- The court found that doctors failed for weeks to investigate the woman’s worsening pain and bleeding.
- Delays in surgery and a premature hospital transfer led to severe complications and permanent injury.
- North West Health was held fully liable for the devastating harm caused by negligent care.
A woman who turned to public healthcare services during her pregnancy was left permanently scarred, unable to have children, and burdened with chronic pain after a series of avoidable medical mistakes.
The High Court in the North West has found that repeated failures at several state clinics and hospitals caused the woman devastating and lasting harm. Judge S Mfenyana held that the North West Department of Health was fully liable for her injuries.
The judge further found that medical and nursing staff repeatedly failed to investigate her worsening symptoms, delayed urgent intervention, and transferred her prematurely to a lower-level facility without proper notes or a care plan.
The court found that what began as complaints of abdominal pain and bleeding in March 2015 developed into a ruptured cornual ectopic pregnancy that should have been investigated far sooner.
The rupture led to emergency surgery, further complications, several invasive operations, a hysterectomy, abdominal abscesses, wound sepsis, severe scarring, and permanent loss of fertility.
A month of unanswered pain
The woman first sought antenatal care in early March 2015. She returned days later with abdominal pain and unusual discharge. In April, she again presented with severe abdominal pain and bleeding.
She was admitted, medicated, and referred through the provincial health system, eventually reaching Ganyesa Hospital, where scans confirmed what doctors believed was an intrauterine pregnancy.
But the court found that the staff focused on the pregnancy itself and failed to investigate the cause of her recurring pain and bleeding.
Judge Mfenyana remarked that the issue was not whether the staff at Phaposane, Tlakgameng, and Ganyesa made an incorrect diagnosis of an intrauterine pregnancy. The issue was whether the source of the plaintiff’s abdominal pains and vaginal bleeding was addressed. It was clearly not.
The judgment raised serious questions about the care provided during that period, with Judge Mfenyana observing, “one wonders what it was that they were treating, if at all.”
The court accepted expert evidence that although a cornual ectopic pregnancy is rare and difficult to diagnose, it is not impossible to diagnose, and persistent symptoms demanded investigation.
Judge Mfenyana wrote that a reasonable nurse or doctor in the position of the nurses and staff would have investigated the plaintiff’s complaint. This would have enabled them to provide the best available care and treatment to her.
Delays that set disaster in motion
By the time the woman was finally transferred to Joe Morolong Memorial Hospital, she was in haemorrhagic shock. Her haemoglobin had dropped to life-threatening levels. Emergency surgery saved her life, but the court found that what followed deepened the harm.
Experts agreed that a second operation should have happened about 24 hours earlier. Her pulse rate rose to 134 beats per minute. She developed a fever, worsening tachycardia, and abdominal swelling, yet intervention was delayed.
Judge Mfenyana held that the failure to adequately monitor the plaintiff during this period supports the surgeons’ view that a second operation should have been performed sooner.
During the second surgery, a bowel perforation was discovered. The court found that the perforation was not negligent because such injuries can occur during complex surgery even with proper care. But what happened around it was another matter.
Just two days after that major operation, the woman was transferred back to Ganyesa Hospital, even though she was still medically fragile and had no referral notes or treatment plan. The court described that move as hasty, unjustified, and harmful.
Judge Mfenyana noted that she was not in a stable condition when she was transferred to Ganyesa on 7 May 2015.
Lasting harm and a clear legal finding
The woman later developed severe septic complications and had to undergo a third operation. She was left with a complex abdominal wound, a hernia requiring further surgery, daily chronic pain, emotional trauma, disfigurement, and permanent infertility after the hysterectomy.
The defence attempted to link some complications to HIV-related immune issues, but the court rejected that argument, finding there was no rational connection between later health records and the events of 2015.
The court also drew a negative inference from the State’s failure to call a key treating doctor to explain critical decisions made during the woman’s care, which left important questions unanswered.
In one of the judgment’s strongest conclusions, Judge Mfenyana held that the prolonged delay in investigating and diagnosing the cause of the plaintiff’s pain and bleeding set everything in motion.
The judge added that it is evident that the outcome for the woman was caused by the conduct of the defendant.
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