Cape Town - Limpopo health MEC’s attempt to avoid liability for medical negligence by a blunt denial, has failed in the Supreme Court of Appeal (SCA).
Her department was found vicariously liable for a baby girl born with brain damage.
The department will now have to cough up financial damages incurred, as a result of not monitoring the mother’s labour process “at its most critical stage”.
The SCA dismissed the application for leave to appeal from the Limpopo health MEC who wanted to transfer responsibility to the patient, by opposing an order from the Gauteng Division of the High Court in Pretoria.
The appeal concerned a medical negligence claim in terms of which a mother (the respondent), acting on behalf of her minor child (D M), claimed damages in the high court arising from the brain injury which D M suffered during the birth process at Dilokong Hospital in 2010.
According to the high court judgment, the hospital had been negligent due to a “lack of adequate monitoring at the most critical stage”.
“She was fully dilated and was in the second stage of active labour.
“At 2am, the attending midwife again summoned the doctor who was on call. The clinical notes recorded that the doctor promised to attend.
It further recorded that the plan was to monitor the foetal and maternal condition.
“The note made at 2am was the last entry made in the clinical notes.
“There is no indication of any monitoring whatsoever having taken place between 2am and the delivery of the baby at 3.35am. Despite it being common cause that D M was born at 3am, the partogram inexplicably reflects an entry purporting to show the position of the foetal head (in utero) at 4am,” the judgment read.
Observations after birth noted that the baby girl had suffered seizures, her “cry” was not audible, and her muscle tone was described as “floppy”, and due to a number of added medical complications – including hypoxia (from a sustained reduction in the supply of oxygen to the brain) – the baby girl developed severe asymmetrical mixed-type cerebral palsy.
SCA Judge Mahube Molemela, said the MEC’s application to the SCA amounted to a bare denial of negligence on their part “without stating material facts.”
“It is clear from all the medical evidence that there was a lack of adequate monitoring at the most critical stage of the (mother’s) labour. This conduct fell far short of the very guidelines intended for public hospitals and clinics in South Africa.
“In the face of slow progress in labour and the presence of thick meconium, there was no intervention on the part of the hospital staff to expedite the delivery of D M to avoid the eventuation of harm.
“However, it must be borne in mind that the doctor was summoned for the first time at 1.30am.
“Based on the evidence, it is more probable than not that had the doctor who had been summoned arrived, he would, upon noting the unfavourable maternal and foetal conditions and the fact that the respondent was fully dilated, have delivered D M by forceps within 20-25 minutes of that doctor’s arrival.
This means that D M would probably have been delivered by 2.15am. It follows that D M’s brain injury would not have eventuated if her delivery had been expedited,” said Judge Molemela.
Cape Times