The High Court has approved a settlement of €33m in the case of a 25-year-old woman who was profoundly brain injured at birth.
It brings to more than €35m the total settlement in the case, described in court as the largest ever in a case of its kind.
Senior counsel Dr John O'Mahony said the settlement funds will be paid in stages over the woman's lifetime to pay for the extensive care she requires.
Shauni Breen from Togher in Cork city was one of twin sisters born prematurely at 33 weeks' gestation in December 1997 at Wexford General Hospital.
Ms Breen's twin sister was born healthy and it was alleged that the hospital was negligent in its failure to have an appropriate medical team in place for what was a high-risk labour involving twins with Ms Breen being in an abnormal position in the birth canal.
The claims were denied by the HSE and liability was not admitted.
In her action for damages, it was claimed that Ms Breen should have been delivered by caesarean section within 15 minutes of her twin sister and that a failure to do so resulted in a lack of oxygen resulting in a profound brain injury.
Ms Breen has cerebral palsy and uses a wheelchair almost full time.
She has a cognitive impairment and completed her education in a school for those with special needs and now attends an Enable Ireland day centre five days a week.
Dr O'Mahony said Ms Breen had required an extensive amount of care since birth, which had been provided by her family.
He described her as the "light of the family's life" and had borne her disability with great fortitude, strength and good humour and good nature.
He said she would require care for the rest of her life and her family was getting on with things in an admirable and dedicated fashion.
Mr Justice Paul Coffey approved the settlement and wished Ms Breen and her mother Marie Foley well, through whom the action was brought.
In 2018, an interim payment of damages €1.95m was made in the case.
The final settlement figure approved today by the court was €33.25m, making the total settlement value €35.2m, the highest ever for a personal injuries case in Ireland.
Afterwards, the family's solicitor Anne-Marie Donnelly said the family was relieved that the court process was over and that the settlement would provide for therapy and care for Ms Breen.
Ms Donnelly said: "Not withstanding the daily challenges faced by Shauni, she continues to maintain her sunny disposition and brings joy to everyone who meets her.
"She is a kind, gentle, cheerful girl. It is clear that she is the central figure in a large and loving family.
"Shauni and her family are relieved to have closure of the lengthy legal process against the HSE.
"The payments which will be made to Shauni over the coming years will ensure she leads her life to the best of her ability having the benefit of the many treatments that will be provided through the settlement."
Ms Breen's mother also wished to thank all those who had helped her over the years, including the teachers in Enable Ireland, the medical professional, friends and family.
