After his left kidney was removed following a life-saving surgery, a man won his medical negligence case this week at the Western Cape High Court.
The 55-year-old man was rushed to Mitchells Plain District Hospital (MPH) after he attended a New Year’s Eve party to celebrate the beginning of 2020.
As he was leaving the celebration, he was shot in the back by an unknown assailant in which the bullet entered his lower back on the left-hand side and exited through his upper abdomen.
He was admitted to the emergency unit at MPH, where he underwent emergency, life-saving surgery, however, the administering doctor, at first instance, could not establish whether or not there was an injury to the plaintiff’s kidney. The court heard that the injury he sustained to his renal pelvis was “a complex injury”.
“The only way in which this could be established was with imaging. The trajectory of the bullet was not ascertained during the surgery and (the doctor), who observed only an on-expanding haematoma, could not grade the kidney injury and whether or not there was a leakage problem,” the court noted.
After the life-saving surgery, the man discharged himself from MPH on January 3 because he was not satisfied with the treatment he received and sought private medical care; however, he could not afford the fees and returned to MPH a day later.
By January 7, the man was discharged from hospital with fluid still draining from the gunshot wound.
Eventually, having presented himself to the hospital again with abdominal tightness and increased heart rate and antibiotic treatment, the man had to be readmitted on January 21, 2020, to theatre, where he underwent the surgical removal of his left kidney.
During court proceedings, the court heard from both parties’ experts, in a joint minute that “the initial surgery by (the doctor) saved the patient’s life, life-threatening injuries being bleeding from the torn mesenteric vessels and contamination from the multiple perforated bowel”.
Judge Johan van der Berg found that the removal of the plaintiff’s kidney was “factually caused by the infection and inflammation that occurred as a result of the delay in repair which made reconstructive surgery inappropriate”.
“(The doctor) was alive to the possibility or may have suspected an injury to the left kidney at the time of performing the life-saving emergency surgery as is evidenced by the detailed description of what was done during surgery to identify or exclude an injury to the left kidney. On a conspectus of the expert testimony, imaging should have been performed during 2 to 6 January 2020.
“I conclude, therefore, that the defendant was negligent in not offering the appropriate or timeous treatment reasonably required to diagnose and treat the pelvic renal injury,” said Van der Berg.
The plaintiff’s expert witness, a trauma specialist, said in his testimony: “So if you do the right things and things don’t go right, you’re still justified in what you’ve done, but you’ve done all the right things first. Know exactly what you’re doing, what you’re supposed to be doing. You do it.
“You can find injuries that are better or worse. The healing of the patient can be better or worse. There may be lots of other factors. What we are arguing here is whether one should actually have known to do the right thing which was not done in this case, in my opinion.”
According to the defendant’s expert witness, an experienced general surgeon who specialises in sub-speciality trauma, said in all his time as a surgeon since 1974, he had not come across a case such as this.
“In the first seven days the plaintiff was at MPH, there was hardly anything in the clinical picture to indicate that there was anything wrong.”