Hospital not liable after woman’s leg was amputated above knee

A WOMAN whose right leg was amputated above the knee lost her legal bid to claim damages from the Gauteng MEC for health as the court found the hospital was not negligent and that the woman lost her leg as a result of a rare neurovascular complication.

Nonyaniso Mntimba turned to the Gauteng High Court, Pretoria, as she claimed that her leg was amputated due to the negligence of the doctors and nurses at the Tambo Memorial Hospital in Boksburg.

Mntimba was shot in both lower limbs on December 26, 2018, and she was admitted and treated at Tambo Memorial Hospital for five days. Unfortunately, while she was still in hospital, her right leg was amputated above the knee.

The issue before the court was whether there was negligence on the part of the medical and nursing staff of the hospital in treating her.

A vascular surgeon – who focuses on injuries to arteries and veins other than those located in the heart and brain – testified on her behalf that thrombosis is often caused by barotrauma .

According to him, a few days after Mnimba’s admission to hospital, she suffered a loss of sensation in her legs, which was followed by paralysis. This led to what is called ischemia.

He testified that when confronted with this condition, the nurse should have reported it to a doctor who would have been able to interpret it.

A nurse testified that Mntimba had shown signs of ischemia: pain and decreased sensation. According to her, the nurses who were dealing with her at the time were supposed to report the condition immediately to a doctor, as only a doctor can diagnose ischemia.

A professor of surgery, meanwhile, testified on behalf of Mntimba that in his opinion, due to the injuries suffered by the plaintiff, she should never have been admitted to Tambo

Memorial Hospital and she should rather have been referred to Charlotte Maxeke Johannesburg Hospital.

He said it is incumbent on the nursing staff to phone the doctor when they notice a change in the condition of a patient. When there was a loss of sensation, a fasciotomy could have been done.

It was his opinion that had there been an intervention at the stage of loss of sensation in the limbs, the plaintiff’s leg would most probably have been saved.

But a vascular surgeon who testified on behalf of the MEC for health told the court that there were several checks done on the patient to evaluate the limb perfusion.

In his opinion, the delay in operating was unlikely to have contributed to the limb loss.

The experts refuted the plaintiff’s expert witness testimony that there was poor monitoring, poor recording, and a failure to act on changes in the plaintiff’s condition. According to him, the plaintiff was monitored and when she complained, the doctor was called.

According to him, ischemia presented itself for the first time in the plaintiff after she had spent about four days in the hospital and Tambo Memorial Hospital did not have the requisite specialties. Therefore, she was immediately transferred to another, bigger hospital that could deal with the sudden thrombosis.

Judge David Makhoba noted that the hospital records stated exactly how and when Mntimba’s condition was reported. Her condition suddenly deteriorated and when she was unable to feel her right foot and move her toes, it was immediately reported to a doctor who attended to her. An ambulance was arranged to transfer her to another hospital shortly afterwards.

“In my view, the defendant’s nursing staff provided the necessary care to the plaintiff under the circumstances by checking her condition within reasonable timeframes,” the judge said in turning down her claim.