The High Court has dismissed an application for leave to appeal in a medical negligence matter, holding that negligence had not been proved on the balance of probabilities.
The claimant brought proceedings against the Member of the Executive Council for the Department of Health, North West Province, following complications arising from a caesarean section. She alleged that the surgical procedure resulted in her developing a rectovaginal fistula and the removal of her left ovary and tube, which rendered her unable to bear children. The original trial court dismissed the claim.
The claimant raised numerous grounds of appeal, including that the trial court erred in finding there was no causal link between her injuries and the conduct of the medical practitioners, and that the court failed to draw a negative inference from the fact that the clinicians were not called to testify. She further contended that the court disregarded expert evidence indicating that a junior doctor should not have operated on a high‑risk patient without senior supervision. The claimant also argued that the court applied a “beyond reasonable doubt” standard rather than the appropriate balance of probabilities test.
Leave to appeal may only be granted where there is “a measure of certainty that another court will differ from the court whose judgment is sought to be appealed against.”
In addressing the medical negligence standard, the court reiterated that a medical practitioner is expected to adhere to the general level of skill, care and diligence exercised by members of the profession at that time. It will only constitute negligence if the practitioner’s conduct fails to meet this general standard of care. If an error is one that a reasonably competent practitioner might have made, it will not constitute negligence.
The court held that the lower court had correctly applied the balance of probabilities test, considering all evidence including expert testimony, and concluded that the claimant had not met the threshold required for leave to appeal. The application was accordingly dismissed with costs.
This judgment reinforces the heightened threshold for leave to appeal and confirms that medical negligence claims require demonstration that the practitioner’s conduct fell below the standard of a reasonably competent practitioner, not merely that an error occurred.
AMM v Member of the Executive Council for the Department of Health, North West Province