The Member of the Executive Council for Health, Eastern Cape v DL obo AL

The respondent, acting on behalf of her minor child AL, instituted a delictual claim for medical negligence against the MEC for Health, Eastern Cape. AL was born by caesarean section at a public hospital in Graaff-Reinet in October 2011 and later diagnosed with cerebral palsy. It was common cause that there were no antenatal complications. During labour, cardiotocography (CTG) monitoring was conducted between 02h01 and 02h18 and again between 06h11 and 06h23, with no monitoring in between. The respondent alleged that hospital staff negligently failed to monitor labour in accordance with the 2007 National Maternal Guidelines and failed to expedite delivery when foetal distress arose, resulting in an acute profound hypoxic ischaemic brain injury. The high court found negligence and causation established. The MEC appealed to the Supreme Court of Appeal.

The appeal was upheld. The order of the high court was set aside and replaced with an order dismissing the plaintiff’s claim.

The case reinforces the strict requirement in South African medical negligence law that causation must be proven and cannot be inferred from negligence alone. It underscores the importance of properly evaluating expert evidence, respecting admitted facts, and distinguishing between wrongful conduct and proof that such conduct caused the harm. The judgment is particularly significant in cerebral palsy litigation against public health authorities.