In a February 2025 judgment, the High Court dealt with the issue of professional negligence and causation in a case which revolved around a claim for damages by the claimant, who alleged that the defendant, a district hospital under the control of the MEC for Health, Western Cape, was negligent in providing medical treatment following a gunshot wound, resulting in the removal of his left kidney. The court had to determine whether the defendant negligently delaying appropriate imaging and treatment, and whether this delay caused the claimant’s kidney to be removed. The court held that the delay in performing the necessary imaging and treatment was a significant factor that led to the complications and eventual removal of the kidney, thus constituting professional negligence.
The claimant was involved in a gunshot incident on 1 January 2020 and sustained serious injuries. He was admitted to a District Hospital and underwent emergency surgery performed by a medical officer, which saved his life. The surgery addressed injuries to the small bowel and mesentery and observed a non-expanding haematoma around the left kidney. However, the subsequent medical care he received raised significant concerns about the adequacy and timeliness of the treatment provided. Despite the initial life-saving measures, the claimant’s condition required further diagnostic imaging to assess the extent of the kidney injury. The delay in performing a contrast CT scan allowed infection and sepsis to set in, complicating the clinical picture and making reconstructive surgery more challenging. Ultimately, this delay led to the removal of the claimant’s left kidney on 21 January 2020.
The claimant argued that timely imaging, particularly a contrast CT scan, should have been performed within a few days of the initial surgery to assess the extent of the kidney injury. The defendant contended that the standard of care was met and that the injury to the renal pelvis was complex and rare, making it difficult to repair.
The court found that the hospital was negligent in not providing timely and appropriate treatment. The evidence showed that imaging should have been performed between 2 and 6 January 2020, but it was only done on 11 January 2020. This delay allowed infection and sepsis to set in, complicating the clinical picture and making reconstructive surgery more challenging. The court noted that if the CT scan had been performed earlier, the injury to the left kidney could have been detected and treated more effectively.
Regarding the issue of causation, the court determined that the delay in appropriate imaging and treatment was the factual cause of the injury. The court concluded that the infection and inflammation resulting from the delay lead to the removal of the claimant’s kidney on 21 January 2020.
The court held the defendant liable for such damages as the plaintiff may prove to have arisen as a result of the negligent treatment administered to him at the Defendant’s hospital.
A.L.S v MEC for Health, Western Cape (116612021) [2025] ZAWCHC 30 (6 February 2025)