The Gauteng health department is facing a damages claim of more than R30 million, instituted on behalf of a mother and her now 11-year-old daughter, after the child was born with severe brain damage due to the negligence of the medical staff at the Natalspruit Hospital in Katlehong.
The mother, who cannot be identified to safeguard her child, turned to the Gauteng High Court, Johannesburg as she blamed the medical staff at the hospital for the fact that her child now suffered from cerebral palsy.
Her claim includes R18.7m for future medical and related expenses and R3.6m for the pain and suffering she and the child had to endure.
The mother testified that she had an uneventful pregnancy, although she is HIV-positive. In September 2012, she went to a local clinic, complaining of lower abdominal pain, after which she was transferred to hospital.
It was established that she was bleeding and that she was in labour.
The mother claimed that the nursing and medical staff at the hospital were negligent in that they failed to attend to the vaginal bleeding during labour for about nine hours. It was said that she needed an emergency cesarean section, which was never performed.
As a result, the child suffered brain damage and resultant cerebral palsy, is epileptic and developmentally delayed and has a marked speech delay and speech deficits.
The mother and her medical experts argued that the injury suffered by the child was directly linked to the failure by health employees to timeously identify that her labour was not progressing normally.
The health department initially denied that the medical and nursing staff of the hospital were negligent. However, during trial, the departments’ experts - an obstetrician and a gynaecologist - conceded and agreed with the mother’s experts that the care received from the hospital during the birth of the child was substandard.
The mother’s evidence and that of the witnesses were largely uncontested, with the department’s witnesses conceding the evidence.
The court noted that the facts of this matter indicate that the mother experienced an uneventful pregnancy carrying to full term without any illnesses, infections or complications save for her positive HIV status.
On examination at the clinic she was found to be bleeding vaginally and was then referred to Natalspruit Hospital by the midwives at the clinic. At the Natalspruit Hospital, she was examined by a doctor who made notes in the clinical records that she was referred and examined for lower abdominal pain.
There is no indication in the clinical records that she was examined or assessed for the vaginal bleeding until much later. A doctor then ordered that a sonar be done, which did not happen.
It further appeared from the clinical notes that the monitoring of the foetus and the mother was not done as prescribed by the Maternity Care Guidelines in that the maternal monitoring was not done hourly as prescribed.
The labour was allowed to proceed as if normal until delivery. The baby was born compromised and immediately admitted to neonatal intensive care. The baby immediately showed signs of a brain injury due to lack of oxygen.
Acting Judge MD Botsi-Thulare said from the facts it is clear that if the birth was properly managed, the stressful situation facing the foetus could and should have been recognised and reacted upon. Negligence on the part of the medical staff has therefore been proved.
“If there was proper monitoring and assistance, foetal distress would have been detected and appropriate assistance would have been given with the delivery by a timeous caesarean section,” the judge said.
While later admitting negligence, the department also objected to the mother’s claim on the basis that she had instituted it out of time. The mother explained that she first had to obtain the medical records and consult experts to establish whether she could hold the department accountable.
In rejecting the department’s objection in this regard, the judge said it would be unrealistic to expect the mother, who has no knowledge of medicine, to have knowledge of what caused her child’s condition without having first had an opportunity of consulting a relevant medical professional or specialist for advice.
“It is trite that in certain cases involving medical negligence matters, a claimant is entitled to first obtain independent medical advice… In the absence of such independent medical advice, a claimant cannot be deemed to have had knowledge of the facts from which a debt arises,” the judge said.
She concluded that the department of health is 100% liable for the damages the mother can prove that she and her child had suffered due to the medical negligence.
The amount of damages due to her will be determined at a later stage.