The Gauteng MEC for health and social welfare Nomantu Nkomo-Ralehoko has succeeded in appealing a High Court ruling in a case of a child who was born with a head injury. The High Court ruling held her department liable. This would have made her liable for the incident that happened at a public hospital.
High Court ruling overturned
The Supreme Court of Appeal’s order on Monday overturned the Johannesburg High Court’s judgement. It stated that Nkomo-Ralehoko was liable for damages suffered by Ms M as a result of a brain injury. The High Court found that the injury was sustained during her child’s birth.
In the lawsuit, Ms. M accused the medical staff of negligence. She said on May 18, 2010, she went to give birth to her son L at Tshwane District Hospital. The medical staff did not provide her with the necessary attention and expertise, she said.
Medical staff was negligent
She alleged that the medical staff neglected to utilise a cardiotocography equipment (CTG) to check her baby’s heartbeat. As a result, they did not detect irregularities in his heartbeat.
Due to this, Ms. M’s labour was excessively prolonged, and a timely referral for a caesarean section was not made. The child therefore experienced cerebral palsy. It is a condition brought on by hypoxia and birth-related brain damage, she argued.
Insufficient evidence
The court rejected Ms. M’s claim. It concluded that there was insufficient evidence to support the theory that the child’s birth injury caused his brain damage.
The hospital staff was not deemed to have been negligent. According to that court’s ruling. The High Court’s ruling was reversed by the entire court.
It was decided that Ms. M’s and the baby’s conditions were good when they arrived at the hospital. However, there was reason for concern when they were first placed on the CTG machine due to the machine’s traces.
Since the foetal heartbeat ought to have been monitored continuously or every two hours using a CTG machine, this was not done. And the disregard for the department of health’s instructions in doing so, constituted negligent conduct.
Appeal upheld
The MEC’s appeal against the full court’s decision was upheld by the SCA. It was discovered that the baby’s heartbeat was regular for hours. This was after the abnormality that was noticed when the mother was originally placed on the CTG was fixed. It was fixed with a Ringer’s Lactate solution.
The obstetricians concurred that the additional irregular traces (type 2 decelarations) were noticed at 14:00. These were not significant enough to notify the staff that an emergency C-section was necessary. They were noticed one hour and 15 minutes before the baby’s birth.
More crucially, the medical specialists concurred that the baby had suffered an acute and severe brain injury. This was the one that happens quickly, lasts a short while. It can also be distinguished from a persistent partial brain injury. And the injury takes several hours to develop, they concluded.
Not supported by expert opinion
Based on this, the SCA determined that the assertion that the medical professionals neglected Ms. M. was not supported by the evidence.
The SCA also found that the question of whether CTG monitoring provides warning of sentinel events that lead to newborn brain damage was not conclusively answered by expert opinion or scholarly literature.
