Ventilator settings selected by a paediatrician treating a newborn baby who suffered a collapsed lung a few hours after birth were directly responsible for the severe lung injuries the baby suffered, the Port Elizabeth High Court heard on Thursday.
Expert neonatologist Prof Johan Smith told the court it was his opinion that mismanagement of the baby’s treatment, including obscure ventilator settings and the delay in administering crucial medication by paediatrician Dr Charmaine van Heerden, led to the child suffering severe brain and lung injuries.
“If Surfactant was administered timeously it all would probably have been avoided,” Smith said.
Surfactant is a bioactive liquid which assists the airways to expand when breathing.
It was a naturally occurring substance in the body but was usually absent in premature babies, Smith said.
The parents of the little girl, now 10, who are not being named as per a court order, are suing Van Heerden and Netcare Greenacres Hospital for R23m claiming negligence on behalf of both parties led to their daughter being severely disabled and brain-damaged.
Smith told acting judge Nicholas Mullins that had Van Heerden given the girl Surfactant prior to her collapsing at 3am on November 22 2008, her near-death injuries could have been avoided.“I must emphasis the importance of Surfactant.“[It] is widely available, especially in private practice.“[Van Heerden] had nothing to lose by using the drug.“[The baby] had a lot to lose by not receiving the proper treatment,” Smith said.According to records before court, Van Heerden only administered the life-saving treatment after the child stopped breathing and had no blood pressure when she arrived at the hospital after being called by nursing staff.Smith, head of neonatology at Tygerberg Children’s Hospital in Cape Town, said he found it peculiar that Van Heerden had used unusual ventilator settings on the baby after she was resuscitated.“[The ventilator] was blowing in more air rather than allowing the lungs time to release the air leading to ir trapping,” Smith said.“There was too little time for the lungs to release air.”Smith said there was extensive evidence that the role played by the Continued Positive Air Pressure (CPAP) and the resuscitation efforts had been contributing factors leading up to the child’s collapse, which could have been avoided if Surfactant was administered timeously.Both Van Heerden, who now lives in Namibia, and Greenacres Hospital have denied negligence on their part.