Mother can sue state for R16m after hospital leaves child brain damaged

A mother has got the green light to pursue a R16m medical negligence claim against the Mpumalanga health department, accusing Piet Retief Hospital staff of causing her son’s lifelong disabilities through poor care during his birth.

The Mpumalanga High Court found that hospital staff were negligent in monitoring the mother and her unborn child during labour and that this negligence caused the boy’s brain injury and cerebral palsy.

The court ordered the MEC for health to pay 100% of the damages suffered by the child. The exact amount will be determined at a later stage even though the mother cited R16m in her original claim.

The mother, who gave birth to her son in 2009, told the court that her pregnancy had been normal and that there had been no problems with her health or that of her unborn child. But during labour, she said, the hospital failed to properly monitor the baby.

The court heard that there was no recorded foetal monitoring during crucial periods of labour, including the more than two hours before the child was delivered by forceps.

The mother also told the court that her baby did not cry properly after birth and struggled to breastfeed. She said nurses slapped his feet to try to make him respond and that when he eventually cried, it was only a weak “squeaking sound”.

It is inherently contradictory to champion the absolute reliability of the hospital’s Apgar scores and post-natal assessments while simultaneously acknowledging that the very same staff failed spectacularly in their mandatory monitoring and recording duties during labour

—  Takalani Ratshibvumo, acting judge president

The baby later had to be fed through a tube and remained in hospital for about a week.

Now at the age of 17, he had never sat, stood, walked or spoken and was completely dependent on his mother. He also suffered seizures and was on medication.

The health department disputed that the hospital caused the injuries. Its experts argued that the boy had been born in good condition, pointing to high Apgar scores and the fact that he did not require resuscitation.

But acting judge president Takalani Ratshibvumo rejected the department’s argument. The judge pointed out that the hospital’s own experts accepted that the monitoring and record-keeping during labour had been substandard.

“It is inherently contradictory to champion the absolute reliability of the hospital’s Apgar scores and post-natal assessments while simultaneously acknowledging that the very same staff failed spectacularly in their mandatory monitoring and recording duties during labour,” Ratshibvumo said.

The judge also accepted the mother’s evidence about what she saw immediately after the birth. Ratshibvumo said her evidence was direct and had not been disputed by the hospital staff or contradicted by the records.

By failing to monitor the foetus for several hours — most critically during the delayed second stage between 2am and 4.10am — the staff closed their eyes to the foetus’s condition

—  Ratshibvumo

“Her observations align perfectly with the clinical picture of evolving neonatal encephalopathy,” the judge said.

The court found that the hospital had a duty to properly monitor the baby during labour, particularly during the critical second stage. Instead, there were major gaps in the records.

“By failing to monitor the foetus for several hours — most critically during the delayed second stage between 2am and 4.10am — the staff closed their eyes to the foetus’s condition,” Ratshibvumo said.

The judge found that proper monitoring could have detected the baby’s distress earlier, allowing doctors to intervene before the brain injury became permanent.

“I am satisfied that the plaintiff’s expert witnesses provided a logical, coherent, and medically sound sequence of events,” the judge said.

The court ultimately found that the mother had proved, on a balance of probabilities, that the hospital’s negligence caused the child’s hypoxic-ischaemic brain injury and resulting cerebral palsy.

The health department was ordered to pay the mother’s legal costs.

Sowetan