Hello

Your subscription is almost coming to an end. Don’t miss out on the great content on Nation.Africa

Ready to continue your informative journey with us?

Hello

Your premium access has ended, but the best of Nation.Africa is still within reach. Renew now to unlock exclusive stories and in-depth features.

Reclaim your full access. Click below to renew.

Hospital appeals in a case of a postoperative death

Relatives of the patient successfully sued the hospital for medical negligence, but the hospital appealed both the judgment and the costs awarded.

What you need to know:

  • One of the grounds of the appeal was that the initial case was filed out of time.
  • The case was filed on August 30, 2016, more than eight years after the death of the patient.
  • The appellate court had to determine whether the leave to file the case out of time was properly granted.

On March 13, 2008, a patient died from a highly reputable hospital after an operation to remove her thyroid gland, when she was diagnosed with a toxic goiter.

That her death was linked to the surgery was not in doubt. She had bled at the site of the surgery and the blood clot compressed her trachea, subsequently cutting off oxygen to her lungs.

The surgeon, in court, admitted that had the wound been opened up when the patient was still alive and the pressure released, the patient may not have died.

Relatives of the patient successfully sued the hospital for medical negligence, but the hospital appealed both the judgment and the costs awarded.

One of the grounds of the appeal was that the initial case was filed out of time. The case was filed on August 30, 2016, more than eight years after the death of the patient.

One of the relatives of the deceased was asked during the initial hearing, why the case was filed out of time and her response was that she had sought the court’s leave to do so.

She also attributed her lateness to file the case on the Medical Board that took five years to make a ruling on the matter.

The appellate court had to determine whether the leave to file the case out of time was properly granted. The law is that cases of medical negligence are to be filed within a period of three (3) years of the incidence complained of but this one was not. However, in this case, relatives of the deceased sought permission from the Chief Magistrate to file the case out of time.

The permission was granted on August 29, 2016. The application was made and granted exparte as provided in the law. This was made clear when the case was first filed. And this was not challenged by the hospital.

To the appellate court, this matter was properly addressed by the trial court. Reviewing this matter would be tantamount to ambushing relatives of the deceased, especially when the hospital did not follow the legal procedure of raising such an issue.

The hospital, in its appeal, submitted that during the initial trial the relatives of the patient did not specifically set out the particulars of the negligence.

The appellate court noted that the objectives of particulars or specific details of a case are to reduce or eliminate surprises and give fair notice of the case to the opposing party and define the scope of the evidence.

And in any event any party to a proceeding has a right to apply to court for an order requesting for further and clearer particulars in a case. 

The appellate court noted that in the relatives of the deceased clearly told the trial court that the patient died on March 30, 2008 due to negligence of the health-workers as shown in the manner in which they handled and treated the patient.

The relatives of the deceased also stated in their plaint that at the time the patient was admitted in the health facility, a duty of care and implied contractual obligation arose between the hospital and the patient.

This meant that the health-workers would exercise all reasonable skills and care ascribed to them to ensure the safety and care of the deceased. However the health-workers mismanaged the deceased in a negligent manner that led to her premature death.

The appellate court ruled that if the hospital had not been satisfied with the particulars as given by the relatives of the deceased in the plaint, it should have requested for more particulars.

This was never done. Clearly in the plaint the main issue was that the hospital was accused of negligently managing the deceased as its patient.

A vital issue that was to be determined was whether the patient was managed negligently. It is a cardinal principle of law that a duty of care arises once a doctor or other health-care professional agrees to diagnose or treat a patient.

That professional assumes a duty of care towards that patient. And a hospital is vicariously liable for the negligence of members of its staff, including nurses and doctors if they do so in the course of their normal duties.

It was the evidence of the doctor who operated on the patient that the blood pressure of the patient should have been checked every 15 minutes after the operation and then after 30 minutes thereafter then 1 hour until it was stable and then every four hours but in this case the blood pressure had not been monitored for 10 hours. The doctor admitted that this was not proper and should not have happened.

According to the surgeon and his colleagues the surgery went on quite well. It was the aftercare which had issues. It was the nurses on duty who should have followed and monitored the patient’s progress keenly since it was the first post-operative night.

And to make matters worse some of the medical notes were missing and there was no explanation given for the missing documents.

To the appellate court these were vital documents which could not have been mishandled especially when the hospital was aware that the case had been reported to the Medical Board. 

The appellate court defined negligence as failure to exercise the standard of care that a reasonable prudent person would have exercised in a similar situation.

Court further defined it as culpable carelessness, any conduct that falls below the legal standard established to protect others against unreasonable risk of harm, an act that no careful person would be guilty of.

Court also delved into the responsibility of the hospital in a case of negligence. To court authorities who own hospitals in law owe the same duty of care to the patient as the humblest doctor. The hospital authorities cannot of course do this by themselves.

They must do this by the staff, which they employ and if their staff are negligent in giving the treatment, they are just as liable for the negligence as is anyone else who employs others to do his duties for him.

According to the courts of law, hospital authorities are in fact, liable for breach of duty of care owed to patients by its members of staff. They cannot escape responsibility even if they themselves were not conducting the operation.

The appellate court ruled that the health-workers who were employees of the hospital carelessly managed the deceased’s delicate condition after her operation.

Important treatment notes were deliberately kept away from the Medical Board and court as a cover up. The hospital was, as a result, found vicariously liable for the negligence of its staff.