A Gqeberha gynaecologist and obstetrician has made an out-of-court R4,5m settlement to a woman left permanently disfigured after injuries during childbirth, reports The Herald. The settlement, on Monday 31 January, was the culmination of a three-year-long legal battle.
Dr Daniel Truter had been taken to court after the birth of the woman’s second child at Life St Georgeʼs Hospital on 17 April, 2016, In papers before the High Court in Gqeberha, she said she had suffered a fourth-degree peri-anal tear during childbirth. Two days being discharged from hospital, a colorectal surgeon diagnosed her with a recto-vaginal fistula (an abnormal connection between the lower portion of the rectum and vagina).
She blamed Truter for failing to take the necessary care while delivering her baby.
Truter took on the woman as a patient in September 2015, and at her 36-week check-up, found that her baby was lying in a transverse position (the head on one side of her body and the feet on the other).
Court documents state that an episiotomy (enlarging the vagina opening to allow the infant to pass through) had been performed on her during the birth of her previous child.
Truter delivered her second child by means of vacuum extraction, sutured the peri-anal tear and discharged her two days after birth.
Two days later she noticed fluid leaking from her “private parts” and upon readmission to St Georgeʼs Hospital on 22 April, 2016, the initial stitches were removed. The tear was surgically repaired, as well as her sphincter and vagina.
She said Truter failed to perform an episiotomy when it was required, even after she informed him that she had one done during the birth of her first son. She also said he failed to identify the severity of the tear.
She said that due to her ordeal, she had to be admitted to hospital, would require future surgical procedures, endured a great deal of pain and suffering, and had to attend physiotherapy. She had to incur medical expenses and would have to incur more in future. She still suffers from a sphincter defect and anal incontinence, according to court papers, as well as from depression, and will be unable to give birth vaginally in future.
In his rebuttal, Truter said during his assessment with his patient in her 32nd week of pregnancy, the foetus was lying in a transverse position, and he had advised her that if it remained in that position, it would be necessary to consider altering her birth plan from giving natural birth to having a C-section.
During this consultation, she did not express any objection to her birthing plan being altered, he said in court documents. The 34-week follow-up assessment showed the foetus was in a cephalic presentation (head in the pelvis), negating further discussion about a possible Caesarean.
Truter denied negligence or breaching his duty of care.
The woman initially demanded payment of more than R14.9m, but eventually settled for R4,5m for past and future loss of income, past and future medical expenses, physiotherapy, individual and marital psychotherapy and general damages.
The deadline for payment to be made is 1 March. Truter must also pay the costs of the lawsuit, the woman’s expert witnesses she relied on in preparation for her trial, and all documents that had to be prepared.
In 2019, Truter left the private sector (after a decade in private practice) to join the public sector at Dora Nginza Hospital. He told The Herald at the time that the exorbitant costs of private practice had many doctors drowning in medical insurance rates of up to R1m a year.
The Herald article – Doctor Daniel Truter to pay R4.5m in damages (Restricted access)
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