A man who was shot in the lower back five years ago and endured lifesaving surgery – but then subsequently, had to remove his left kidney – has won a medical negligence case in the Western Cape High Court.
The 55-year-old man had been taken to Mitchells Plain District Hospital (MPH) after the shooting, in which a bullet entered his lower back on the left-hand side and exited through his upper abdomen.
In the emergency unit, the administering doctor, initially, could not establish whether there was an injury to his kidney. The court heard that the injury to his renal pelvis was “a complex injury”.
“The only way in which this could be established was with imaging. The trajectory of the bullet was not ascertained during the surgery and (the doctor), who observed only an on-expanding haematoma, could not grade the kidney injury and whether or not there was a leakage problem,” the court noted.l
After the surgery, the man discharged himself from MPH because he was not satisfied with the treatment he received, and sought private medical care. However, reports The Sunday Tribune, he could not afford the fees and returned to MPH a day later.
Several days later, he was discharged from hospital with fluid still draining from the gunshot wound.
Eventually, having returned the hospital again with abdominal tightness and increased heart rate and antibiotic treatment, he had to be readmitted to theatre three weeks later where he underwent removal of his left kidney.
During court proceedings, the court heard from both parties’ experts, in a joint minute that “the initial surgery by (the doctor) saved the patient’s life, life-threatening injuries being bleeding from the torn mesenteric vessels and contamination from the multiple perforated bowel”.
Judge Johan van der Berg found that the removal of the plaintiff’s kidney was “factually caused by the infection and inflammation that occurred as a result of the delay in repair. which made reconstructive surgery inappropriate”.
“(The doctor) was alive to the possibility or may have suspected an injury to the left kidney at the time of performing the life-saving emergency surgery, as is evidenced by the detailed description of what was done during surgery to identify or exclude an injury to the left kidney. On a conspectus of the expert testimony, imaging should have been performed at the time… I conclude, therefore, that the defendant was negligent in not offering the appropriate or timeous treatment reasonably required to diagnose and treat the pelvic renal injury,” the judge said.
The plaintiff’s expert witness, a trauma specialist, said in his testimony: “So if you do the right things and things don’t go right, you’re still justified in what you’ve done, but you’ve done all the right things first. Know exactly what you’re doing, what you’re supposed to be doing. You do it.
“You can find injuries that are better or worse. The healing of the patient can be better or worse. There may be lots of other factors. What we are arguing here is whether one should actually have known to do the right thing which was not done in this case, in my opinion.”
According to the defendant’s expert witness, an experienced general surgeon who specialises in sub-speciality trauma, said in all his time as a surgeon since 1974, he had not come across a case such as this.
“In the first seven days the plaintiff was at MPH, there was hardly anything in the clinical picture to indicate there was anything wrong.”
Sunday Tribune PressReader article – Mitchell Plains man wins negligence case (Open access)
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