This blog is co-authored by Boitumelo Phillips, candidate attorney.
In July 2025, the High Court delivered a significant judgment in a medical negligence case involving the claimant, who acted on behalf of her minor son, and the defendant, the Member of the Executive Council for Health, representing the respondent. The matter arose from the birth of the claimant’s son at a hospital in July 2012. After reviewing the evidence, the court concluded that the child’s injury was directly caused by the hospital staff’s failure to intervene in a timely manner and their neglect to follow established maternity guidelines, making the defendant liable for the harm suffered.
The mother, a high-risk patient, experienced prolonged and complicated labour. Despite clear indications that her labour was not progressing as it should, the hospital staff failed to perform a caesarean section and instead administered oxytocin to stimulate contractions. Critically, the staff did not conduct the required continuous electronic foetal monitoring or cardiotocography, which would have detected signs of foetal distress and allowed for timely intervention.
Expert witnesses, including radiologists and obstetricians, agreed that the child’s brain injury was caused by a hypoxic ischaemic event during labour, meaning the baby’s brain was deprived of oxygen due to prolonged or excessive contractions. The consensus among the experts was that proper monitoring and timely surgical intervention would almost certainly have prevented the injury. The court found that the failure to act on warning signs, such as abnormal foetal heart rates and the claimant’s deteriorating condition, constituted substandard care.
A central issue at trial was whether the child’s condition was due to cerebral palsy resulting from birth injury or an unrelated genetic disorder such as autism spectrum disorder. There was one paediatrician who suggested the latter; however the court preferred the view of the majority of experts, who linked the injury to negligent care during labour. The court noted that, in the absence of a clear and timely repudiation of the joint expert reports, it was bound to accept the agreed facts and opinions.
Applying the “but-for” test for causation, the court concluded that, on a balance of probabilities, the child’s injury was a direct result of the defendant’s failure to intervene timeously and to follow established maternity guidelines. The judgment highlights the critical importance of adhering to clinical guidelines, especially in high-risk deliveries, and demonstrates that healthcare providers will be held liable when substandard care leads to injury.