The South African Medical Association (SAMA) has again called for law reform after the National Prosecuting Authority (NPA) changed the charges against paediatric surgeon Professor Peter Beale from culpable homicide to murder, reports MedicalBrief.
Beale, whose case was yesterday postponed to Monday, is facing three counts of murder and one of fraud.
TimesLIVE reports that SAMA expressed concerns about the charging and prosecution of doctors, saying reform was urgently needed, and that “the law, as it stands and as it is applied, may hamper patient safety and the achievement of a safety culture”.
Beale is accused of “unlawfully and intentionally” causing the death of a three-year-old boy in March 2012, a 21-month-old girl in July 2016 and a 10-year-old boy in October 2019 after he had operated on the children.
“The criminal justice system often ignores organisational factors to instead target the individual who happened to hold the scalpel when the incident occurred,” said SAMA.
“Where a doctor is reckless or grossly negligent, criminal prosecution may be warranted. However, no ethical doctor enters an operating theatre to harm a patient. And when things go wrong, as they sometimes do in medicine, doctors are just as devastated and often overcome with feelings of guilt.”
Beale and anaesthetist Dr Abdulhay Munshi had been charged with culpable homicide when the 10-year-old died after a routine laparoscopic operation at Johannesburg’s Park Lane Hospital in October 2019.
The boy's operation was expected to last an hour and a half but took almost four.
The boy's lung collapsed soon after surgery, and he died in the ICU. Netcare, under which Park Lane falls, later suspended the two doctors and the Health Professions Council of South Africa investigated the case, reports IOL.
A few years earlier, Mediclinic had suspended Beale from practising at their hospitals.
“… it is important to acknowledge the immense unimaginable pain of the parents who lost a child. The underlying events are tragic, in every sense of the word,” SAMA said on Thursday.
“SAMA’s concerns about charging, prosecuting and convicting doctors in no way seeks to minimise the effect of such devastating events on the families …. Instead, we are worried that criminalisation of bona fide medical errors and adverse events are an unsuitable response that would do little to prevent future tragedies.
“Charging doctors with murder in cases of medical error is unjustifiably extreme, detrimental to patient safety, may deter doctors from certain risky procedures and specialities, and disregards the complexities and challenges inherent in medical practice.”
Meanwhile, the court is still looking for assessors to assist in the trial, News24 reports.
Beale appeared briefly in the Gauteng High Court (Johannesburg) yesterday. The court considered appointing assessors in the medical field who would assist the judge during the proceedings.
Judge Thifhelimbilu Mudau said: “I am confident that on Monday we should have a full team. We therefore agreed this matter stand down until Monday as I conclude the exercise.”
Mudau said the task wasn't easy as the assessors he needed had to be experts in the medical field.
Beale is out on bail. On the fraud charge, Beale is alleged to have defrauded the mother of the 10-year-old boy by claiming pathology results obtained on 12 March 2012 (before the boy’s death) at Netcare’s Parklane Clinic revealed a rectal biopsy stating the child had Hirschsprung’s disease that required surgical intervention, News24 previously reported.
Beale allegedly knew there was no confirmation of the existence of the disease in the rectal biopsy, and thus, the procedure was neither necessary nor appropriate.
The cause of death was consistent with septic peritonitis as a complication of surgery for Hirschsprung’s.
Four years later, at Morningside Mediclinic in 2016, Beale allegedly caused the death of a 21-month-old girl who was born with oesophageal atresia and had gastro-oesophageal reflux disease.
Beale claimed she needed a laparoscopic nissen fundoplication surgical procedure. But after the operation, the baby’s oxygen saturation levels dropped.
The surgeon was accused of failing to adequately or appropriately assess and address the blood loss suffered, which ultimately caused the child to go into bradycardia (suffer a low heart rate).
In the case of the 10-year-old, Beale also allegedly told the boy’s parents that their son needed laparoscopic nissen fundoplication surgery, because he apparently had intestinal metaplasia. However, the state contends that Beale knew there were no features of intestinal metaplasia nor any feature of dysplasia or malignancy in the biopsy, and the procedure was neither necessary nor appropriate.
Beale will face trial alone as co-accused Munshi was shot six times in the back of his head and killed in Setember last year, after a vehicle rammed into his car.
News24 – Murder, fraud trial of surgeon Peter Beale stalls for judge to deliberate on assessor
See more from MedicalBrief archives:
Accused paediatric surgeon Dr Peter Beale struck from HPCSA register
Culpable homicide charge added to surgeon Peter Beale’s murder/fraud case
Petition to drop ‘premature’ criminal charges against Beale and Munshi
Calls for specialised medical courts as top surgeon hit with more charges