A Gauteng patient whose right leg was amputated above the knee lost her legal bid to claim damages from the Health MEC, with the court finding, instead, that the hospital was not negligent and that her amputation resulted from a rare neurovascular complication.
The Star reports that Nonyaniso Mntimba had approached the Gauteng High Court claiming the amputation was due to the negligence of the doctors and nurses at the Tambo Memorial Hospital in Boksburg.
She had been shot in both lower limbs on 26 December 2018, and was admitted and treated at the hospital for five days. While she was there, her right leg was amputated above the knee.
The issue before the court was whether hospital staff had been negligent in treating her.
A vascular surgeon, who specialises in injuries to arteries and veins other than those in the heart and brain, testified on her behalf that thrombosis is often caused by barotrauma.
According to him, a few days after Mnimba’s admission, she suffered a loss of sensation in her legs, followed by paralysis. This led to ischaemia.
He testified that when confronted with this condition, the nurse should have reported it to a doctor who would have been able to interpret it.
A nurse testified that Mntimba had shown signs of ischaemia: pain and decreased sensation. According to her, the nurses who were dealing with her at the time were supposed to report the condition immediately to a doctor, as only a doctor can diagnose ischaemia.
A professor of surgery, meanwhile, testified on behalf of Mntimba that in his opinion, due to the injuries suffered by the plaintiff, she should never have been admitted to Tambo Memorial Hospital, but should rather have been referred to Charlotte Maxeke Johannesburg Hospital.
He said it was incumbent on nursing staff to phone the doctor when they notice a change in a patient’s condition. When there was a loss of sensation, a fasciotomy could have been done.
He said had there been an intervention at the stage of loss of sensation in the limbs, the plaintiff’s leg would most probably have been saved.
But a vascular surgeon who testified on behalf of the Health MEC told the court several checks were done on the patient to evaluate the limb perfusion.
In his opinion, the delay in operating was unlikely to have contributed to the limb loss.
The experts refuted the plaintiff’s expert witness testimony that there was poor monitoring, poor recording, and a failure to act on changes in her condition. According to him, the plaintiff was monitored and when she complained, the doctor was called.
He said ischaemia presented itself for the first time in the plaintiff after she had spent about four days in the hospital and Tambo Memorial Hospital did not have the requisite specialities.
Therefore, she was immediately transferred to another, bigger hospital that could deal with the sudden thrombosis.
Judge David Makhoba noted that the hospital records stated exactly how and when Mntimba’s condition was reported. Her condition suddenly deteriorated and when she was unable to feel her right foot and move her toes, it was immediately reported to a doctor who attended to her. An ambulance was arranged to transfer her to another hospital shortly afterwards.
“In my view, the nursing staff provided the necessary care … under the circumstances by checking her condition within reasonable timeframes,” the judge said in turning down her claim.
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