The High Court has approved a final lump sum settlement of €18m for an 11-year-old boy with cerebral palsy.
It brings to almost €20m the total settlement in the case of Alex Foley from Midleton, Co Cork.
He had sued the HSE through his mother Laurane over the circumstances of his birth at Cork University Hospital on 5 October 2010.
The claims were denied and, five years ago, the boy secured a €1.98m interim payment.
The case had been adjourned to today to decide on his future care needs.
His parents said they had fought against the "might of the State and the HSE" in an 11-year legal battle.
The court was told Alex had surgery in the US paid for by local fundraising efforts and can now walk up to 2km because of that surgery.
Patrick and Laurane Foley said "every penny" from today's settlement will be used for further therapy, treatment and equipment to give their son the "quality of life he deserves".
They added: "Our battle started when we were at our weakest and consumed with the 24-hour care of Alex.
"It has been a struggle since that day as we have fought for Alex's rights against the might of the State and the HSE.
"It will help him live as best a life as possible with his injury, but of course it won’t change what happened."
Mrs Foley added: "There is no amount of money that could compensate Alex for his injury, or give him back the life he should have had. What this will do is ensure he has a life that is as good as it can be. It is the very least he deserves."
The High Court was previously told Mrs Foley was pregnant with twins and there was an alleged failure to identify, at an earlier stage, a complication of pregnancy – vasa praevia – in which a baby's blood vessels cross or run near to the internal opening of the uterus. The HSE denied the claims.
Alex was in poor condition when born, but his brother Jacob was in a normal condition.
Mrs Foley told the court it is absolutely amazing Alex can now walk. She said they wanted to accept a lump sum payment as they did not want "to go through the process anymore".
Approving the settlement, Mr Justice Paul Coffey said the extraordinary if not miraculous progress Alex has made must be a great comfort to his parents.
Outside court, the Foleys thanked those who over the years fundraised and donated for his key surgery and equipment.
"Thank you to all those who helped Alex get his SDR surgery at the time in his life when it would be most effective and helped fulfill his wish to walk.
"And to those who fundraised and donated for his wheelchairs, both of which the HSE would not provide," Mrs Foley said.