The parents of a little girl with cerebral palsy are suing a paediatrician and Greenacres Hospital for nearly R23m, claiming one bad decision after another led to the child being permanently brain-damaged and wheelchair-bound.
The aggrieved mother and father, from Despatch, say their daughter was stripped of any prospect of a normal life and her future was instead clouded with a dependance on nappies and medication.
She was constantly in pain – and they want those responsible to pay up.
Netcare Greenacres has spared no expense in defending the medical negligence claim, with renowned advocate Barry Roux SC set to argue the matter in the Port Elizabeth High Court on Monday.
Roux became a household name when he defended Paralympic athlete Oscar Pistorius for murder.
At the age of 10, Jane* cannot walk, talk, see or hear properly, and it is expected that her condition will deteriorate.
For her parents, watching their daughter suffer has been a heartbreaking experience.
They have since divorced and Jane lives with her mom.
They said their daughter had in her young life been subjected to numerous surgeries, was vulnerable to respiratory infections and suffered from epilepsy.
“She has to attend the Aurora Stimulation Centre in PE and has far-reaching special education needs. She will probably be institutionalised in her later life,” the father, 37, said.
The parents set out in court papers how the alleged negligent actions of Dr Charmaine van Heerden, or alternatively the hospital nursing staff, led to their daughter’s debilitating injuries.
Van Heerden, who has since left Port Elizabeth and now works in Windhoek, Namibia, has shifted blame to the hospital’s neonatal nurses.
The doctor said in court papers that she had at all times done everything in her power to care for her patient.
Van Heerden’s lawyer, Karen Lee, said on Friday that they were preparing for trial and therefore did not want to comment at this stage.
The parents are claiming in respect of general damages, and past and future medical expenses, as well as for pain, suffering, disability, disfigurement and loss of amenities of life.
In June 2008, Jane’s mother, 32, found out she was pregnant. Regular checks with her gynaecologist reaffirmed a healthy pregnancy and no foetal abnormalities.
But at about 5.30pm on November 20 2008, the celebrated pregnancy quickly turned into a nightmarish ordeal for the young parents.
At just 32 weeks’ pregnant, the expectant mum began experiencing contractions.
Numerous attempts were made to delay labour, but during the early hours of the next morning, when it was discovered that the baby was in distress, an emergency caesar was booked.
Van Heerden was present at the delivery and immediately took over management of Jane’s care.
The parents, in court papers, claim the infant’s one-minute and five-minute Apgar scores were normal at eight and nine points respectively, and that she was admitted to Greenacres Hospital’s Neonatal Intensive Care Unit (NICU) at about 6.30am.
She was treated by Van Heerden for the next 41 days.
On admission, Van Heerden said, Jane’s pulse rate was normal, while her respiration was a little fast and saturation levels a little low.
Jane was ultimately discharged on January 1 2009 – but it was her time spent in hospital, where she experienced one setback after another, that has since rendered her wholly dependent on others for the rest of her life.
The parents, represented by lawyer Morne Struwig, accused nurses of failing to effectively advocate for their baby to ensure she received the optimum healthcare and treatment she required.
The infant had displayed consistent and increasing respiratory grunting episodes subsequent to delivery.
Several low blood oxygen episodes noted in hospital records during the afternoon and evening of November 21 were allegedly ignored by Van Heerden when she did her ward rounds.
It is further claimed that the doctor failed to diagnose and treat Jane for abnormally elevated carbon dioxide levels in the blood.
“Her negligent omissions and acts gave rise to the acute deterioration in the condition of the infant at approximately 3am on November 22,” court papers read.
But hitting back on the allegations, Van Heerden said when she left the NICU at
about 9am on November 21, she gave specific standing instructions to nurses on duty, whose names she could not recall, to maintain the baby’s vital signs and to contact her in the event the levels fell out of the stipulated parameters.
Van Heerden said she examined the baby for the last time on November 21 at about 4.30pm and found her to be stable. Her previous instructions stood.
“A single significant [low blood oxygen] episode occurred at approximately 11pm, during which her oxygen levels fell below 90% for approximately two hours, according to her charts.”
She said she was not notified of the event and was only called telephonically when Jane collapsed at 3am on November 22.
When she arrived at the hospital, Jane’s saturation levels were at 50%, she was not breathing spontaneously and she had no blood pressure.
Van Heerden performed a resuscitation on the little girl.
She said she was forced to replace the ambubag three times due to it malfunctioning. When the ventilator similarly failed to work, she was forced to perform manual ventilation.
An ultrasound later showed haemorrhages on the brain.
Jane began seizing and her condition worsened with time.
“In consequence of this, the infant suffered a permanent and severe brain injury and cerebral palsy.”
The parents said by accepting Jane as a patient, Van Heerden at all material times had a duty of care to provide services with the professional skill, care and diligence expected of a specialist paediatrician.
Such services needed to be rendered without negligence on her part.
Furthermore, by admitting the child to Greenacres, the hospital staff had a duty to provide the patient with professional medical and nursing services, as well as adequate care and supervision.
The medical staff were employed by the hospital and therefore were acting in the course and scope of their employment.
Hospital general manager Andre Bothma said while they continued to sincerely empathise with the parents of the little girl and for the circumstances in which they found themselves, he was not in a position, in light of the impending court case, to comment on the matter.
“We can only confirm that we will present our case in court to defend our position from a liability perspective,” Bothma said.
* Not her real name.
What went wrong - parents say
The parents of a 10-year-old girl suffering from cerebral palsy made damning allegations against a specialist paediatrician, Netcare Greenacres Hospital and its nurses. This is what they allege went wrong: Dr Charmaine van Heerden:
● Failed to take quick and appropriate steps to provide respiratory support to the newborn;
● Had opted for non-invasive respiratory nasal support, instead of invasive support given the baby’s condition at that stage;
● Ignored the intermittent and significant desaturation episodes throughout November 21 2008, and instructed hospital staff not to do further blood gas tests unless her condition deteriorated;
● Failed to check the ambubag and ventilator used for defects and then used the incorrect ventilator setting;
● Failed to timeously diagnose the collapse of her left lung;
● Failed to timeously order a blood transfusion; and
● Ordered and allowed an excessive administration of intravenous fluids and glucose, which probably gave rise to an acute renal injury. Greenacres Hospital:
● Failed to provide functional equipment to its staff;
● Failed to ensure skilled nurses were employed in the Neonatal Intensive Care Unit (NICU); and
● Failed to ensure a correct nurse-topatient ratio in the NICU.
The hospital staff:
● Failed to notify Van Heerden of the 11pm episode as was required;
● Failed to ascertain precisely from Van Heerden what her alleged standing instructions were on the morning of November 21 2008;
● Failed in light of the deterioration of the baby’s condition to recommend that an ABG blood test be performed;
● Failed to properly monitor her respiratory stability;
● Failed to check the functionality of the ventilation equipment;
● Failed to query the high dosage of sleep medication prescribed;
● Failed to timeously incubate her;
● Failed to keep proper and consistent records.