Two Eastern Cape mothers can breathe a sigh of relief after winning court cases against the Eastern Cape health department for negligence during the deliveries of their babies.
In both cases, one heard in the Bhisho High Court and the other in the Mthatha High Court, it was ruled that specific information about the mothers and their children be redacted to protect their identities.
In the first matter heard before judge Bantubonke Tokota, the mother instituted a claim against health MEC Sindiswa Gomba after her son was diagnosed with cerebral palsy.
Born on October 18 2010 at Frere Hospital in East London, the baby boy was first diagnosed with tachypnoea (fast breathing).
The next day it was recorded that the child was comfortable and had been taken to his mother.
Two days later, hospital staff detected jaundice in the baby, who needed an immediate blood transfusion.
It was then discovered that the baby and his mother had incompatible blood groups.
According to the judgment, a witness called on behalf of the mother testified that the baby showed very high levels of bilirubin, which is a yellow pigment that is caused as the body gets rid of old red blood cells.
High bilirubin levels are more common in newborn babies as it takes some time after birth for an infant to start efficiently metabolising bilirubin and excreting it.
The baby’s total serum bilirubin (TSB) level after birth was above the normal threshold, which resulted in the development of kernicterus, a rare form of brain damage, due to the build-up of bilirubin.
Witness testimony confirmed that an immediate blood transfusion was needed but the B+ blood the child needed had to be ordered from Port Elizabeth.
Hospital staff claimed to have ordered the blood on October 20, but hospital records prove that it was only done on October 21.
At lunchtime on October 21 the mother requested a transfer of the baby to Life Beacon Bay Private Hospital and a blood transfusion was done at 8pm that same day, but it was too late.
Tokota found that there was negligence on the part of Frere Hospital in acting in accordance with the Guidelines for Maternity Care in SA in that the proper measures to treat and prevent the damages the baby suffered were not taken in good time.
“It is clear to me that the Frere Hospital staff were negligent in not ordering the fresh blood immediately upon discovery of jaundice of [the child].
“The failure to act immediately contributed to and/or caused the harm suffered by [the mother and her child].
“In the premises, I find that [the mother] is entitled to judgment in her favour,” Tokota said.
Tokota further ordered that the department of health pay damages to the mother and her child.
Meanwhile, also on November 19, judge Gerald Bloem of the Bhisho High Court, ruled in favour of a woman whose daughter suffered severe brain damage after being deprived of oxygen before birth.
The child, born on September 19 2013 suffered hypoxic-ischaemic injury due to negligence by the Dr Malizo Mpehle Hospital, Tsolo, Bloem found.
Hypoxic-ischemic encephalopathy (HIE) occurs when the brain does not receive enough oxygen or blood flow for a period of time, and in this case was found to have occurred shortly before the child’s birth.
Bloem found that nursing staff at Dr Malizo Mpehle hospital were negligent in the treatment of the mother and her unborn child in that they did not monitor the infant’s heart rate and mother's blood pressure at sufficient intervals.
If they had it would have indicated that there were complications from the start.
“In this case there was no foetal heart monitoring from 11.30am until 5.40pm on 18 September 2013, a period of about six hours.
“There was also no monitoring between 5.40pm on 18 September 2013 and 4.40am on 19 September 2013, a period of about 11 hours. It means that during those periods the child’s condition was unknown,” Bloem said.
Bloem further found that it was known to the medical and nursing staff that the mother had hypertension during her pregnancy and that a woman who is pregnant for the first time, as in this case, is at high risk during labour due to the risk associated with prolonged and obstructed labour.
The prolonged labour and the woman’s unmanaged hypertension resulted in the unborn baby being deprived of oxygen.
“I am of the view that reasonable nurses in the position of the nursing staff who treated [the mother] on 18 and 19 September 2013 would have foreseen the reasonable possibility of harm to [the mother] and her unborn child and would have taken steps to guard against its happening,” Bloem said.
“Reasonable nurses would have foreseen that their failure to regularly monitor [the mother] and the foetal heart rate would harm [the mother] and her unborn child.
“Regular monitoring would have warned those nurses of a developing injury to the child’s brain if starved of oxygen during labour and that such an injury would have adverse consequences for [the mother] and her child.
“The nursing staff in this case failed to take such steps.
“In all the circumstances, I am satisfied that [the mother] proved on a balance of probability that the nursing staff who treated [the mother] were negligent.
“The injury to the child’s brain could probably have been avoided,” Bloem said.
Bloem ordered that the department of health political head be held liable for all the damages the mother could prove and that the department be held liable for the costs of the trial.