[MEDIA SUMMARY] Life Healthcare Group (Pty) Ltd v Dr Abdool Samad Suliman

Mrs Sibaya was a pregnant patient whose contracted doctor was unavailable on the day she went into labour. The contracted doctor requested Dr Suliman to 'cover' for him, which Dr Suliman agreed to do. When nurses at the hospital called Dr Suliman to inform him that Mrs Sibaya was in labour and had been admitted, he provided telephonic instructions regarding sedation and medication, allowing the labour to proceed. Dr Suliman gave telephonic instructions on subsequent calls but never visited the hospital to assess Mrs Sibaya in person. The nurses failed to read the CTG (cardiotocography) results to Dr Suliman during these calls. Because Dr Suliman did not attend in person, he was unaware that the foetus was in distress. When Dr Suliman finally arrived at the hospital several hours later, logistical problems occurred and he had to perform an episiotomy. Mrs Sibaya's baby subsequently developed cerebral palsy, which could have been prevented had the foetal distress been detected earlier by either the hospital nurses or Dr Suliman.

• Whether Dr Suliman owed a legal duty of care to Mrs Sibaya when he agreed to 'cover' for her contracted doctor
• Whether Dr Suliman breached his legal duty of care by providing only telephonic instructions without attending to the patient in person
• Whether there was a factual causal link between Dr Suliman's negligence and the injuries suffered by Mrs Sibaya's baby
• How damages should be apportioned between the hospital and Dr Suliman in circumstances of contributory negligence

The appeal by Life Healthcare Group (Pty) Ltd was upheld. The SCA found Dr Suliman liable for contributory negligence and apportioned damages between the hospital and Dr Suliman on a 60:40 basis (hospital: 60%, Dr Suliman: 40%).

A doctor owes a legal duty of care to a patient immediately upon agreeing to 'cover' for another doctor and assuming responsibility for that patient's care. This duty arises regardless of whether the doctor characterizes the arrangement as temporary or describes the patient as not being 'their' patient. A medical practitioner breaches their duty of care when they fail to act as a reasonable practitioner in their field would act in the circumstances. In obstetric cases involving a patient in labour, providing only telephonic instructions without personally attending to assess the patient may constitute a breach of the duty of care where such personal attendance would enable detection of complications (such as foetal distress) that could prevent serious injury. Where both a hospital and a doctor are found to be negligent in relation to the same patient outcome, damages may be apportioned between them according to their relative degrees of fault.

The judgment indicates that the high court was unable to find a factual causal link between Dr Suliman's negligence and the resultant injuries, but the SCA reached a different conclusion on the evidence. This suggests that on the evidence presented, the court was satisfied that personal attendance by Dr Suliman would have, on the balance of probabilities, led to detection of the foetal distress and prevented the cerebral palsy. The court's discussion of the 'covering' arrangement highlights the practical realities of medical practice where doctors substitute for one another, but emphasizes that such arrangements do not diminish the legal responsibilities owed to patients. The specific apportionment ratio of 60:40 reflects the court's assessment that while both parties were negligent, the hospital bore somewhat greater responsibility for the outcome, likely due to the nurses' failure to properly communicate the CTG results.

This case establishes important principles in South African medical negligence law regarding when a doctor-patient relationship arises and the duties that flow from such relationship. It clarifies that a doctor who agrees to 'cover' for another doctor assumes a legal duty of care to that patient immediately upon such agreement. The case also reinforces the standard of care expected of medical practitioners, particularly that telephonic instructions alone may not satisfy the duty of care in circumstances requiring personal assessment. The judgment provides guidance on apportionment of damages in cases involving concurrent negligence by both a hospital and a medical practitioner. It emphasizes that doctors cannot avoid liability by characterizing their role as merely 'covering' for another practitioner when they have assumed responsibility for patient care.