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Brain-damaged patient: trial court erred

The Western Cape High Court has referred a medical case, in which a minor patient suffered brain damage during an operation, back to court for further hearing as it erred in its findings.

The Western Cape High Court has referred a medical case, in which a minor patient suffered brain damage during an operation, back to court for further hearing as it erred in its findings.

Published Jul 6, 2022

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Cape Town - The Western Cape High Court has referred a medical case, in which a minor patient suffered brain damage during an operation, back to court for further hearing as it erred in its findings.

According to Judge Patrick Gamble, a prima facie case of negligence was made by the plaintiff, Philippa van Zyl on behalf of the minor patient, as it should have found that there was substandard treatment of a laryngospasm, a sudden spasm of the vocal cords, by an anaesthetist employed by the health department.

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Western Cape Department of Health spokesperson, Mark van der Heever, said: “The Department notes this judgement, the substance of which is that this matter will now be heard at trial with further evidence offered. Only thereafter, and based on the facts, will a ruling will be made. As this matter is ongoing, we may not comment further at this time.”

Judge Gamble had granted the plaintiff’s application for appeal after the court a quo granted absolution to the provincial department of health. The case for damages will now be further heard by the court a quo.

According to court documents, the patient, who was 12 at the time, underwent routine surgery at Tygerberg Hospital in Bellville for repair of a left inguinal hernia.

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“The operation, which required the administration of a general anaesthetic, proceeded without any problems. As the patient was being revived from the anaesthetic he experienced a laryngospasm, causing his brain to be deprived of oxygen for an appreciable time – so-called hypoxia – which, it is claimed, resulted in the patient suffering anoxic brain damage.

“In 2014 proceedings were brought on behalf of the patient to recover damages from the defendant, who bore responsibility for any acts or omissions by staff at the hospital resulting in injury and damages to its patients. The defendant denied liability and the matter eventually went to trial on the merits. The trial proceeded before (Judge Lister) Nuku who heard the expert evidence on behalf of the plaintiff of, inter alia, an anaesthetist, a neurosurgeon and a clinical neuropsychologist. At the conclusion of the plaintiff’s case, the defendant successfully applied for absolution from the instance,” court documents read.

Judge Gamble further said absolution was granted solely on the basis that the plaintiff had, “failed to adduce sufficient evidence to make out a case for negligence on the part of the defendant”.

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“Importantly, the view held throughout by (expert witness and anaesthetist) Prof. Lundgren (in her expert report to the patient’s attorneys, her expert summary and her viva voce evidence) was that Dr Ramklass had not restored the patient’s oxygen supply in time so as to avoid the onset of hypoxia. She never deviated from that view…

“The professor remained of the view throughout that the treatment administered by Dr Ramklass in response to the patient’s sudden laryngospasm was not delivered timeously. She considered that the records available to her established that Dr Ramklass bagged the patient for a protracted period of time (more than 5 minutes) when she should have taken no longer than a minute at the most before administering the drugs which she ultimately did,” court documents read.

The appeal succeeded with a costs order made and remitted back to the court a quo for further hearing.

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Cape Times

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