We require a public health system that recognises the dignity and rights of those who are compelled to use its facilities.
It is that basic sensitivity that the Constitution demands, a judge said, in dealing with a case of medical negligence which left a now 12-year-old with cerebral palsy.
The mother of the child turned to the Gauteng High Court, Pretoria, where she is claiming millions of rand from the Limpopo health authorities following her child’s ordeal.
The court ruled in her favour that if the staff at the Limpopo WF Knobel Hospital were not negligent during her pregnancy, the child’s brain damage could have been prevented.
It was found that the mother received substandard care. She had an uncomplicated pregnancy, yet she left the hospital with a baby girl who will never be able to care for herself.
Judge Colleen Collis remarked that in our country poverty and a lack of literacy abound. “Masses of our people attend public health facilities. Their lack of sophistication and the vulnerability that accompanies poverty are factors that cannot be ignored.
“They are entitled to be treated in the same way as patients who can afford private medical assistance. That means that they should be fully informed and should be as involved as possible in their own treatment.”
The judge said this does not require a drain on public resources.
“This case is not about the availability of material resources. It is about a doctor communicating adequately with a patient,” the judge said.
The health authorities did not call any witnesses to testify, although they did oppose the claim.
The mother testified that in the early hours of April 11, 2012, she experienced a rupture of membranes having been at her full term of pregnancy.
She was taken to hospital and told by the nurse that based on the dilatation of her cervix she was still far from delivering the baby.
She was examined hours later and because she had a high blood pressure, she was given medication for it.
As she was very hungry and given food, but then she vomited the medication which was given to her and then lost consciousness.
She only woke up the next day, and was then informed by the nursing staff that she had given birth.
A medical expert told the court that on detection of the high blood pressure, she ought to have been monitored closely - every 20 to 30 minutes. Instead, she was left for hours.
The nursing staff’s failure to have done so, meant that the plaintiff received substandard medical care from them, the court was told.
Her condition progressed into her developing seizures. The court was told that the mother’s condition posed a risk to the placenta - the organ through which the foetus receives blood and oxygen. In addition, impaired placental function increases the risk of the development of hypoxia in the foetus.
“If the birth was properly managed the harmful situation the foetus experienced should have been recognised and timeously reacted upon,” the expert said.
While the staff said they followed the maternity guidelines, the judge said these are just guidelines. It is by no means cast in stone and it does not take away the responsibility of the nurses to call for help when it is needed.
Judge Collis noted that all experts agreed that the nursing staff should have taken appropriate emergency steps in order to diagnose foetal compromise timeously and had such steps been taken, the injury to the child could have been prevented or mitigated.
The amount of damages will be determined at a later stage.
Pretoria News