The Star Late Edition

Mom claiming R30m after child brain damaged

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, and was transferre­d to hospital.

It was establishe­d that she was bleeding and that she was in labour.

The mother claimed 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 Caesarian 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 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 also 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.

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 acted 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 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 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.