Anaesthetist Dr Abdulhay Munshi was shot dead in Johannesburg on Wednesday night (16 September) in what has been described by the Health Professions Council as a vigilante killing and by the SA Medical Association as an assassination. The family that accused the two doctors of culpability in their child's death have denied any involvement.
MedicalBrief 's most recent update – Tuesday (22 September):
The Health Professions Council of SA has written to President Cyril Ramaphosa about the criminal case against Dr Peter Beale and Dr Abdulhay Munshi. According to TimesLIVE, the HPCSA said yesterday it had written to Ramaphosa about the matter after a “lack of action” by the National Prosecuting Authority and the Minister of Justice.
“This has implications for the medical profession. We are just acting responsibly, just like when we notified the Minister of Justice and Minister of Police, we feel he needs to be aware of what is happening,” said spokesperson Kgosi Letlape.
Letlape said the case had criminalised the medical profession and many doctors feared working in such conditions. “I am a practising doctor and I cannot practise under this climate where I may be killed for helping society. That is not the environment we want to practise in, where (by) my professional action, I can be treated as if I am a criminal when there is provision in the law in terms of how these matters should be handled. We are in danger. We can’t practise in this climate, the laws of the county are not being followed. Why are you not dealing with this the way it should be, why are you criminalising medicine?” asked Letlape.
The National Prosecuting Authority on Sunday (September 20) issued a statement saying that any decision to prefer criminal charges meant that an inquest hearing was not necessary. But doctors who executed their duties according to the law did not have to fear criminal prosecution.
“By law, an inquest shall be conducted in instances where criminal proceedings are not instituted and where a death has occurred and that such death was a result of unnatural causes. In this instance, the latter is not applicable,” said NPA spokesperson Phindi Mjonondwane.
In any case of potential negligent loss of life, the NPA is “duty bound to take action with the aim of deciding whether or not, criminal proceedings should be instituted against such a medical practitioner".
A criminal charge of medical negligence was laid by the father of the deceased boy, Zayyan Sayed, in October 2019. The NPA assessed the case docket and established that there was a prima facie case.
“The NPA, guided by Section 179(2) of the Constitution of South Africa which empowers the NPA to institute criminal proceedings on behalf of the State and to carry out any necessary functions incidental to instituting criminal proceedings, enrolled a case of culpable homicide against two medical practitioners, namely, Doctor Peter Beale and Doctor Abdulhay Munshi
“Furthermore, the NPA reiterates that the rights to equality before the law applies to every citizen within the borders of South Africa. It is therefore our view that, if medical practitioners, in the execution of their duties, act within the confines of the law, then they do not have to fear criminal prosecution.”
Once the prosecution has been furnished with a copy of Munshi's death certificate, charges against him can be formally withdrawn in court. Beale will be back in court on 16 November.
A report in the Sunday Times quotes Beale's lawyer, Jeanne Albertse, denying claims of death threats against him.
“There is an attorney-client privilege between me and my client. I am not disclosing anything else other than saying he has not received death threats, according to him.”
In an interview with the Sunday Times, Sayed said rumours that the charges against the doctors were about to be withdrawn were “absolute hogwash”.
“Naturally there is a lot of speculation about the motive for the murder and status of the case against the doctors. It seems some are now trying to use this unfortunate and tragic incident to delegitimise the ongoing court process.
“The evidence is there. Beale and Munshi would not have been arrested if there was no evidence. People are claiming that the murder happened because the case was going to be dropped, but they are doing this because they don't want to be held accountable.”
Earlier reports:
Netcare and the SA Private Practitioners Forum (SAPPF) have added their voices to the condemnation of Dr Abdulhay Munshi’s murder, reports The Star. Netcare said it was saddened by the senseless shooting of Munshi who had devoted his life to health care and was known for his compassion and dedication to his patients and his profession.
Mohammadh Sayed, the father who took Johannesburg anaesthetist Dr Abdulhay Munshi and paediatric surgeon Prof Peter Beale to court over the death of his 10-year-old son Zayyaan Sayed, has released a press statement through his lawyers on Friday (18 September) denying involvement in the crime.
“The inferences sought to be drawn in the media are irresponsible, reckless, speculative and sensationalist. Mohammadh Sayed denies any involvement in the crime and sincerely hopes that the perpetrators will be found and brought to justice as soon as possible,” read the statement.
Mohammadh Sayed said he was not being malicious in pursuing criminal charges against Munshi and Beale.
Sayed said it was "a matter of public record" that he had followed a legal route "in pursuit of the truth" regarding the death of his son.
“He has instructed his legal team to engage with the investigating and prosecuting authorities on a regular basis in his endeavours to ensure that justice is not only achieved but also done in a legitimate and transparent manner in this matter.
“The investigation thus remains in the hands of the police and the National Prosecuting Authority. He has endeavoured to hold the doctors involved accountable, criminally and before the Health Professions Council of SA. This is to ensure that no other parent suffers the pain and anguish that he and other parents endured before,” the statement read.
"He has instructed his legal team to engage with the investigating and prosecuting authorities on a regular basis in his endeavours to ensure that justice is not only achieved but also done in a legitimate and transparent manner in this matter," the statement said.
SA Health Minister Dr Zweli Mkhize said he was “shocked and dismayed” by the murder.
“At a time when the safety and psychological well-being of our healthcare workers is under the spotlight‚ it is unthinkable anyone would consider taking the life of a health worker‚ people who have been in the front line of the fight against COVID-19. We wish to convey our heartfelt condolences to the family of Dr Munshi‚ his colleagues‚ friends and the medical fraternity as a whole.
“We call on the law-enforcement agencies to do everything in their powers to ensure the perpetrators of this heinous crime are brought to book and face the full might of the law‚” Mkhize said.
SAPPF CEO Dr Chris Archer described the anaesthetist as “a kind and gentle person who was dedicated to his patients and maintained excellence in his profession and practice, who was arrested and treated like a common criminal when a patient under his care died unexpectedly last year”.
The HPCSA has said apparent “vigilante behaviour” was involved in the “untimely and gruesome death”. At a briefing, HPCSA chairperson Dr Kgosi Letlape said health professional should stand together to protect the profession. “This is a sad day and it is extremely dangerous if healthcare professionals are going to be treated like criminals,” Letlape is quoted as saying in a News24 report.
“We do not want to practice under those circumstances or have a climate of fear when we have a solemn duty and an oath to uphold to put our patients first.”
Letlape said due process needed to be followed in the medicine field within a sector that is self-regulated. The inquiry into Beale and Munshi was interrupted by the decision to press charges, instead of leaving the matter to “independent structures”.
“What is impacting on our ability to do our job is that… there is an unlawful process that is happening in the courts of law,” he charged.
Letlape said the HPCSA was “painfully aware of the contagion of legalisation” in the field and was seeking to rewrite regulations to stop delays in investigations, turning current processes within the council “similar to the courts”.
Munshi was gunned down by a motorist who rear-ended his vehicle then opened fire multiple times. Munshi was killed in Orange Grove about 3.50pm.According to various media reports, between four and six shots were fired.
SA People reports that according to Social Cohesion Advocate Yusuf Abramjee, the fatal shooting took place in Orange Grove when “a car with no registration plates bumped into the doctor’s car. When he got out, they opened fire and fled. Nothing was stolen.”
Dr Jonathan Witt, co-founder of the Renegade Report, said on Twitter on Wednesday evening: “A colleague was shot 6 times in what appears to be revenge for a poor patient outcome.”
TimesLive quotes an eyewitness, Dayton Ramiah, who said he had just arrived home and was offloading his van with his father when he heard a loud bang.
“I assumed it was a backfire. I looked back and saw a black BWM stopped outside our gate. As I looked I heard four gunshots. They were so quick.”
Running to the gate with his father, an ex- policeman, Ramiah said he saw a dark grey C-Class Mercedes-Benz race off.
“The windows were tinted. You couldn’t see who was inside. It was speeding. There were no number plates on it.”
Ramiah ran to the car with his father.
“There was an elderly white woman who had stopped. She saw everything.”
Ramiah’s father, Daryn Ramiah, said the woman described how she was behind the Mercedes-Benz when the shooting happened.
“What she told us was crazy. She said the accident happened. She said after the shooting the doctor got out and walked to the back of his car.
“The driver, who was apparently a white guy, got out of the Mercedes, walked up to the BWM driver and shot him. A bullet him in the right eye. He was shot in the chest, twice in the back and once under the arm.”
“Between the crash, the shooting and the killer driving off was about three minutes. It was so quick.”
SAMA said that deplored the violence that resulted in Munshi's murder, and that it was a sad day when a country could not guarantee the safety of its healthcare workers. News24 reported that SAMA spokesperson Dr Angelique Coetzee said: “It appears to be more of an assassination than a robbery gone wrong.
“We are all aware of the case that was against him and the paediatric surgeon and these charges were, according to our sources, about to be dropped, based on the postmortem evidence,” said Coetzee.
She said the whirlwind that came with this matter would lead to doctors being reluctant to treat certain patients.
“The low point of this is that doctors will in future check if a patient is politically connected or may be a high profile person out there because of fear of themselves being targeted and that will lead to poorer intervention and care,” said Coetzee.
Coetzee is quoted as telling the The Star that before Munshi’s death, the anaesthetist and Beale had received death threats. However, they didn’t take them seriously.
“The doctor (Munshi) and the paediatric surgeon (Beale) had received death threats before but it wasn’t taken seriously, I didn’t take it seriously. Dr Beale mentioned it to me last week and I don’t even think he took it seriously,” she said.
The Medical Protection Society (MPS) said in a statement on Thursday that it was shocked and saddened at the death. “The thoughts and prayers of MPS and South Africa’s healthcare profession are with Dr Munshi’s family during this sad time.”
The SA Society of Obstetricians and Gynaecologists (SASOG) and the Gynaecology Management Group (GMG) released a statement on strongly condemning violent crime and appealing to the government to “step up efforts to manage this scourge and to protect its citizens”.
“This incident highlights an apparent escalating trend of violence against health care professionals, including a recent incident in which a female doctor was physically attacked by the male relatives of a patient who passed away. This trend is of great concern to the SASOG and GMG because doctors are unable to practice their profession of healing when they are in constant fear of their lives.
“While the death of a patient is always tragic and highly traumatic, even when everything possible is done, medical outcomes are not always predictable and may be undesirable. While great strides have been made to improve the safety of operations and other medical interventions, some patients still become very ill and may even die. This does not mean that the doctor is at fault.
“We respect and fully support the rule of law and the regulatory processes guiding investigations and the quest for justice. We believe that professional bodies should lead in the prevention, identification and management of medical negligence and should lead investigations in this regard. In South Africa, it is the role of the Health Professions Council of South Africa (HPCSA) to investigate all matters of alleged medical negligence. SASOG and GMG were therefore deeply concerned that Dr Beale and Dr Munshi were immediately ‘villainised’ in the media following the tragic passing of Zayyaan Sayed last year, before a proper investigation by the HPCSA could take place.
“Globally, reforms regarding medical culpable homicide have taken place or are under discussion in countries including India, New Zealand, Australia and the United Kingdom and SASOG is working with the Federation of South African Surgeons (FoSAS) and the South African Anaesthetic Society (SASA) to speed up these reforms in South Africa.”
The Radiological Society of SA has said it was outraged at the “brutal and senseless” murder.
Dr Dharmesh Daya, its president, urged the authorities to act without fear or favour to find and arrest the murderers.
“We are outraged by the brutal murder of Dr Munshi. Doctors travel at all times of day and night to see patients. There are increasing numbers of reports of doctors and paramedics being attacked and killed. Doctors are already at risk from the diseases they treat, as we have seen in the Covid-19 pandemic. It is even more tragic when they are violently killed while following their calling and serving the community.”
Munshi and paediatric surgeon Dr Peter Beale were accused of culpable homicide for the death of 10-year-old Zayyan Sayed shortly after an operation last year and were on R10,000 bail each. Th charges related to the death of 10-year-old Zayyaan Sayed in October 2019 at Netcare‘s Park Lane Clinic. The child's death followed hours after Beale performed what was meant to be a routine laparoscopic operation to stop reflux.
The boy’s father, Mohammadh Sayed, chief operating officer at cigarette manufacturer Carnilinx, laid culpable homicide charges against the doctors and the story featured prominently in the media, which led to further allegations against the doctors emerging. The EFF also got involved demanding HPCSA action against Beale and Munshi.
After Zayyaan’s death, Netcare launched an internal investigation into the incident, suspending both doctors in the interim. The HPCSA also launched its own investigation after more families came forward with claims that children had allegedly died or were left with permanent impediments from treatments by Beale.
The December 2019 arrest of the two doctors, most unusual in a case of culpable homicide, caused consternation in the medical fraternity.
Durban orthopaedic surgeon Dr Rinesh Chetty started a Change.org petition called #dropitandwait, signed by almost 70,000 people warning that the SA medical profession and patient care were put under threat by the arrests. The petition called for due processes to be followed.
“Drop the criminal case allow the medico-legal investigation to take place. Make an informed decision after all the facts and evidence have been reviewed by both medical and legal experts.
“Stop this unprovoked and unprecedented attack on the medical profession.
“It will only cause harm. The doctors and their legal teams are co-operating. Was there a need for handcuffs, jail and police vans?” read the petition.
Chetty said at the time that media reports had caused a major issue. “It has not been helped by the fact that all doctors are bound by a confidential policy and that there was an active medical investigation going on about the case.”
Several medical organisations also expressed concerns.
Dr Schalk Burger, president of the South African Spine Society, said such cases were generally complex. He was quoted saying there was concern over the doctors being unable to generate an income while awaiting the conclusion of the process, as well as their grief, anxiety and the public humiliation that they faced.
The Association of Surgeons of South Africa stated that surgery and anaesthesia could not be regarded as precise arts. “The spectre of adverse events, including death, is ever-present. We will engage with the national minister of health to frame legislation providing immunity from criminal charges for surgeons and anaesthetists in all cases until due processes have been completed.”
Dr Phillip Webster, president of the South African Orthopaedic Association, opposed the actions of the NPA, saying he believed it was creating a potentially dangerous precedent that could have serious repercussions for clinical autonomy in the future.
Dr Moogandra Naidoo, chairman of the KZN Specialist Network, said as far as they were aware, there had never been a warrant of arrest issued for a healthcare practitioner in a criminal matter and such issues were normally handled via a summons or warning.
“Why is it necessary to treat medical professionals like common criminals, by handcuffing and then placing them in an overcrowded holding cell, pending their transfer to court in a police vehicle with sirens wailing?” Naidoo asked.
SAMA chair, Dr Angelique Coetzee, said the accused doctors had rights and were innocent until proven guilty. “Medicine is inherently risky, and severe consequences are unfortunately not uncommon – even when there are no mistakes involved. Until an investigation is concluded, there are not yet enough facts to make any medical conclusions.”
Daphney Chuma, of the HPCSA, said if the legal approach used in the case of Beale and Munshi was perpetuated, the board was concerned that medical doctors would in future allow patients to die naturally without intervening, for fear of being criminally prosecuted.
Photo: Anaesthetist Dr Abdulhay Munshi with Dr Peter Beale. Photo courtesy of ENCA
Full report in The Star (subscription needed)
See also: