Topham v Member of the Executive Committee for the Department of Health, Mpumalanga

The appellant, Mrs Doreen Topham, was involved in a motor vehicle collision on 1 May 2006 and sustained a dislocation of her right hip. She was taken to Rob Ferreira Hospital, where she was examined by Dr Molete, an intern employed by the Mpumalanga Department of Health. Despite severe hip pain and inability to stand or walk, Dr Molete failed to diagnose the hip dislocation, relied on inadequate x-rays, and discharged her. Eight days later, a private doctor diagnosed the hip dislocation, and she was re-admitted to the same hospital. Due to the delay in diagnosis and treatment, she developed avascular necrosis of the femur head. She instituted a delictual claim against the MEC for Health, Mpumalanga, based on medical negligence.

The appeal was upheld with costs. The order of the High Court was set aside and replaced with an order declaring the respondent liable for the appellant’s proven or agreed damages arising from the negligent failure to diagnose her hip dislocation and the resultant avascular necrosis, together with the costs of the trial.

The case is a leading Supreme Court of Appeal authority on medical negligence, particularly regarding failure to diagnose traumatic injuries. It reinforces the applicable standard of care, clarifies the assessment of negligence and causation in medical delict, and underscores the duty of medical practitioners not to discharge patients when the cause of severe pain remains undiagnosed. It also affirms vicarious liability of provincial health authorities for negligent conduct of their medical staff.