Member of the Executive Council of Health and Social Development, Gauteng Provincial Government v M (obo L P M)

A minor child, L, was born on 18 May 2010 at Tshwane District Hospital after a prolonged labour. The mother, Ms M, arrived as an unbooked patient with no antenatal records. Foetal monitoring was conducted intermittently using CTG and Doppler. Initially non‑reassuring CTG tracings improved after administration of Ringer’s Lactate. Later in labour, CTG monitoring showed decelerations and rising foetal heart rate. Foetal distress was diagnosed at 14h30 and preparation for caesarean section commenced, but Ms M became fully dilated and delivered vaginally at 15h10. L was born severely compromised, required resuscitation and ventilation, and later developed cerebral palsy. Ms M sued the MEC for damages, alleging negligent monitoring and failure to perform a caesarean section timeously, causing hypoxic‑ischaemic brain injury during birth.

The appeal was upheld with costs. The order of the full court was set aside and replaced with an order dismissing the appeal to that court, thereby restoring the trial court’s dismissal of the claim against the MEC.

The judgment reinforces the SCA’s jurisprudence on medical negligence involving birth‑related hypoxic‑ischaemic injury, particularly the distinction between acute profound and partial prolonged hypoxia. It confirms that adverse neonatal outcomes do not, without more, justify an inference of negligence, and that CTG monitoring does not reliably predict or prevent acute sentinel events. The case strengthens safeguards against hindsight reasoning in medical negligence claims.