In March 2026, the High Court found a provincial MEC for Health, liable for the claimant’s damages caused by a hypoxic-ischaemic brain injury, manifesting as cerebral palsy, which her child suffered during labour and birth at a public hospital as a result of the negligent conduct of the hospital’s medical staff.
The pregnant claimant was admitted to hospital after being transferred from a clinic with lower abdominal pain. She delivered the child more than 2 days later by natural vaginal delivery. She alleged that she underwent prolonged labour in circumstances where a caesarean section (c-section) was indicated, resulting in the child’s diagnosis of cerebral palsy due to birth asphyxia.
It was agreed by the parties that the child was diagnosed with cerebral palsy and mental retardation consequent upon suffering a hypoxic-ischaemic insult due to birth asphyxia and/or hypoxia. The child also has epilepsy and presents with developmental delays, speech deficits and behavioural problems.
Joint expert minutes were filed by the parties’ expert witnesses: radiologists, midwives, gynaecologists/obstetricians and paediatricians.
The main issue determined by the court was whether the hospital’s medical staff were negligent in their care and treatment of claimant and the unborn child, and, if so, whether such negligence contributed to the compromised outcome suffered by the child.
The court accepted that the general consensus amongst the experts was that the child’s injury probably occurred intrapartum shortly before delivery. The claimant was in labour for approximately 50 hours. The medical staff did not adequately monitor her and the foetal condition and they essentially left her to her own devices. Having diagnosed the claimant with foetal tachycardia, the on-call doctor did not personally review her condition despite being called by the nursing staff. The medical staff incorrectly interpreted the cardiotocography tracings and failed to diagnose foetal distress. Consequently, the medical staff administered Oxytocin when it was contraindicated and they failed to diagnose or exclude cephalopelvic disproportion. The medical staff failed to indicate the claimant for intrauterine resuscitation and an emergency c-section.
The court accepted the experts’ evidence that there were no antenatal risk factors for a hypoxic ischaemic injury and there was no sentinel event to justify the poor outcome suffered by the child.
The court decided that the medical staff failed to take reasonable steps to prevent foreseeable harm. There were sustained warning signs, including persistent foetal tachycardia and prolonged labour, which were not appropriately managed. On causation, the court found that the injury probably occurred during labour and that the substandard care materially increased the risk of harm. The cumulative effect of the failures in monitoring, diagnosis, and intervention supported the conclusion that the injury was caused by the negligence of the medical staff.
This judgment highlights the importance of proper monitoring and timely required intervention during labour. If warning signs are not appropriately managed by medical staff, it may result in a poor outcome for a baby and a consequent medical malpractice claim.
LPM obo LM v THE MEC FOR HEALTH: NORTH WEST PROVINCIAL GOVERNMENT