Authored by Jessica Blunden and Jason Hudson.
In February 2026, the High Court dismissed a claim for damages arising from a patient's death following surgery at a provincial hospital. The court found that the claimant had failed to prove, on a balance of probabilities, that the hospital's medical staff were negligent or that their conduct caused the patient's death.
The patient was transferred from one hospital to another for urgent surgery to address a bowel obstruction. He was a known epileptic who had previously undergone abdominal surgery following a gunshot wound. That surgery was performed successfully, and the patient initially appeared to be recovering well. However, during the early hours of the following morning, the patient suddenly jumped out of bed, began vomiting and gasping, and died despite resuscitation efforts.
The claimant alleged that hospital staff failed to manage the patient's epilepsy, used seizure-inducing anaesthetic drugs, failed to administer anti-seizure medication, and failed to intubate and properly resuscitate the patient after his fall. The claimant's expert, a trauma surgeon, opined that the patient may have suffered an epileptic seizure causing him to fall, sustain a head injury, and die as a result of inadequate post-operative care.
The hospital contended that the patient died of sepsis caused by a perforated small bowel linked to adhesions from his prior gunshot wound, a complication that was unpredictable and could not have been prevented. This was supported by the post-mortem report, which recorded the cause of death as sepsis due to a perforated small bowel obstruction.
The court noted that the claimant's expert conceded under cross-examination that there was no clinical evidence that the patient had suffered an epileptic seizure. The proposition that a seizure had occurred was therefore speculative. The court accepted the hospital's expert evidence that the patient's chronic anti-epileptic medication could not have been safely administered orally, given his bowel obstruction and vomiting, and that intravenous administration would have required blood test results not available before emergency surgery. The court further found that the resuscitation was adequate, noting that a doctor was called within five minutes and resuscitated the patient for ten minutes, and that there was no evidence a different method would have changed the outcome.
The court applied the established test for medical negligence, emphasising that a medical professional is not expected to exercise the highest possible degree of skill, but the general level of skill and diligence ordinarily exercised by a reasonable member of the profession under similar circumstances. Where conflicting expert opinions exist, a court must assess the extent to which each opinion is founded on logical reasoning and established facts, rather than speculation.
The claim was dismissed with costs.
This judgment illustrates that courts will carefully scrutinise expert evidence in medical negligence claims and will not impose liability where opinions are based on speculation rather than proven facts. The finding that the hospital's expert, independently and before sight of the post-mortem report, reached a conclusion consistent with the post-mortem findings was compelling. Expert evidence that relies on facts not established in evidence carries little weight.
Ngcobondwana v MEC for Health, Eastern Cape [2026] ZAECELLC (19 February 2026)