical expert supports the breach of duty. This is explained further on our misdiagnosis claims hub, which sets out the four-element test that applies to every misdiagnosis case in Ireland.

What are the warning signs of a pulmonary embolism, and what risk factors should doctors weight?

Pulmonary embolism warning signs are deceptively varied, which is why the diagnosis is missed so often. Eve's Protocol expects doctors to weight these features against a structured pre-test probability tool, not against intuition. Knowing the warning signs and risk factors is also the first step in deciding whether your timeline supports a viable claim.

Red-flag symptoms of pulmonary embolism

• Sudden shortness of breath at rest or on minimal exertion, often described as "I can't catch my breath".
• Pleuritic chest pain: chest pain that worsens on deep breath or cough, sometimes mistaken for musculoskeletal pain.
• Tachycardia: heart rate over 100 beats per minute without an obvious cause such as exercise or fever.
• Coughing up blood (haemoptysis), even small streaks.
• Light-headedness, syncope, or collapse, particularly on standing.
• Unilateral leg swelling, pain, or warmth suggesting a deep vein thrombosis (DVT) that has migrated.
• Low-grade fever without infection.
• A sense of impending doom or anxiety with no precipitating cause, sometimes the only feature in younger patients.

Risk factors Eve's Protocol expects clinicians to weight

• Recent surgery, particularly orthopaedic, abdominal, or cancer surgery within the last 90 days.
• Prolonged immobility from hospitalisation, plaster cast, or long-haul travel over four hours.
• Active cancer or recent chemotherapy.
• Combined oral contraceptive (COC) or hormone replacement therapy, especially in the first three months of use.
• Pregnancy or recent childbirth, peaking in the first six weeks postpartum.
• Personal or family history of DVT, PE, or inherited thrombophilia such as Factor V Leiden.
• Obesity (BMI > 30) and age over 60, both independent risk multipliers.
• Recent COVID-19 infection, which roughly triples short-term VTE risk.
• Smoking and chronic medical conditions such as heart failure or inflammatory bowel disease.

A patient presenting with one or more red-flag symptoms and two or more risk factors is, in Eve's Protocol terms, in PE-likely territory regardless of how mild the chest pain feels. A doctor who attributes such a presentation to anxiety, viral infection, or musculoskeletal pain without first calculating a Wells score and ordering a D-dimer is repeating the most-litigated diagnostic-failure pattern in Ireland.

How often is pulmonary embolism missed in Irish hospitals?

Pulmonary embolism is missed often enough to be classified as a leading preventable cause of in-hospital death. According to the HSE^[9], around 5,000 people experience a venous thromboembolism (VTE) in Ireland each year, with more than one in twelve people affected over a lifetime. The clinical literature reports that PE is misdiagnosed at first presentation in up to one-third of cases.

Three Irish data points anchor the scale of the problem.

Source	Finding	What it means for claims
Ireland East Hospital Group PE study (Blood, 2021)	958 inpatient PE episodes over 3 years across 11 hospitals serving 1.1m people. Incidence 0.37 per 1,000 adults per year. In-hospital mortality 3.1%.	PE is common enough that every Irish ED encounters it regularly. The clinical patterns are predictable.
HSE 2021 hospital figures	6,772 people had VTE either occur during, or in the 90 days after, a hospital admission. Up to 70% of these were potentially preventable with correct prophylaxis.	Hospital-acquired thrombosis (HAT) is a major Irish patient-safety issue. Lack of risk assessment is often litigated.
State Claims Agency NIMS data (2022 vs 2023)	19.3% increase in reported diagnosis incidents year on year. 79% of all diagnosis errors involved delayed access to diagnosis.	Delay (not absent care) is the dominant fact pattern in Irish diagnostic claims, including PE.

The pressure on Irish emergency departments compounds the problem. According to the Irish Nurses and Midwives Organisation^[21], 122,186 patients waited on trolleys or chairs in Irish EDs during 2024, with record-level overcrowding at University Hospital Limerick, Cork University Hospital, and University Hospital Galway. ED overcrowding is a recurring feature of named Irish coronial findings involving missed PE, including the inquest into the death of Eve Cleary at University Hospital Limerick (verdict October 2021)^[16].

One detail the official guidance does not capture: even after Eve's Protocol launched in July 2025, public awareness of VTE remains very low. HSE-cited surveys show that 75% of adults have never heard of DVT, and fewer than one in ten can name a symptom. Patients often arrive at the ED with PE already advanced because they did not recognise the warning signs.

Why is pulmonary embolism missed? Seven failure points in triage to discharge

Pulmonary embolism is missed because its symptoms overlap with anxiety, chest infection, musculoskeletal pain, asthma, and acute coronary syndrome. From handling diagnostic-failure cases in Irish hospitals, the same pattern of breakdowns recurs. The seven failure points below trace where the diagnosis fails between the moment a patient arrives and the moment they are discharged.

This is a clinical-and-investigative framework. It is not a legal scoring tool. If your situation matches several of these points, that is a signal to seek expert review, not a prediction of outcome.

This pattern is not theoretical. Coroners have repeatedly identified versions of these failure points in Irish PE deaths. Katie Doyle (27), Beaumont Hospital (verdict April 2024) illustrates failure points 1, 3, and 6. A Wells score of 1.5 was calculated. The D-dimer required by hospital protocol was not ordered. She was discharged with a panic-attack diagnosis. She collapsed at home and died of bilateral pulmonary embolism four days later. The coroner returned a verdict of medical misadventure.

What the official guidance does not say: family-channel communications now matter more than they used to. Texts, WhatsApp messages, repeated GP calls, and second-opinion attendances are admissible evidence in clinical negligence proceedings. They establish a pattern of concern that the clinical team failed to weight.

Pulmonary embolism versus the wrong diagnoses it gets confused with

The most-litigated misdiagnoses in Irish PE claims share an overlapping symptom profile with PE. The differences matter, because Eve's Protocol expects doctors to use structured probability assessment, not intuition, when these features overlap.

Wrong diagnosis given	What overlaps with PE	What should have flagged PE
Anxiety or panic attack	Tachycardia, breathlessness, sense of doom, chest tightness	Persistent tachycardia at rest, hypoxia on observation, presence of risk factors (COC, postpartum, recent surgery), no clear emotional trigger
Chest infection or bronchitis	Cough, pleuritic chest pain, low-grade fever, breathlessness	Sudden onset, no productive cough, normal or only mildly raised inflammatory markers, hypoxia disproportionate to chest examination
Acute coronary syndrome (heart attack)	Chest pain, ECG changes, raised troponin, breathlessness	Pleuritic rather than crushing pain, S1Q3T3 pattern on ECG, normal coronary arteries on angiography, right heart strain on echo
Musculoskeletal chest pain	Pleuritic pain reproduced on palpation, no clear cardiac cause	Tachycardia, hypoxia, leg swelling, recent immobility or surgery, syncope
Asthma exacerbation or COPD flare	Breathlessness, wheeze, hypoxia	No previous wheeze, no response to bronchodilators, normal peak flow, presence of unilateral leg swelling
Postpartum recovery or "normal pregnancy fatigue"	Breathlessness, leg swelling, tachycardia	New onset, asymmetric leg swelling, pleuritic pain, syncope, family history of clots

The pattern across these comparisons is consistent: PE is the diagnosis that fits the worst-case interpretation of overlapping features, and Eve's Protocol exists precisely because intuition rules it out too quickly.

How should pulmonary embolism be diagnosed in Ireland?

Eve's Protocol, in force from 4 July 2025, is the binding national standard for VTE diagnosis in Irish hospitals. It mandates a specific risk-adapted diagnostic algorithm. Knowing the algorithm is essential, because most claims turn on a clear deviation from it. HSE NCG-VTE Eve Protocol.

Step	Tool	What the doctor must do
1	Pre-test probability	Apply the two-level Wells score (or Revised Geneva). Document the score in the chart. Irish ED reference.
2A	D-dimer (PE-unlikely)	If Wells ≤ 4, order an age-adjusted D-dimer. A negative result safely excludes PE in low-probability patients.
2B	CTPA (PE-likely)	If Wells > 4 or D-dimer positive, proceed to CT pulmonary angiography (CTPA). CTPA is the gold-standard imaging test.
3	V/Q scan	Use ventilation/perfusion scintigraphy where CTPA is contraindicated, including pregnancy, contrast allergy, or significant renal impairment.
4	Bedside echo (high-risk)	For haemodynamically unstable patients, transthoracic echocardiography looks for right ventricular dysfunction. Reperfusion (thrombolysis or embolectomy) is started immediately.
5	Severity scoring	Once confirmed, the Pulmonary Embolism Severity Index (PESI or simplified PESI) stratifies 30-day mortality risk and determines whether outpatient management is safe.

Eve's Protocol also requires that anticoagulation should be started without delay in patients with high or intermediate clinical probability of PE while diagnostic workup is in progress. Waiting hours for a CTPA without starting interim treatment is a recognised breach pattern.

One detail the guidance does not say in plain terms: a clear chest X-ray and a normal ECG do not exclude PE. Around 70 to 80% of patients with acute PE have an abnormal ECG, but the abnormalities are non-specific. Doctors who anchor on a "clean" chest X-ray or a "normal" ECG and stop investigating without a Wells score are repeating the most common Irish diagnostic-failure pattern.

Wells score calculator (educational)

The Wells score is the pre-test probability tool Eve's Protocol expects an Irish clinician to apply at the bedside. Tick the criteria that applied to the patient. The calculator returns the score and category exactly as the clinician should have recorded.

Educational only. Not medical advice. Not legal advice. The Wells score is one factor among many that a clinician weighs. Use this to understand what should have been documented in the chart, then speak to a solicitor about your specific situation.

Clinical signs of DVT (leg swelling, pain on palpation along deep vein) +3

PE is the most likely diagnosis (or equally likely) +3

Heart rate over 100 beats per minute +1.5

Immobilisation 3+ days or surgery in the past 4 weeks +1.5

Previous DVT or PE +1.5

Coughing up blood (haemoptysis) +1

Active malignancy (treated within 6 months or palliative) +1

Score: 0 of 12.5

Tick any criteria above to calculate.

Reset

When is a missed pulmonary embolism actually negligent under Irish law?

A missed pulmonary embolism is negligent in Ireland when no reasonably competent doctor of the same speciality, acting with ordinary care, would have made the same diagnostic error. This is the Dunne v NMH [1989] test, reaffirmed by the Supreme Court in Morrissey v HSE [2020] IESC 6.

"The true test for establishing negligence in diagnosis or treatment on the part of a medical practitioner is whether he has been proved to be guilty of such failure as no medical practitioner of equal specialist or general status and skill would be guilty of if acting with ordinary care."

Unlike in England and Wales, in Ireland the standard of care is set by the Dunne principles, not the UK Bolam/Bolitho test. Under Bolam, a doctor is not negligent if a "responsible body of medical opinion" would have done the same thing. Under Dunne, you must prove that no reasonable practitioner of equal status would have made the error. Independent expert evidence is essential. This is explained on our breach of duty page and applied in detail on the misdiagnosis hub.

Ireland vs UK: pulmonary embolism misdiagnosis claim differences

Feature	Republic of Ireland	England and Wales
Negligence test	Dunne v NMH [1989] IR 91 (no reasonable peer would have erred)	Bolam/Bolitho (responsible body of opinion)
Time limit	Two years from date of knowledge (Statute of Limitations 1991, s.2)	Three years from date of knowledge (Limitation Act 1980, s.11)
Date-of-knowledge formulation	Statutory four-element test (injury, significance, cause, defendant identity)	Largely judge-made, similar elements
Pre-action body	Clinical negligence is exempt from the IRB; goes direct to High Court	Pre-action protocol; possible NHS Resolution involvement
Trial venue for catastrophic claims	High Court Clinical Negligence List (Practice Direction HC132)	King's Bench Division
Clinical standard of care	HSE Eve's Protocol (NCG-VTE), in force 4 July 2025	NICE NG158 (VTE diagnosis and management)
General damages cap (catastrophic)	€550,000 (Personal Injuries Guidelines 2021)	~£500,000 (Judicial College Guidelines, no statutory cap)
Mental-distress payment for fatal claims	€35,000 cap shared among dependants (Civil Liability Act 1961, s.49)	Statutory bereavement award £15,120 (England) / no cap on dependency
Period payment orders	Available since 1 October 2018, rarely used since Hegarty v HSE [2019]	Routinely used in catastrophic claims since 2005
Open disclosure	Mandatory under Patient Safety Act 2023 (commenced 26 September 2024)	Statutory Duty of Candour since 2014

What about a doctor following a UK clinical guideline? Where a clinician relied on a UK pathway (such as NICE NG158 for VTE) instead of Eve's Protocol, the Irish court still applies the Dunne test against the standard expected of a reasonably competent Irish-jurisdiction practitioner. The HSE National Clinical Guideline is the controlling reference, with NICE serving as supporting evidence at most.

Recent Irish case law has clarified how clinical guidelines such as Eve's Protocol interact with Dunne. In Perez v Coombe Women and Infants University Hospital, the High Court confirmed that modern clinical guidelines, escalating triggers, and electronic records serve as instructive evidence of the standard of care. Yet the Dunne principles remain the controlling test. Departing from Eve's Protocol is not automatically negligent. The deviation must still meet the "no reasonable practitioner" threshold.

Customary practice is no longer an absolute defence. A widely-followed practice cannot defend against negligence if the practice itself ignores clear, documented warning signs. An ignored elevated D-dimer, an undocumented Wells score in a tachycardic patient, or a discharge without safety-netting are exactly the kind of facts that overcome a customary-practice defence.

What the expert needs to show

The independent medical expert must form three conclusions on the balance of probabilities.

• Breach: The clinician failed to follow a recognised diagnostic step that no reasonably competent peer would have skipped.
• Causation: But for that failure, the patient would have received earlier treatment with a materially better outcome.
• Harm: Specific physical, psychological, or financial harm flowed from the delay.

Common defences raised by the State Claims Agency and hospitals

Knowing what the defence will likely run helps claimants and families set expectations. The same defence patterns recur in PE misdiagnosis claims handled by the State Claims Agency and by private-hospital insurers.

• "PE is the great masquerader." The defence argues that the symptom overlap with anxiety, MSK pain, and chest infection is well-documented in the medical literature, so the missed diagnosis was within reasonable practice. Counter-argument: Eve's Protocol exists precisely because of the masquerader problem, and structured probability assessment is meant to catch what intuition misses.
• "Atypical presentation." The defence argues the patient's symptoms did not fit the classic PE picture. Counter-argument: most PE presentations are atypical, and the very purpose of Wells/YEARS scoring is to capture probability without requiring textbook features.
• "Causation is not proven." Even if the diagnosis was missed, the defence argues the patient would have died or suffered the same outcome with earlier treatment. This is often the central battleground. Counter-evidence comes from sequential imaging showing fresh and older thrombus, treatment-response evidence, and expert testimony on what timely thrombolysis or anticoagulation would have achieved.
• "Customary practice." The defence argues that other reasonably competent doctors would have made the same error. Counter-argument: customary practice no longer survives where it ignores documented warning signs, an ignored elevated D-dimer, or a clear Wells score.
• "Contributory negligence." Where the patient self-discharged, refused investigation, or did not return when advised, the defence may argue contributory negligence to reduce damages. Counter-argument is fact-specific: did the patient receive adequate safety-netting and red-flag advice?
• "Limitation has expired." The defence routinely tests the date of knowledge. Counter-argument is the Section 2 four-element analysis applied to the actual timeline.

Anticipating the defence shapes the evidence-gathering plan. Independent expert reports, contemporaneous family communications, and a clean records timeline answer most of these arguments. None of these defences should deter a claimant from seeking a free case review. They simply set the bar for the evidence that will be needed.

How does the date of knowledge work for late-presenting pulmonary embolism harm?

The two-year time limit for a pulmonary embolism misdiagnosis claim runs from your date of knowledge, not from the date of the medical error itself. Under Section 2 of the Statute of Limitations (Amendment) Act 1991, the clock starts when four things become known together. You must know that you had an injury, that the injury was significant, that it was caused by the defendant, and the identity of the defendant.

For PE, this matters because harm often presents late. Three patterns recur. Unlike in England and Wales, in Ireland the limitation period for personal injury and clinical negligence is two years (not three under the UK Limitation Act 1980), and the date-of-knowledge formulation under Section 2 of the 1991 Act is statutory rather than judge-made.

Pattern 1: Discharge then collapse

You attend the ED, are sent home with anxiety or chest infection, and collapse within days. The fatal or near-fatal event happens after the alleged misdiagnosis. The date of knowledge for a dependant's claim usually crystallises at the death or coronial finding, not the original presentation.

Pattern 2: Survived PE with late-emerging complications

You survive the PE, but months later are diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH) or post-PE syndrome. A second-opinion consultation reveals the original presentation should have been investigated. Irish courts have accepted the date of receipt of independent expert evidence as the trigger date, following the approach in Philp v Ryan [2004] IESC 105.

Pattern 3: Records review reveals an earlier missed PE

A second admission for a confirmed PE prompts a records review that shows an earlier presentation should have been worked up. The date of knowledge here is the date the records review or expert opinion linked the earlier failure to the harm.

Date of knowledge / time limit calculator

Enter the dates that apply to your situation. The calculator reads each candidate trigger against the two-year window under Section 2 of the Statute of Limitations (Amendment) Act 1991. The output is a guide, not a final assessment.

Guidance only. Only a solicitor can confirm your specific date of knowledge. The calculator does not give legal advice. Approaching or past the window does not always mean a claim is statute-barred. Speak to a solicitor.

Date of original missed or delayed diagnosis

Date you became aware of significant harm (or date of death for fatal cases)

Date an independent expert linked the failure to the harm (optional)

Today's date

Fill in at least the original-diagnosis date and today's date. The calculator will analyse each candidate trigger against the two-year window.

Reset

Two practical extensions matter for PE claims. For minors, the two-year clock does not start until the eighteenth birthday. Statute of Limitations 1957. For people lacking capacity, the period is paused until capacity is regained. For fatal claims, the dependants have two years from the date of death or the dependants' own date of knowledge, whichever is later.

What about pulmonary embolism in pregnancy and after birth?

Maternal pulmonary embolism remains the leading direct cause of maternal mortality in the UK and Ireland confidential enquiries. MBRRACE-UK Maternal Mortality 2020-22. VTE incidence in pregnancy is approximately 1 in 1,000 maternities, around ten times the non-pregnant baseline. The risk peaks in the first six weeks postpartum.

The diagnostic challenge is real. Physiological dyspnoea, tachycardia, and leg swelling are common in pregnancy and overlap with PE symptoms. D-dimer is naturally elevated in pregnancy, so standard cut-offs are unreliable. V/Q scintigraphy is often preferred over CTPA in pregnancy to limit radiation to maternal breast tissue. Treatment uses LMWH because direct oral anticoagulants cross the placenta.

For obstetric injury claims connected to pregnancy or postpartum care, the dedicated maternal birth injury claims page covers the obstetric pathway in depth. The PE-as-misdiagnosis angle is the focus of this page, particularly where a postpartum woman presented with breathlessness, chest pain, or leg swelling and was sent home without investigation. Sarah-Kate O'Meara, a 17-year-old who died from a PE three days after starting the contraceptive pill while carrying a previously-unknown Factor V Leiden mutation, is a recent Irish example. Inquest narrative verdict, July 2025.

What about hospital-acquired blood clots and Eve's Protocol?

Hospital-acquired thrombosis (HAT) describes any VTE that occurs during a hospital admission or within ninety days of discharge. Around two-thirds of all VTE events globally are hospital-acquired, and up to 70% of those are potentially preventable with appropriate risk assessment and thromboprophylaxis. HSE Preventing VTE in Hospitals.

Eve's Protocol now requires every Irish hospital to perform a VTE risk assessment on admission, prescribe thromboprophylaxis where indicated, and reassess on any change in clinical condition. Consider a hospital that admits a patient for a routine procedure, fails to risk-assess for VTE, and fails to prescribe LMWH. The patient is discharged. They develop a fatal PE within ninety days. That sequence shows a clear breach pattern. Audits at Cork University Hospital previously showed only 24% of patients had a documented VTE risk assessment at baseline. Irish Medical Journal HAT audit.

Three categories of HAT claim recur in Irish practice.

• Post-surgical: Orthopaedic, abdominal, or cancer surgery without prophylaxis. Failure to prescribe LMWH or extended-duration anticoagulation.
• Post-medical-admission: Acute medical illness with reduced mobility. Risk assessment skipped or thromboprophylaxis not started within the first 24 hours.
• Post-discharge: Patient develops PE within 90 days of leaving hospital. Discharge planning failed to assess ongoing VTE risk or to give the patient an alert card explaining red-flag symptoms.

Where care fell short of Eve's Protocol, that deviation forms strong evidence of breach under Dunne, supported by an independent expert. For a broader explanation of patient-monitoring failures, see our failure to monitor page.

What does long-term harm look like after a missed pulmonary embolism?

Long-term harm after a missed pulmonary embolism is more common than survivors expect. Up to 40 to 50% of PE survivors experience persistent symptoms beyond six months, falling within the spectrum of post-PE syndrome. The HSE Eve's Protocol now mandates structured three-to-six-month follow-up to screen for sequelae.

Long-term outcome	What it means	Why it matters for compensation
Post-PE syndrome	Persistent dyspnoea, exercise limitation, fatigue at six months or later. Up to half of survivors are affected.	Direct impact on loss of earnings and quality of life. Often under-diagnosed without active screening.
Chronic Thromboembolic Pulmonary Hypertension (CTEPH)	Roughly 2-3% of survivors in screening studies. Pulmonary endarterectomy may be curative, but only with early recognition.	Catastrophic injury bracket. Future surgery, transplant assessment, lifelong oxygen, severely reduced life expectancy.
Chronic Thromboembolic Disease (CTED)	Symptomatic chronic thrombus on imaging without resting pulmonary hypertension.	Functional limitation justifying special damages for adapted work, pulmonary rehab, ongoing imaging surveillance.
Persistent right ventricular dysfunction	Common after major PE. Distinct from CTEPH. Reduces exercise tolerance.	Cardiac follow-up costs, exercise rehab, fitness-related career impact.
Recurrent VTE	Anticoagulation duration depends on whether the clot was provoked or unprovoked.	Lifelong anticoagulation cost, monitoring burden, bleeding-risk impact on lifestyle.
Psychological injury	PTSD, anxiety, fear of recurrence. Well-documented after near-fatal PE.	Psychiatric treatment costs, time off work, separate head of damages. See our PTSD claims page.

The reason long-term harm matters is that special damages often dwarf general damages. A claim that captures only acute hospital costs misses the future-care valuation that defines a properly assessed catastrophic-injury claim.

Who do I claim against?

Public hospital PE misdiagnosis claims in Ireland are managed by the State Claims Agency under the Clinical Indemnity Scheme. According to the SCA Annual Report 2024, the agency paid €210.5 million in clinical care damages in 2024, with outstanding clinical liability standing at €5.35 billion. Private hospital and consultant claims go against the relevant professional indemnity insurer.

Three defendant pathways apply.

Where care was delivered	Defendant	Indemnity
HSE hospital ED, ward, or outpatient clinic	HSE	State Claims Agency, Clinical Indemnity Scheme
Private hospital (Bon Secours, Beacon, Mater Private, Hermitage, Blackrock, Galway Clinic, Bons Cork)	The hospital and the consultant separately	Hospital insurer + Medical Protection Society (MPS) or Medisec for the consultant
GP practice	The individual GP	The GP's professional indemnity insurer (commonly MPS or Medisec)

For claims involving more than one defendant, common in PE because the patient often passes through GP care, an ED encounter, and a ward admission, each defendant is named separately. For more on this, see our emergency department errors page and GP negligence page.

How liability is shared between multiple defendants

Where the patient was seen by a GP, attended the ED, was admitted to a ward, and the missed diagnosis spans multiple contacts, liability is apportioned between defendants based on each one's contribution to the harm. Under the Civil Liability Act 1961, each defendant remains potentially liable for the full claim (joint and several liability), with the right to claim contribution from co-defendants.

Three apportionment patterns recur in PE claims.

• Sequential failures: GP missed first, then ED missed, then ward failed to risk-assess. Each failure compounds the next. Apportionment depends on whether earlier intervention would have prevented the harm.
• Single dominant failure: An earlier contact had a reasonable explanation, and the dominant negligent act sits with one provider, often the ED encounter immediately before collapse.
• Systems failure: No individual is solely at fault, but the hospital's systems, training, or staffing failed. The hospital itself becomes the principal defendant under direct corporate liability.

From a practical perspective, naming multiple defendants is rarely a barrier. The State Claims Agency manages public-hospital and GP claims under separate indemnity arrangements, and private-hospital insurers participate alongside consultant indemnifiers (MPS or Medisec) where relevant. Multi-defendant claims often settle through a coordinated mediation under HC132 case management.

What evidence is needed to prove a pulmonary embolism misdiagnosis claim?

A pulmonary embolism misdiagnosis claim in Ireland needs three categories of evidence. The first is complete medical records. The second is an independent expert report on breach and causation. The third is a quantifiable record of the harm caused.

Evidence category	What to gather	Why it matters
Medical records	GP notes, ED triage and clinical notes, ECG strips, blood results (especially D-dimer and troponin), imaging reports (chest X-ray, CTPA, V/Q), ward charts, drug charts, discharge letters, ambulance Patient Care Reports.	The Wells score, D-dimer omission, and discharge instructions are usually visible in the records. Missing or altered notes are often the first red flag.
Independent expert report	Respiratory physician, emergency medicine consultant, or general physician based outside Ireland. The expert reviews records against Eve's Protocol and the Dunne standard.	Proceedings cannot issue without a supportive expert report on breach and causation. Expert report process.
Causation evidence	Pathology reports, autopsy findings, sequential imaging showing fresh and older thrombus, treatment records demonstrating the difference earlier intervention would have made.	"But for the missed diagnosis, the outcome would have been better" must be proved on the balance of probabilities.
Harm and special damages	Loss of earnings calculations, future-care reports, occupational therapy assessments, psychiatric reports, vocational assessments.	Special damages frequently dwarf general damages in catastrophic PE claims. Special damages page.
Family communications	WhatsApp messages, texts, emails, voicemails showing concern raised at the time. Diary entries.	Establishes the pattern of concern that the clinical team failed to act on. Failure point 7 above.

One detail that catches families off guard: hospital records can be requested under the GDPR Subject Access Request route^[20] within thirty days, free of charge. Acting early matters because internal incident reviews and root-cause analyses become available faster after the Patient Safety Act 2023^[5], which commenced on 26 September 2024. Open disclosure is now mandatory for serious patient-safety incidents.

For the records-request workflow, see how to request your medical records.

How is compensation valued for pulmonary embolism misdiagnosis in 2026?

Compensation in Irish medical negligence claims is calculated under the Judicial Council Personal Injuries Guidelines (2021)^[11], which replaced the Book of Quantum in April 2021. According to RTE News (9 July 2025)^[12], the Judicial Council approved a proposed 16.7% uplift in January 2025, which would have raised the catastrophic-injury maximum from €550,000 to €642,000. The Government decided in July 2025 not to bring the proposal to the Oireachtas, so the proposed uplift has not taken legal effect. The current cap remains €550,000 in general damages. Awards always vary case by case and depend on severity, recovery, and prognosis.

Unlike in England and Wales, in Ireland general damages are governed by the Judicial Council Personal Injuries Guidelines (2021), not the UK Judicial College Guidelines. Irish brackets are materially different and have been compressed since the 2021 reform. Cross-jurisdiction settlement comparisons must be discounted accordingly.

Two heads of damage apply.

General damages: pain, suffering, loss of amenity

The Guidelines split injuries by body system and severity. PE outcomes spread across several bands.

• Catastrophic injury (massive PE causing cardiac arrest, hypoxic-ischaemic brain injury, severely reduced life expectancy) sits in the top bracket of the Guidelines.
• Severe lung damage (post-PE syndrome with permanent functional limitation, CTEPH requiring pulmonary endarterectomy) attracts substantial general damages.
• Psychological injury (PTSD, complex anxiety, fear of recurrence) attracts a separate award. Quantum depends on chronicity and treatment response.

Special damages: financial losses

Special damages are quantifiable financial losses, typically the larger head of damages in catastrophic PE claims. They include:

• Past and future loss of earnings calculated by an actuary.
• Future care costs for nursing, occupational therapy, home adaptation, and assistive equipment.
• Medical expenses and travel costs for ongoing treatment.
• Psychiatric treatment and pulmonary rehabilitation costs.
• Funeral and probate costs in fatal claims, plus statutory mental-distress and dependency awards under the Civil Liability Act 1961.

Awards always vary by facts and evidence. The Personal Injuries Guidelines apply only to general damages and act as a court-binding guide rather than a rigid tariff. Special damages depend on actuarial and vocational evidence specific to the individual.

Period Payment Orders for catastrophic outcomes

Where a missed pulmonary embolism causes catastrophic injury such as hypoxic-ischaemic brain damage or chronic thromboembolic pulmonary hypertension, the court has the statutory power to order a Period Payment Order (PPO) instead of a single lump sum for future care and loss of earnings. PPOs were introduced by the Civil Liability (Amendment) Act 2017^[7] and commenced on 1 October 2018.

In practice, PPOs have been very rarely used since the High Court decision in Hegarty v HSE [2019] IEHC 788, which found that the Harmonised Index of Consumer Prices indexation under the Act would tend to under-compensate plaintiffs. Most catastrophic PE settlements continue to be agreed as lump sums, sometimes with interim payments. New regulations with updated indexation are awaited.

How long does a pulmonary embolism misdiagnosis claim take in Ireland?

Most pulmonary embolism misdiagnosis claims in Ireland take eighteen months to four years from instruction to resolution, although complex catastrophic-injury claims can run longer. Two recent procedural reforms are reducing average timelines.

The Clinical Negligence List (Practice Direction HC132)

Effective from April 2025, the High Court operates a dedicated Clinical Negligence List under Practice Direction HC132. A specialist judge manages timetabling, expert-evidence exchange, and mediation. Cases now move faster than the historical norm because case-management directions are issued earlier.

Certificates of Compliance (Practice Direction HC131)

Before a trial date can be assigned, parties must file a Certificate of Compliance confirming complete pleading, full witness schedule disclosure, and full expert-report exchange. This forces early disclosure of medical evidence and frequently triggers settlement discussion before trial.

The dismissal-for-delay risk

The Supreme Court decision in Kirwan v Connors [2025] IESC 21 reformulated the test for dismissing personal injury proceedings for delay. The High Court applied the new test in Murphy v Aer Lingus Group PLC, dismissing a long-standing personal injury claim involving a pulmonary embolism after twelve years of inactivity. The lesson: act promptly within the two-year date-of-knowledge window. For a deeper analysis, see our time limits page.

Claim type	Typical range	What affects it
Survived PE, liability admitted early	14-24 months	Quantum agreement, medical recovery, future-care evidence
Survived PE, liability disputed	24-42 months	Expert exchange, mediation, Clinical Negligence List timetable
Fatal PE, liability admitted	18-30 months	Probate, dependants' valuations, inquest interaction
Catastrophic PE with CTEPH or hypoxic injury	30-60 months	Future-care valuation, periodic-payment-order assessment, life-expectancy evidence

These ranges are typical experience-based estimates, not guarantees. Your facts, evidence, and recovery drive the actual timeline. The historical Irish median for clinical negligence claims often exceeded four years pre-HC132, so the new procedural framework is improving outcomes for claimants.

What to do next

If you believe a pulmonary embolism was missed in your care or in the care of a loved one, four practical steps protect your position.

1. Write down the timeline. Dates of presentation, who you saw, what was said, what was done, when you were discharged, when you returned. Detail decays fast.
2. Preserve communications. Texts, WhatsApp messages, and emails to family and GP. Take screenshots and back them up.
3. Request your medical records. Use the GDPR subject-access route. We can draft and send the request on your behalf.
4. Get an early case review. A specialist solicitor can tell you whether your timeline supports a viable claim and whether the date-of-knowledge analysis still leaves you within the two-year window.

How to start a pulmonary embolism misdiagnosis claim in Ireland

Estimated effort to begin: 30 to 45 minutes for the initial consultation. What we need: timeline, names of hospitals or GPs, any records you already hold.

1. Free consultation. Call 01 903 6408 or email us a brief outline. We will review your timeline against the date-of-knowledge test.
2. Records collection. We request the full set under GDPR. We track receipt and chase delays.
3. Independent expert review. A respiratory physician or emergency medicine consultant reviews the records against Eve's Protocol and the Dunne standard.
4. Letter of claim. If the expert supports breach and causation, we issue the formal letter and engage the State Claims Agency or insurer.
5. High Court proceedings. Filed in the Clinical Negligence List. Most claims settle before trial, but the case is built for trial throughout.

Eligibility self-check: do you have a viable Irish PE misdiagnosis claim?

Five quick questions. Answer based on the patient's experience. The result is a signal, not a verdict.

General guidance, not legal advice. The result does not predict whether your claim will succeed. Only a solicitor can give a case-specific assessment.

Question 1 of 5

Did the missed, delayed, or wrong diagnosis happen in Ireland?

Yes No

What to bring to your first consultation

Bringing the right material to a first consultation makes the case-review faster and more accurate.

• Timeline: Dates of every relevant medical contact, who you saw, what was said, what was done, and when you were discharged.
• Any medical records you already hold: ED discharge letters, GP notes, ambulance Patient Care Reports, imaging results.
• Written communications: WhatsApp messages, texts, emails to family, screenshots of contemporaneous concerns.
• Death certificate, autopsy report, and inquest documents for fatal claims.
• Names and addresses of treating hospitals, EDs, GPs, and consultants.
• Names and contact details of witnesses who attended consultations or witnessed deterioration.
• Documentation of financial losses: payslips, time-off records, receipts for ongoing medical expenses.

If you do not have everything yet, that is fine. We can request medical records on your behalf under the GDPR subject-access route.

GDPR records request letter generator

Fill in the four fields. The generator produces a formatted Subject Access Request letter that quotes Article 15 of the GDPR and the Data Protection Act 2018. Hospitals and GPs must respond within one month, free of charge.

Personal-use template. If you are considering a formal claim, we recommend speaking to a solicitor first. We can request and chase records on your behalf as part of the case review.

Your full name

Your address

Hospital, GP, or healthcare provider

Approximate date(s) of treatment

Generate letter Copy to clipboard Print

Common questions about pulmonary embolism misdiagnosis claims in Ireland

How long do I have to make a pulmonary embolism misdiagnosis claim in Ireland?

Two years less one day from your date of knowledge under Section 2 of the Statute of Limitations (Amendment) Act 1991. The clock does not start at the date of treatment. It starts when you first knew, or ought reasonably to have known, that the delay or wrong diagnosis caused you significant harm.

• For survivors with late-emerging complications: from a second-opinion or expert report.
• For dependants in fatal claims: from the date of death or the dependants' own knowledge.
• For minors: the clock starts on their eighteenth birthday.

Why it matters: Acting late risks a statute-barred claim, which the court cannot revive.

Next step: Read our date of knowledge guide or the full time-limits page.

I was told my chest pain was anxiety. Can I still claim?

Yes, where the anxiety diagnosis was reached without the diagnostic steps Eve's Protocol requires. The Katie Doyle inquest at Beaumont Hospital (verdict April 2024) confirmed that a Wells score should have triggered a D-dimer per hospital protocol. Omitting the test was a significant factor in her death. An anxiety diagnosis is not negligent in itself, but only if the doctor first ruled out PE through the proper algorithm.

• Was a Wells score documented?
• Was a D-dimer ordered?
• Were tachycardia, family history, contraceptive use, or recent immobility weighted?

Why it matters: The "anxiety dismissal" pattern is one of the most common breaches in Irish PE claims.

Next step: Read our ED errors page.

What if my D-dimer was negative but I still had a pulmonary embolism?

A negative D-dimer alone does not exclude PE in a high-probability patient. Eve's Protocol requires CTPA in high-suspicion cases regardless of D-dimer result. If the doctor stopped at a "clear" D-dimer despite a high Wells score or significant red flags, that may meet the Dunne breach threshold.

• What was the Wells score?
• Were there strong risk factors (recent surgery, postpartum, malignancy, immobilisation)?
• Was a CTPA still indicated despite the negative D-dimer?

Why it matters: The "false reassurance from D-dimer" pattern is well-documented in PE misdiagnosis claims.

Did the contraceptive pill cause my pulmonary embolism, and can I claim?

The combined oral contraceptive (COC) is a known VTE risk factor, and the risk is much higher in women carrying inherited thrombophilia such as Factor V Leiden. A claim does not arise from the prescription alone. It arises where the prescribing doctor failed to take a proper family history, failed to warn about the risk, or failed to investigate a clear PE presentation.

• Was a family history of clots taken before prescribing?
• Was thrombophilia screening considered where indicated?
• Was the patient warned about red-flag symptoms?

Why it matters: The Sarah-Kate O'Meara inquest in July 2025 highlighted Factor V Leiden plus COC use as a recognised high-risk combination.

I developed a pulmonary embolism after surgery. Was this preventable?

Often yes. Eve's Protocol requires VTE risk assessment on admission and thromboprophylaxis (LMWH, mechanical, or both) where indicated. Around 70% of hospital-acquired VTE is potentially preventable. A claim arises where risk assessment was skipped, prophylaxis was not prescribed, or prophylaxis was discontinued too early after discharge.

• Was a VTE risk assessment completed?
• Was LMWH prescribed at the right dose?
• Was extended-duration prophylaxis arranged for high-risk surgery (orthopaedic, abdominal cancer)?

Why it matters: Hospital-acquired thrombosis is a leading preventable cause of in-hospital death.

Next step: Read our surgical errors page and failure to monitor page.

My family member died of a missed PE. How do we claim as dependants?

Dependants of someone who died of a missed pulmonary embolism in Ireland can bring a fatal-injuries claim under the Civil Liability Act 1961. The estate can also continue any cause of action the deceased had at the time of death. The two-year clock runs from the date of death or the dependants' own date of knowledge, whichever is later.

• Inquest findings (medical misadventure or narrative verdicts) are factual context, not determinative.
• Mandatory open disclosure under the Patient Safety Act 2023 may surface key facts earlier than before.
• Statutory mental-distress payment is fixed but dependency loss is calculated separately.

Why it matters: Fatal claims need careful structuring across statutory and common-law heads of damage.

Next step: Read our claim after death and estate page.

Can I claim against a private hospital or consultant?

Yes. Private hospital PE misdiagnosis claims are made against the hospital (for systems failures) and against the treating consultant separately (for clinical errors). The hospital's insurer responds for nursing or systems issues. The consultant's professional indemnity insurer (commonly Medical Protection Society or Medisec) responds for individual clinical decisions.

• Identify the contracting party (some consultants treat patients on a private contract within a public hospital).
• Both defendants may be named in the same proceedings.
• The Dunne test applies equally in private and public settings.

Why it matters: Identifying the right defendant is essential to a viable claim.

Next step: Read our private hospital negligence page.

Does my PE misdiagnosis claim go through the Injuries Resolution Board?

No. Clinical negligence claims are exempt from the Injuries Resolution Board (formerly known as the Personal Injuries Assessment Board until 2023). They proceed directly to the High Court Clinical Negligence List under the PIAB Act 2003, Section 3(d).

• No IRB application required.
• Letter of claim issued directly to the SCA or insurer.
• Mediation often used within Clinical Negligence List management.

Why it matters: A common misconception is that all personal injury claims go through the IRB.

Next step: Read our claim process hub.

How much compensation could a missed pulmonary embolism claim be worth?

Compensation for a missed pulmonary embolism in Ireland depends on the severity of the harm, the recovery, and the impact on earnings and care needs. The current Judicial Council Personal Injuries Guidelines (2021) cap general damages at €550,000 for catastrophic injury. A proposed 16.7% uplift was approved by the Judicial Council in January 2025 but the Government decided in July 2025 not to bring it to the Oireachtas, so the proposed increase has no legal effect. Special damages for future care, loss of earnings, and lifelong treatment are typically much larger than general damages.

• Catastrophic outcomes (cardiac arrest, hypoxic brain injury) attract the highest brackets.
• Survived PE with permanent functional limitation (CTEPH, post-PE syndrome) attracts substantial general damages plus future-care awards.
• Wrongful death claims apply Civil Liability Act 1961 calculations plus statutory mental-distress payments.

Why it matters: Outcomes vary by facts and evidence. Awards are not guaranteed.

Next step: Read our medical negligence compensation guide.

Do I need a solicitor to make a pulmonary embolism misdiagnosis claim?

No, you are not legally required to instruct a solicitor. Yet most claimants do, because clinical negligence claims involve strict time limits, complex expert evidence, and procedural rules. The Clinical Negligence List operates under Practice Directions HC131 and HC132, which require precise procedural compliance.

• Independent expert reports are required before proceedings can issue.
• The State Claims Agency rarely concedes liability before formal proceedings.
• Early procedural mistakes can extinguish a claim.

Why it matters: One missed step can defeat an otherwise valid claim.

Next step: Read our why choose us page or no win no fee guide.

What is Eve's Protocol and why does it matter for my claim?

Eve's Protocol is the HSE National Clinical Guideline on Venous Thromboembolism (NCG-VTE), in force across Ireland from 4 July 2025. It is named in memory of Eve Cleary, who died at University Hospital Limerick in 2019. It is Ireland's first national clinical guideline named after an individual patient.

• It mandates Wells or Revised Geneva scoring at the bedside.
• It requires age-adjusted D-dimer in low-probability patients.
• It requires CTPA in high-probability cases or after positive D-dimer.
• It requires VTE risk assessment on every hospital admission.

Why it matters: Departure from Eve's Protocol is now the clearest evidence of a deviation from the accepted standard of care, supporting the Dunne breach test.

Can I claim if I survived the pulmonary embolism?

Yes. Survival does not extinguish a claim. Many of the strongest Irish PE misdiagnosis claims involve survivors who later developed chronic thromboembolic pulmonary hypertension (CTEPH), persistent post-PE syndrome, psychological injury, or who had a permanent reduction in earning capacity. The legal test remains breach + causation + harm.

• Late-emerging complications often shift the date of knowledge to a later trigger date.
• Special damages can be substantial even where general damages sit in a lower bracket.
• Psychological injury after a near-fatal PE is a recognised separate head of damages.

Why it matters: Survivors sometimes assume "no harm, no claim". The opposite is often true.

What if no one warned us about VTE risk before surgery?

Warning a patient about the risk of post-surgical VTE and prescribing thromboprophylaxis where indicated are both required by Eve's Protocol. A claim can arise where the surgical team failed to risk-assess, failed to prescribe LMWH, failed to give an alert card on discharge explaining red-flag symptoms, or failed to arrange extended-duration prophylaxis after high-risk procedures.

• The VTE risk assessment form should be visible in the surgical admission paperwork.
• The drug chart should show LMWH for the appropriate duration.
• The discharge letter should reference VTE warning signs.

Why it matters: Hospital-acquired thrombosis is the leading preventable cause of in-hospital death.

Next step: Read our surgical errors page.

Is depression, PTSD, or anxiety after a missed pulmonary embolism compensable?

Yes, where the psychological injury is medically diagnosed and causally linked to the missed diagnosis. PTSD, generalised anxiety disorder, and persistent fear of recurrence are well-documented after near-fatal PE and after the death of a relative from missed PE. These attract a separate head of general damages and may also support special damages for psychiatric treatment, time off work, and reduced earning capacity.

• A psychiatric or psychological report supports the claim.
• Family members in fatal claims may have a separate nervous-shock claim under recognised legal categories.
• The Personal Injuries Guidelines (2021, updated 2025) provide brackets specific to psychological injury.

Why it matters: Psychological injury is often under-claimed because survivors and bereaved families do not realise it qualifies.

Next step: Read our PTSD and psychological injury page.

Can dependants claim for grief and shock after a fatal missed PE?

Yes, but the legal route differs from a personal-injury claim. Under Section 49 of the Civil Liability Act 1961, dependants of a person who died as a result of clinical negligence can recover a statutory mental-distress payment, currently capped at €35,000 in total for all dependants combined (raised from €25,394.76 by Statutory Instrument 6 of 2014). The cap is shared regardless of how many dependants claim. Dependants can also claim for dependency loss (the deceased's financial and services contribution), funeral expenses, and any pain and suffering the deceased experienced before death.

• The mental-distress sum is statutory, not at large.
• Dependency calculation uses an actuarial approach.
• Nervous-shock claims by witnesses to the death are a separate, narrower category.

Why it matters: Bereaved families often do not know the statutory scheme exists or how it interacts with civil claims.

Next step: Read our claim after death and estate page.

Can I claim if I was discharged from a Minor Injury Unit or Out-of-Hours GP service?

Yes. Minor Injury Units (MIUs), Local Injury Units, and out-of-hours GP cooperatives (D-Doc, ShannonDoc, NorthDoc, SouthDoc, WestDoc, Caredoc) are subject to the same Dunne standard as full EDs and in-hours practices. The defendant is the operating organisation and any treating clinician individually, depending on contract.

• MIUs are not designed for high-acuity diagnosis. Misdirection of a PE-suspect patient to an MIU is itself a process question.
• Out-of-hours GP services typically refer to the day-time GP and to the ED. Failure to refer is a recognised claim pattern.
• The claim follows the same two-year date-of-knowledge limitation period.

Why it matters: Patients sometimes assume MIU and out-of-hours discharge cannot ground a claim. They can.

Next step: Read our out-of-hours GP negligence page.

References

1. Dunne v National Maternity Hospital [1989] IR 91 - Supreme Court of Ireland (BAILII, 1989).
2. Morrissey v Health Service Executive [2020] IESC 6 - Supreme Court of Ireland (BAILII, March 2020).
3. Statute of Limitations (Amendment) Act 1991, Section 2 - Irish Statute Book.
4. Personal Injuries Assessment Board Act 2003, Section 3 - Irish Statute Book.
5. Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023 - Irish Statute Book (commenced 26 September 2024).
6. Civil Liability Act 1961, Section 49 (mental distress payment) - Irish Statute Book (cap raised to €35,000 by S.I. 6/2014).
7. Civil Liability (Amendment) Act 2017 (Period Payment Orders) - Irish Statute Book (commenced 1 October 2018).
8. HSE National Clinical Guideline on VTE (Eve's Protocol) - Health Service Executive (Effective 4 July 2025; publicly launched 22 July 2025).
9. HSE launches Eve's Protocol announcement - HSE press release (July 2025).
10. State Claims Agency: Learning through diagnosis incident reporting - SCA NIMS analysis.
11. Judicial Council Personal Injuries Guidelines - Judicial Council of Ireland (in force since April 2021; proposed 16.7% uplift not implemented).
12. 16.7% personal injury award increase will not go ahead - RTE News (9 July 2025).
13. Outcomes Following Acute Pulmonary Embolism in an Irish Population - American Society of Hematology, Blood (2021).
14. Hospital-Acquired Thrombosis Prevention - A single-centre cross-sectional study - Irish Medical Journal.
15. MBRRACE-UK Maternal Mortality 2020-2022 - UK and Republic of Ireland Confidential Enquiry into Maternal Deaths.
16. Inquest into Eve Cleary at University Hospital Limerick - Irish Times (verdict of medical misadventure, 13 October 2021).
17. Inquest into Katie Doyle at Beaumont Hospital - Irish Times (April 2024).
18. Inquest into Sarah-Kate O'Meara at the Mater Hospital - Irish Times (July 2025).
19. Pulmonary Embolism clinical pathway - EMed.ie (Cork University Hospital reference).
20. Right of access to your information - Data Protection Commission Ireland (Article 15 GDPR guidance).
21. 122,186 patients treated on trolleys in 2024 - Irish Nurses and Midwives Organisation (INMO TrolleyWatch, January 2025).

Glossary of pulmonary embolism and Irish clinical-negligence terms

Plain-English definitions for the technical terms used on this page. Useful if you are reading medical records or comparing the records to what should have happened.

Term	What it means
Pulmonary Embolism (PE)	A blood clot that has travelled to the lungs, usually from a deep vein in the leg, blocking blood flow.
Deep Vein Thrombosis (DVT)	A blood clot in a deep vein, usually in the leg. The most common origin of a PE.
Venous Thromboembolism (VTE)	The umbrella term covering both DVT and PE.
Wells score	A clinical scoring system that estimates the probability of PE before any test is ordered. Two-level (PE-likely or PE-unlikely) is the form Eve's Protocol expects.
YEARS algorithm	A streamlined three-criteria pre-test probability tool that, combined with a tiered D-dimer cut-off, reduces unnecessary CTPA. Recognised as an alternative to Wells.
PERC rule	Pulmonary Embolism Rule-out Criteria, eight findings used in the ED to exclude PE in low pre-test probability patients without D-dimer.
D-dimer	A blood test that measures clot breakdown products. Negative in low-probability patients excludes PE. Falsely raised in many conditions, so context matters.
Age-adjusted D-dimer	For patients over 50, the threshold rises with age (age × 10 ng/mL FEU). Reduces false positives.
CTPA	Computed tomography pulmonary angiography. The gold-standard imaging test for PE.
V/Q scan	Ventilation/perfusion scintigraphy. Used when CTPA is contraindicated, including pregnancy, contrast allergy, or kidney impairment.
PESI / sPESI	Pulmonary Embolism Severity Index. Used after diagnosis to estimate 30-day mortality risk and decide on outpatient or inpatient management.
LMWH	Low-molecular-weight heparin. The expected interim anticoagulant while diagnostic workup is in progress.
DOAC	Direct oral anticoagulant such as apixaban or rivaroxaban. Long-term treatment after confirmed PE in most patients.
CTEPH	Chronic thromboembolic pulmonary hypertension. A serious long-term complication affecting roughly 2-3% of PE survivors.
Post-PE syndrome	Persistent dyspnoea, exercise limitation, and fatigue beyond six months. Affects up to half of all survivors.
Hospital-Acquired Thrombosis (HAT)	Any VTE that develops during a hospital admission or within 90 days of discharge.
Khorana score	A risk-prediction tool for VTE in ambulatory cancer patients. Score ≥ 2 indicates intermediate-to-high risk.
Eve's Protocol	The HSE National Clinical Guideline on Venous Thromboembolism (NCG-VTE), in force from 4 July 2025. Named in memory of Eve Cleary.
Dunne test	The Irish legal standard for clinical negligence, from Dunne v National Maternity Hospital [1989] IR 91. Stricter than the UK Bolam test.
Date of knowledge	The date when a claimant first knew, or ought reasonably to have known, of the injury, its significance, the cause, and the identity of the defendant. Triggers the two-year limitation clock.
State Claims Agency (SCA)	The body that manages clinical-negligence claims against the HSE under the Clinical Indemnity Scheme.
Clinical Negligence List (HC132)	The dedicated High Court case-management list for clinical negligence claims, in operation from April 2025.
Period Payment Order (PPO)	An index-linked annual payment for life, used in catastrophic clinical negligence claims under the Civil Liability (Amendment) Act 2017.

Fast facts about pulmonary embolism misdiagnosis claims in Ireland

Legal test: Dunne v NMH [1989] IR 91. Stricter than UK Bolam.

Time limit: Two years from date of knowledge under Statute of Limitations 1991 s.2.

Where claims go: Direct to High Court Clinical Negligence List. No IRB filing.

Standard of care: HSE Eve's Protocol (NCG-VTE), in force from 4 July 2025.

Public defendants: Managed by the State Claims Agency. SCA paid €210.5m in clinical care damages in 2024.

Compensation maximum: Catastrophic-injury bracket capped at €550,000 general damages under the 2021 Personal Injuries Guidelines. A proposed 16.7% uplift to €642,000 was not implemented. Special damages for future care, loss of earnings, and equipment are separate.

Speak to a Dublin medical negligence solicitor about a missed pulmonary embolism

If you or a family member experienced a missed, delayed, or wrongly diagnosed pulmonary embolism in Ireland, a free, no-obligation case review can clarify your position. We will explain the date-of-knowledge analysis for your timeline, the strength of the evidence, and the next steps.

Call 01 903 6408 or email us. Our office is at 3rd Floor, Ormond Building, 31-36 Ormond Quay Upper, Dublin D07.

Gary Matthews Solicitors. Regulated by the Law Society of Ireland. Practising Certificate No. S8178.

Related internal guides: misdiagnosis • failure to diagnose • delayed diagnosis • heart attack misdiagnosis • sepsis misdiagnosis • ED errors • maternal birth injury • date of knowledge • compensation