Buthelezi v Ndaba

The appellant, Dr Gabriel Buthelezi, a specialist gynaecologist and obstetrician, performed a total abdominal hysterectomy on the respondent, Ms Priscilla Ndaba, in February 2006. Some weeks after the operation the respondent developed urinary incontinence, which was later diagnosed as being caused by a vesico-vaginal fistula. She instituted a delictual claim in the KwaZulu-Natal High Court alleging that the fistula resulted from Dr Buthelezi’s negligent performance of the surgery. Liability and quantum were separated, and the High Court found the surgeon negligent based largely on expert evidence and concessions made by the appellant. Dr Buthelezi appealed to the Supreme Court of Appeal.

The appeal was upheld with costs. The order of the High Court was set aside and replaced with an order dismissing the plaintiff’s claim with costs.

The case is a leading authority on the evaluation of expert evidence in medical negligence claims and reaffirms that adverse surgical outcomes do not, without more, establish negligence. It underscores the limited role of res ipsa loquitur in medical malpractice cases and clarifies that courts must examine the reasoning underlying expert opinions rather than relying on the mere occurrence of injury or speculative explanations.