The delayed diagnosis that led to a gunshot victim losing a kidney was the result of negligence by the medical staff at Mitchells Plain District Hospital in Cape Town.
This is according to the Western Cape High Court in a judgment stemming from a grievous incident during a New Year’s celebration in 2020. The case concerns the treatment of 55-year-old man, who was shot in the back and subsequently admitted to the Mitchells Plain District Hospital, where he underwent emergency surgery for life-threatening injuries. However, he later underwent a nephrectomy, resulting in a legal battle against the hospital for damages due to alleged negligence.
The incident that led to this court case occurred on the early hours of 1 January 2020, when the man was shot by an unknown assailant. His immediate treatment at the hospital, led by a Dr Moodley, included life-saving surgical procedures intended to address his small bowel and mesenteric injuries. While initial efforts were deemed successful, the ensuing medical treatment faced scrutiny as he struggled with severe pain and recurring complications following his surgery.
Central to the case is the contention that the medical team at the hospital failed to adequately investigate the potential for kidney damage after the gunshot injury. Despite showing symptoms of acute kidney injury and consistent complaints of pain, it was not until 21 January 2020, that he underwent the surgical removal of his left kidney. This delay prompted him to argue that a timely diagnosis via imaging tests would likely have salvaged his kidney. The court examined the expert testimonies of several medical professionals to assess alleged negligence in care.
Dr Frank Plani, a trauma surgeon, testified that the standard of care expected when dealing with gunshot wounds necessitated immediate imaging to assess potential kidney injuries. He highlighted that the failure to perform a CT scan in the immediate days following surgery could have informed a more effective treatment plan and potentially avoided the later radical nephrectomy.
In contrast, the defence maintained that the medical team acted within the bounds of reasonable care, emphasising the complexities of post-surgical treatment especially in a district hospital setting during a busy time of year. Expert witnesses for the defence asserted that the patient received appropriate treatment based on the symptoms presented at the time. Furthermore, they argued that injuries to the renal pelvis, like those sustained by him, are exceedingly rare and often poorly understood.
The court sided with the patient, confirming that the delay in diagnosing and treating the renal injury constituted negligence on the part of the medical staff at the hospital. In delivering the judgment on February 6, 2025, the judge pointed out the critical importance of timely imaging and appropriate referrals in managing such trauma cases effectively. It was concluded that his kidney had become irreparable primarily due to the complications arising from delays in treatment.
The court ordered that the MEC for Health in the Western Cape is liable for damages that may be proven to have arisen as a result of the treatment administered to the plaintiff at the hospital.
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