Durban - “It was the year my heart broke,” was how a Port Shepstone mother clearly remembered 2009 when she learnt that her baby girl, born prematurely, was profoundly blind.
“I wanted those doctors to go to jail,” Aurelia Masiko said in her evidence in the Durban High Court this week in her multimillion-rand claim for negligence for the alleged substandard treatment given to her daughter Asiphe by doctors at King Edward VIII Hospital.
It has been alleged that the doctors were preparing to go on strike at the time.
The trial, before Judge Thoba Poyo Dlwati, has cast a spotlight on the damage too much or too little oxygen can do to retinal development in premature babies and the importance of timely screening for retinal damage or retinopathy of prematurity (ROP) which, the court heard, caused singer Stevie Wonder’s blindness and had been well-documented since the 1940s.
Masiko testified that Asiphe was born at 28 weeks, weighing just more than a kilogram, and placed on a ventilator in ICU where she remained for about a month. She was discharged, allegedly in a rush on the day the strike was starting.
Masiko said during that month, she had expressed unhappiness about the care of her baby.
In a document detailing her complaints, she alleged that when she queried the oxygen levels being given to her baby, a nurse had told her “not to act like a nurse”.
She said when she was discharged, it was not done by a doctor and she was simply given a pack with appointments for a cardiologist and an audiologist, but none for a eye specialist. Nothing was explained to her.
Two days later, her baby became distressed. She took her to Port Shepstone Hospital and handed over the pack to staff there.
She testified that at some stage she noticed that the baby’s eyes were “marbled”. When she returned to King Edward, she was chastised for not keeping an ophthalmologist’s appointment.
“It was the first I heard of it,” she said.
The Department of Health is fighting her claim, which is estimated at R14 million. While its head of paediatrics, Dr Neil McKerrow, says in a memorandum that liability should be conceded, “because of the failure to maintain oxygen saturations in an acceptable range”, because of Masiko’s failure to attend the alleged ROP screening appointment, she should share responsibility.
An application to this effect was refused by the judge.
Professor Johan Smith, the head of paediatrics at Tygerberg Hospital, testified that severe respiratory distress caused the death of most premature babies and needed to be treated as a medical emergency. Part of the treatment involved putting the baby on ventilation.
He said it was essential to monitor oxygen saturation levels using a monitor clipped on to the child which gave almost immediate readings. Asiphe’s readings were consistently 100%, when they should have been between 88% and 95%. “If the alarm on the (clip) device had been switched on, it would have been continuously beeping,” he said.
He said retina development in premature babies was interrupted at birth and too much oxygen suppressed further growth.
From the medical notes, he said, it seemed there was no oxygen management, which should have been done as standard practice.
Smith said the screening for ROP “within a specific window period” was also essential. Sometimes the condition healed itself, but the more serious cases needed laser treatment.
He would have rather kept the “high risk” baby in hospital or transferred it to another hospital to ensure the screening was done.
“A strike should not trump the best interests of a baby and she should have been transferred. I am aware of the overpopulation of babies in government hospitals, but this was not a case which should have fallen through the cracks.”
Under cross-examination, it was suggested that the department could not be held liable if the appointment was not kept. It was also suggested that the doctors were dealing with a matter of “life and death” and were trying to wean the baby off the ventilator.
The judge said it “boggled the mind”, as to why Masiko would want to hide a letter about the screening appointment if it was given to her.
The trial is continuing.
The Mercury