In September 2025, the High Court held a provincial health department liable after hospital staff operated on the wrong knee of a child and provided substandard care. The department was ordered to pay 100% of the patient’s proven damages. The judgment highlights the importance of simple safeguards, including accurate diagnosis, informed consent, surgical-site verification, and careful record keeping.
From an early age, the child struggled to walk, and his left leg grew weaker despite using a brace. He was then admitted to the hospital on multiple occasions. An initial procedure was done to examine his ligaments and identify the correct procedure to undertake. Despite various prior consent forms which referred to procedures being done on the left knee, the orthopaedic surgeon at the hospital proceeded to perform a surgery on the right knee. It was noted the right knee structures were intact, but the surgeon proceeded with an unplanned femoral supracondylar osteotomy on the right knee, leading to significant malalignment and impaired mobility. The issues identified in the left knee remained untreated.
The expert evidence led on behalf of the patient found that the surgeon acted negligently due to a misdiagnosis, the application of the incorrect surgery, and substandard postoperative care. The initial diagnosis was “anterior ligament instability.” In paediatric cases, however, knee ligament tears are uncommon. A careful, age-appropriate assessment would have pointed to a likely diagnosis of congenital valgus knee with attenuation of the medial collateral ligament, malalignment, and relative instability. The expert witness also noted inadequate medical records and vague consent forms. For the right-knee procedure, the consent form referred to “reconstruction of anterior ligaments both knees,” despite earlier forms and the clinical picture identifying the left knee as the source of concern. The patient’s mother testified that she would not have consented to surgery on the right knee.
Due to poor care and rehabilitation following the procedure on the right knee, the patient’s right femur healed with gross malalignment and loss of mobility of the right knee. The misalignment should have been noticed sooner, and corrective measures should have been taken at an earlier stage.
The court applied the established negligence test and considered whether a reasonable surgeon in the same position as the treating surgeon would have foreseen the possibility of the patient suffering an injury as a result of being operated on the incorrect leg, whether the surgery was substandard and whether any reasonable steps were taken to guard against the harm. With no opposing expert or factual evidence led by the defendant, the court found that there was indeed negligence which caused the patient harm and ordered the defendant to compensate the patient for all proven damages, with costs on an elevated scale given the absence of any meaningful defence.
This judgment underscores a series of practical safeguards designed to minimise risk and protect patients. Clinical care must be grounded in contemporaneous documentation, anchored in sound clinical reasoning, and supported by informed consent. Consent should accurately reflect a clear diagnosis and a precisely defined procedure, expressed in plain language.