Department of Health: Western Cape v Oppelt

The respondent, Mr Charles Oppelt, a 17-year-old rugby player, suffered a severe cervical spine injury during a collapsed scrum on 23 March 2002, resulting in permanent paralysis (quadriparesis). He instituted delictual proceedings against the Head of the Western Cape Department of Health, alleging that medical staff negligently failed to treat him by closed reduction within four hours of the injury. He relied on expert evidence that timely closed reduction would probably have resulted in recovery. The High Court found the Department liable on the basis that this failure caused his paralysis. The Department appealed to the Supreme Court of Appeal.

The appeal was upheld with costs, including the costs of two counsel. The High Court’s order was set aside and replaced with an order dismissing the plaintiff’s claim against the Department with costs. The respondent’s cross-appeal on costs fell away.

The case is a leading authority on factual causation in South African delict, particularly in medical negligence claims. It reinforces that plaintiffs must establish causation on a balance of probabilities using reliable expert evidence. The judgment underscores judicial scrutiny of expert opinion, especially where it is based on limited or non-consensual scientific data, and affirms a flexible but rigorous common-sense approach to the but-for test.