This blog was co-authored by Jeneil Peterson, Candidate Attorney.

In October 2024 the High Court addressed a claim involving the birth injury of a child at a Gauteng provincial hospital. The court found that proper medical care during childbirth would have prevented cerebral palsy of the child and found in favour of the claimant, holding the defendant liable for 100% of the damages.

The claimant brought a claim on behalf of her daughter against the Provincial Government. The case centred on the severe permanent impairment the child suffered due to cerebral palsy, which the claimant alleged was caused by the negligence of the healthcare professionals at the hospital during her birth on 16 August 2004.

The claimant’s mother was admitted to hospital on the night of 15 August 2004, experiencing labour pains. Despite being identified as a high-risk patient due to her medical history, including hypertension and a previous caesarean section, the nursing staff failed to monitor her and her unborn child adequately. The claimant testified that after initial examinations at 23:00 and 00:00, she was not examined again until 02:00, when she experienced severe labour pains. By then, it was too late to prevent the injury, and an emergency caesarean section was performed at 03:00. The child was born in a compromised state, requiring immediate intensive care.

The court reaffirmed that both fault in the form of negligence and a causal link between that fault and the child’s damages must be established to establish liability. The assessment of expert witnesses revealed that the injury that caused the child’s cerebral palsy most probably occurred during birth, rather than before or after it and that the risk of the child developing cerebral palsy would have been reduced had there been an earlier detection and delivery intervention. If the CTG monitoring was done more regularly during the hours preceding the birth, as the maternity guidelines require, the risk of cerebral palsy could have been prevented.

The judgment emphasized that the nursing staff’s failure to monitor the mother and her unborn child according to the prescribed guidelines constituted negligence. This negligence directly caused the hypoxic ischemic brain injury that led to the child’s cerebral palsy and severe impairment. The court highlighted the importance of adhering to medical guidelines, especially for high-risk patients. The failure to monitor the mother and her unborn child continuously and at regular intervals was a clear breach of the standard of care expected from healthcare professionals.

This judgment underscores the necessity of establishing a causal link between the negligence and the injury.

This judgment reinforces the need for adherence to medical protocols to ensure the safety and well-being of both mothers and their children during childbirth.

E.N. obo S.N. v MEC for Health Gauteng Provincial Government