Lawyers for Our Lady's Children's Hospital, Crumlin have denied there was any cover up in the case of a four-year-old boy who was left brain damaged after a mistake was made during surgery on his chest when he was six months old.
The hospital has been accused of engaging in a "whitewash" of the facts and a delay in admitting liability.
The High Court has begun hearing an action for damages in the case of Jude Miley, from Dundrum in Dublin, who had surgery in January 2012 when he was six months old to relieve compression on his diaphragm.
A suture was mistakenly left in his chest untrimmed.
It pierced his heart repeatedly, causing cardiac arrest two days after the surgery and resulting in brain damage.
Lawyers for the family said the hospital had engaged in a "whitewash" in its defence and delayed admitting liability and issuing an apology.
The court was told Jude's parents, particularly his mother Anne Louise who is a nurse, had raised concerns about their son's condition immediately after the surgery and the following day and their concerns were ignored.
Two days after the operation he went into cardiac arrest and needed emergency surgery to save his life.
During this time his brain was deprived of oxygen and suffered irreversible damage.
Lawyers for the family said medical notes showed it was "absolutely clear as day" what had happened but the parents were not given an explanation and told what happened was a risk of the original operation on his chest.
Senior Counsel Liam Reidy said the baby was discharged and they were told it was "just one of those things that could happen in such an operation".
They were not told a mistake had been made despite the fact that what happened was unambiguously recorded in the medical notes along with the concerns raised by the boy's mother.
They complained to the hospital and an internal investigation was launched.
The parents requested that they be involved in the investigation and consulted and kept informed.
However their involvement was minimal and they were not consulted or kept informed, the court was told.
Mr Reidy said the parents had to go through legal discovery procedure to find out what happened.
He said there was at the very least evidence of a denial or obscuring of something.
However lawyers for the hospital objected to any suggestion of any kind of cover up.
Senior Counsel Andrea Egan said it was a very complex case and negligence could not be admitted until expert reports were received.
She said what happened were contained in the internal review document which was furnished to the parents in September 2012 but the internal review team had at that stage not determined that there had been a deficit of care.
However, liability was admitted after experts reports were received, she said.
Mr Reidy said it was clearly written in some documents exactly what had happened and said: "Why in God's name were the parents not told this? That is what the duty of care and the duty of candour ordains and it took a discovery application to get those documents and get that admission." Ms Egan said this was not correct.
Mr Reidy said a most remarkable feature of this case was "a whitewash" put forward by the hospital.
He said the internal investigation found, contrary to the facts, there was a new risk they had never heard of before.
Mr Reidy said: "what was new about leaving a piece of suture untied, aimed at the heart, that would pierce the heart with every breath he took".
Mr Reidy said Jude now has developmental delays and physical deficits.
He has irreversible abnormalities of the brain and has complex care needs due to problems with movement, cognition and sight.
He also has severe behavioural problems and needs round the clock care.
He will never be able to live alone and will be dependent on others for the rest of his life.
The court was told Jude's parents Greville and Anne Louise were unable to get adequate medical care for their son here due to pressures on the health service.
Friends set up a trust fund to help him get treatment in the UK and the US.
However, both parents had to give up their jobs to care for their son and take him to overseas appointments.
His mother is unlikely to be able to work again. She had returned to work briefly when they had no money.
His father had to leave a job when he was refused leave of absence to take Jude abroad for treatment.
Liability was eventually admitted by the hospital and the case has come before the court for assessment of damages.
Earlier the court approved a partial settlement of the case for €1.8 million for loss of earnings and to provide suitable accommodation for Jude.
They are seeking damages and aggravated damages.
Mr Reidy said the parents had relied on friends for funds and had lived "hand to mouth" for the past four years.
The case is expected to last a number of days.
