SN obo ON v Member of the Executive Council for Health: Eastern Cape

SN, acting on behalf of her minor child ON, instituted a delictual claim against the MEC for Health: Eastern Cape for damages arising from brain injury sustained by ON during labour and birth at Madzikane KaZulu Memorial Hospital in February 2013. SN was admitted in labour and progressed from latent to active labour. Foetal heart rate (FHR) monitoring was not conducted at the intervals required by the national maternity care guidelines. ON was born with the umbilical cord wrapped three times around his neck, required resuscitation, and was diagnosed with hypoxic‑ischaemic encephalopathy, later manifesting as cerebral palsy. The MEC admitted that FHR monitoring was substandard but denied that this caused the injury, contending instead that the brain damage resulted from an acute profound hypoxic event caused by an unknown sentinel event.

The appeal was upheld with costs. The order of the high court was set aside and replaced with an order directing the defendant to pay the plaintiff’s agreed or proven damages with costs.

This judgment reinforces the application of national maternity care guidelines as a benchmark for reasonable conduct in medical negligence claims. It affirms that admitted substandard monitoring can establish negligence and, where causation is admitted or clearly established, liability will follow. The case is significant for clarifying the evaluation of expert evidence and confirming that failures in intrapartum foetal monitoring can ground liability for cerebral palsy claims against provincial health authorities.