A woman whose right leg was amputated above the knee lost her legal bid to claim damages from the Gauteng MEC for Health as the court found the hospital was not negligent and that the woman lost her leg as a result of a rare neurovascular complication.
Nonyaniso Mntimba turned to the Gauteng High Court, Pretoria, as she claimed that her leg was amputated due to the negligence of the doctors and nurses at the Tambo Memorial Hospital in Boksburg.
Mntimba was shot on December 26, 2018, on both lower limbs and she was admitted and treated at Tambo Memorial Hospital for five days. Unfortunately, while she was still in hospital, her right leg above the knee was amputated.
The issue before the court was whether there was negligence on the part of the medical and nursing staff of the hospital in treating her.
A vascular surgeon - who focuses on injuries to arteries and veins other than those located in the heart and brain - testified on her behalf that in gunshot wounds, thrombosis is often caused by barotrauma which caused an injury to the innermost smooth layer of the blood vessel.
According to him, a few days after Mntimba's admission to hospital, she suffered a loss of sensation in her legs which was followed by paralysis (loss of movement). This led to what is called ischemia.
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 signs of ischemia, which is a condition where she had 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 make a diagnosis of ischemia.
A professor of surgery, meanwhile, testified on behalf of Mntimba that if a hospital cannot treat a patient, the patient must be transferred immediately. He further testified that in his opinion, due to the injuries suffered by the plaintiff, she should never have been admitted to Tambo Memorial Hospital and she should rather have been referred to Charlotte Maxeke Johannesburg Hospital.
He said it is incumbent that the nursing staff must phone the doctor when they notice a change in the condition of a patient. When there was a loss of sensation, a fasciotomy could have been done or a sister, matron, or doctor in the casualty department should have been informed, he said. It was his opinion that had there been an intervention at the stage of loss of sensation of the limbs, the plaintiff’s leg would most probably have been saved.
But a vascular surgeon who testified on behalf of the MEC for health told the court that there were several checks done on the patient to evaluate the limb perfusion. In his opinion, the delay in operating for the fracture 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 the plaintiff’s condition. According to him, the plaintiff was monitored and when she complained, the doctor was called.
According to him, ischemia presented itself for the first time on the plaintiff after she had spent about four days in the hospital and Tambo Memorial Hospital did not have the requisite specialties. Therefore, she was immediately transferred to another, bigger hospital that could deal with the sudden thrombosis.
While counsel argued on behalf of Mntimba that the staff at the hospital were negligent as they did not act fast enough in order to prevent her leg from being amputated, counsel for the MEC submitted that she suffered neurovascular complications which were rare and unforeseeable.
It was argued that the hospital’s medical staff did all they could; however, they were impeded by a lack of resources.
Judge David Makhoba noted that the hospital records exactly stated how and when Mntimba’s condition was reported. Her condition suddenly deteriorated and when she was unable to feel her right foot and her toes could not move, it was immediately reported to a doctor who attended to her.
An ambulance was shortly afterwards arranged to transfer her to another hospital.
“In my view, the defendant’s nursing staff provided the necessary care to the plaintiff under the circumstances by checking her condition within reasonable timeframes,” the judge said in turning down her claim.
Pretoria News