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[2019] ZAECMHC 72
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ZS obo OS v Member of the Executive Council Responsible for Health in the Eastern Cape (1692/2017) [2019] ZAECMHC 72 (19 November 2019)
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IN
THE HIGH COURT OF SOUTH AFRICA
EASTERN
CAPE LOCAL DIVISION, MTHATHA
CASE
NO. 1692/2017
In
the matter
between:
Z[…]
S[…] obo O[…] S[…]
Plaintiff
And
MEMBER
OF THE EXECUTIVE COUNCIL RESPONSIBLE
FOR
HEALTH IN THE EASTERN
CAPE
Defendant
JUDGMENT
Bloem
J.
1.
This is an action for damages instituted
by the plaintiff, in her personal capacity as well as her
representative capacity as mother
and natural guardian of her minor
daughter who was born on 19 September 2013 (“the child”
or “her child”),
against the defendant, the Member of the
Executive Council responsible for health in the Eastern Cape
Province. At the commencement
of the hearing and at the request
of the parties it was ordered that the issue of the defendant’s
alleged liability be separated
from the quantification of the
plaintiff’s alleged damages. It was furthermore ordered
that the latter issue should
stand over for later determination, if
necessary, and that the trial commence only in respect of the
determination of whether or
not the defendant was liable.
2.
Two issues were identified for
determination. The first was whether or not the plaintiff’s
personal claim against the defendant
has become prescribed and the
second whether the plaintiff has shown that the nurses and medical
practitioners at the Dr Malizo
Mpehle Hospital (the hospital) who
treated the plaintiff from the time of her admission until her
discharge (the medical and nursing
staff) were negligent and that
such negligence caused the hypoxic ischaemic injury which the child
sustained shortly before her
birth.
3.
After
the service of summons on the defendant she raised two special
pleas. In the first she relied on the plaintiff’s
failure
to serve a notice of her intention to institute legal action against
the defendant within six months from 19 September 2013,
as
required by section 3(2)(a) of the Institution of Legal Proceedings
Against Certain Organs of State Act (the Act).
[1]
In the second special plea the defendant alleged that the plaintiff’s
personal claim has become prescribed.
4.
Section 3 of that Act, which deals with
the notice to be given to an organ of state of intended legal
proceedings, reads as follows:
“
(1)
No legal proceedings for recovery of a debt may be instituted against
an organ of state unless-
(a)
the creditor has given the organ
of state in question notice in writing of his or her or its intention
to institute the legal proceedings
in question; or
(b)
the organ of state in question
has consented in writing to the institution of that legal
proceedings-
(i)
without such notice; or
(ii)
upon receipt of a notice which
does not comply with all the requirements set out in subsection (2).
(2)
A
notice must-
(a)
within six months from the date on which the debt became due, be
served on the organ of state in accordance
with section 4(1); and
(b)
briefly set out-
(i)
the facts giving rise to the
debt; and
(ii)
such particulars of such debt as
are within the knowledge of the creditor.
(3)
For
purposes of subsection (2)(a)-
(a)
a debt may not be regarded as
being due until the creditor has knowledge of the identity of the
organ of state and of the facts
giving rise to the debt, but a
creditor must be regarded as having acquired such knowledge as soon
as he or she or it could have
acquired it by exercising reasonable
care, unless the organ of state wilfully prevented him or her or it
from acquiring such knowledge;
and
(b)
a debt referred to in section
2(2)(a), must be regarded as having become due on the fixed date.
(4)
(a) If an organ of state relies
on a creditor’s failure to serve a notice in terms of
subsection (2)(a), the creditor
may apply to a court having
jurisdiction for condonation of such failure.
(b)
The court may grant an application referred to in paragraph (a) if it
is satisfied that-
(i)
the debt has not been extinguished by prescription;
(ii)
good cause exists for the failure by the creditor; and
(iii)
the organ of state was not
unreasonably prejudiced by the failure.
(c)
If an application is granted in
terms of paragraph (b), the court may grant leave to institute the
legal proceedings in question,
on such conditions regarding notice to
the organ of state as the court may deem appropriate.”
5.
When the plaintiff realised that the
defendant relied on her failure to serve a notice in terms of section
3(2)(a) of the Act, she
made an application to this court on
9 November 2018 for an order that her failure in that regard be
condoned. The defendant
did not oppose that application.
On 27 November 2018 this court condoned the plaintiff’s failure
to serve a notice
in terms of section 3(2)(a) as read with section
3(1).
6.
The parties agreed that the issue of
prescription should be determined in the light of the evidence that
was placed before the court
in the application for condonation of the
plaintiff’s failure to comply with section 3(2) of the Act.
Therein the plaintiff
alleged
inter
alia
that she accepted that her
child’s “
abnormality was
due to an unanticipated and unavoidable event at the time of his
(sic) birth
” and that she
accepted that “
the staff at the
hospital where I was treated at the time knew what they were doing
and acted appropriately
.” She
furthermore alleged that during March 2018 and at Xabane Location she
met a lady whose name she could not remember
who had a child also
suffering from cerebral palsy. The two of them shared their
experiences of dealing with their respective
children. It was
during that conversation that the lady mentioned that she instituted
legal proceedings for damages against
the defendant arising “
from
the negligence of the hospital staff which led to her baby having
cerebral palsy
”. That
lady gave her the contact details of the attorney who was prosecuting
her claim. The plaintiff made an
appointment to see that
attorney on 15 March 2018. She alleged that, based on what she
had told her attorney, he expressed
the opinion that “
the
medical staff at the hospital were negligent in their caring for me
and my baby during my labour and delivery and that this
was the cause
of my child’s brain damage and subsequent development of
cerebral palsy
”. She
alleged that it was the first time that she acquired knowledge that
she had a claim for damages against the defendant.
She
accordingly instructed her attorney to give notice in terms of the
Act and to issue summons against the defendant. Summons
was
served on the defendant on the 13 July 2018.
7.
The
period of prescription is three years from 19 September 2013.
Mr du Plessis, who appeared on behalf of the plaintiff,
made two
submissions in this regards. The first is that, when the court
condoned the plaintiff’s non-compliance with
the provisions of
section 3(2)(a) of the Act, it indirectly found that the plaintiff’s
personal claim against the defendant
had not prescribed because in
terms of section 3(4)(b)(i) the court could only condone such
non-compliance if it was satisfied
that her claim had not been
extinguished by prescription. I would prefer not to decide the
issue of prescription based on
that submission. Counsel’s
second submission was that the debt shall not be deemed to be due
until 15 March 2018
when the plaintiff was advised by her
attorney that she had a claim for damages against the defendant.
In this regard reliance
was placed on section 12(3) of the
Prescription Act
[2]
which
reads as follows:
“
A
debt shall not be deemed to be due until the creditor has knowledge
of the identity of the debtor and of the facts from which
the debt
arises: Provided that a creditor shall be deemed to have such
knowledge if he could have acquired it by exercising reasonable
care.”
8.
The
Constitutional Court was called upon to interpret the provisions of
section 12(3) of the Prescription Act in
Mtokonya
v Minister of Police
[3]
which was seen by that court as “
an
opportunity of pronouncing once and for all on this issue so that the
law becomes settled
.”
In that case Mr Mtokonya claimed damages against the Minister
of Police arising from his unlawful arrest on 27 September 2010
and subsequent detention until his release five days thereafter. At
the beginning of July 2013 Mr Mtokonya met with his attorney
and
instituted action for damages against the Minister during April 2014,
more than 3 years from the date of his arrest and
detention.
The parties requested the High Court to decide whether a
plaintiff is required to have knowledge that the
conduct of the
defendant giving rise to the debt is wrongful and actionable before
prescription can start running. The High
Court held that such
knowledge was not a requirement before prescription could begin to
run. It accordingly upheld the Minister’s
special plea
based on prescription and dismissed Mr Mtokonya’s claim.
Leave to appeal to the Supreme Court of Appeal
having been refused
the issue presented itself for determination by the Constitutional
Court.
9.
It
was submitted on behalf of Mr Mtokonya in the Constitutional Court
that his claim against the Minister had not prescribed because,
until
he consulted his attorney at the beginning of July 2013, he did not
know that the conduct of the police in not bringing him
before a
court within 48 hours after his arrest on 27 September 2010 was
wrongful and actionable and that he had a remedy
in law against the
police.
[4]
10.
Zondo J (as he then was), writing for
the majority, held that section 12(3) does not require the creditor
to have knowledge of any
right to sue the debtor nor does it require
him or her to have knowledge of legal conclusions that may be drawn
from the facts
from which the debt arises. The Court held that
what section 12(3) requires the plaintiff to have is knowledge of the
facts
from which the debt arises, in other words knowledge of the
facts needed to establish the defendant’s liability.
Section 12(3)
accordingly does not require knowledge of legal
opinions or legal conclusions or knowledge of the availability in law
of a remedy.
The learned Judge summarised the position as
follows in paragraph 45:
“
Knowledge
that the conduct of the debtor is wrongful and actionable is
knowledge of a legal conclusion and is not knowledge of a
fact. …
Therefore, such knowledge falls outside the phrase ‘knowledge
… of the facts from which the debt
arises’ in s 12(3).
The facts from which a debt arises are the facts of the incident or
transaction in question which,
if proved, would mean that in law the
debtor is liable to the creditor
.”
11.
Applied to the facts of the
present matter, those facts demonstrate that when the plaintiff
consulted her attorney on 15 March
2018, she was in possession of all
the material facts that were necessary to institute an action for
damages. Her evidence
in that regard was the following:
“
On
15 March 2018 I consulted with Mr Nonxuba and gave him the history of
pregnancy, labour and delivery of my child as well as the
fact that
my child has been diagnosed with cerebral palsy. Mr Nonxuba,
thereafter, advised me that in his opinion the medical
staff at the
hospital were negligent in caring for me and my baby during my labour
and delivery and that this was the cause of
my child’s brain
damage and subsequent development of cerebral palsy.”
12.
As
at 19 September 2013 when the child was born, the plaintiff had
knowledge of what happened during her pregnancy, labour and delivery
of her child. She acquired knowledge that the child had been
diagnosed with cerebral palsy either on that same day or shortly
thereafter. Her cause of action was complete and the debt of
the defendant became due on 19 September 2013 or shortly thereafter.
That is when she had knowledge of a complete set of facts necessary
to succeed with her claim against the defendant.
[5]
That her attorney expressed an opinion only on 15 March 2018 that
“
the
medical staff at the hospital were negligent
”
in caring for her and her child or that it “
was
the first time that [the plaintiff] became aware that [the child’s]
cerebral palsy was caused by the negligence of the
nursing and the
medical staff at the clinic and also at Dr Malizo
Mpehle
Hospital
”
are accordingly irrelevant. It is accordingly found that the
plaintiff had knowledge of the facts from which the debt
arose (the
facts necessary to succeed with an action for damages) on 19
September 2013 or shortly thereafter.
13.
When
did the plaintiff acquire knowledge of the identity of the
defendant? The only evidence in this regard was adduced by
the
plaintiff. She testified that on 15 March 2018 her
attorney indicated that he could take on her case.
He then
explained to her the procedure to be followed in the execution of his
mandate, if instructed. She then instructed
him to institute an
action on her behalf against the defendant. She testified that
she became aware only then that she had
a claim against the
defendant. The plaintiff’s evidence in this regard is
unchallenged. The plaintiff’s
personal claim would have
become prescribed if she had acquired knowledge of the identity of
the debtor (i.e. that the person against
whom she had to institute a
claim was the defendant) before the expiry of the 3-year extinctive
period on 18 September 2016.
The onus was on the defendant to
prove that the plaintiff had such knowledge before then.
[6]
The defendant did not adduce any evidence and accordingly did not
discharge that onus.
14.
In
my view, the above evidence demonstrates that the plaintiff became
aware of the identity of the defendant for the first time
on 15 March
2018. Although the plaintiff had knowledge of all the facts
necessary to institute an action for damages since
19 September
2013 or shortly thereafter, she did not have knowledge of the
identity of the person against whom such an action
should be
instituted. In my view it could not be expected of a
person who described herself as an “
illiterate
”
and “
a
lay person in respect of legal matters and medical issues
”
to reasonably have had the knowledge that an action should be
instituted, not only against the nurses or medical practitioners
who
treated (or failed to treat) her but, against the defendant who is
vicariously liable for the acts or omissions of the medical
and
nursing staff who were at all material times acting within the course
and scope of their employment as employees of the Department
of
Health of the Eastern Cape, the defendant being the political head
thereof.
[7]
15.
In the circumstances, despite the fact
that the plaintiff had knowledge of the facts necessary for her to
institute an action for
damages, it is found that her personal claim
against the defendant had not prescribed by 13 July 2018 when the
summons was served
on her. That is so because she acquired
knowledge of the identity of the person against whom the action
should be instituted
only on 15 March 2018, the date from which
prescription commenced to run. The defendant’s special
plea of prescription
against the plaintiff’s personal claim
should accordingly be dismissed.
16.
Save for prescription, nothing was
placed in dispute in respect of the merits of the plaintiff’s
personal claim. Regarding
the merits of the plaintiff’s
claim on behalf of her child, the defendant placed in issue whether
the intrapartum hypoxic
ischaemic injury was caused by the negligence
on the part of the medical and nursing staff.
17.
Negligence, for purposes of liability,
arises if:
17.1.
a
diligens paterfamilias
in
the position of the defendant:
17.1.1
would foresee the reasonable possibility
of his conduct injuring another in his person or property and causing
him patrimonial loss;
and
17.1.2
would take reasonable steps to guard
against such occurrence; and
17.2
the
defendant failed to take such steps.
[8]
18.
In her plea the defendant admitted that
the medical and nursing staff were under a legal duty to provide
medical, surgical, nursing,
monitoring, advisory, supervisory and
midwifery services in relation to the plaintiff’s pregnancy and
the delivery of her
unborn child with such skill, care and diligence
that could reasonably be expected of nursing staff and medical
practitioners involved
in providing the above services. The
defendant furthermore admitted in her plea that during September 2013
the plaintiff
and the medical and nursing staff, the latter having
been authorised to do so, concluded an agreement in terms whereof the
medical
and nursing staff would provide care and treatment to the
plaintiff for the delivery of her child of a standard reasonably
expected
of medical and nursing staff in similar circumstances
practising at a public health establishment. The parties have
agreed
that the standard of the services to be provided by the
nursing staff are set out in
The
Guidelines for Maternity Care in the Republic of South
Africa
prepared and issued by
the Department of Health of South Africa in 2007 (Third Edition) (the
Guidelines). In this regard
reference is made to the reports of
the parties’ expert obstetrician and gynaecologists who both
relied on the Guidelines
when they compiled their reports.
19.
The
parties have agreed that the issues of negligence could be determined
in the light of a joint minute prepared by their respective
obstetrician and gynaecologists, Dr Chimusoro for the plaintiff’s
and Dr van Helsdingen for the defendant, against the background
of
their respective reports. Because there was agreement on the
facts set out in the joint minutes, there was no need to
adduce
evidence in respect thereof. This court has to accept those facts
agreed upon by the experts.
[9]
The relevant part of the agreement contained in the joint minute that
was signed by Drs Chimusoro and van Heldingen
on 30 September
2019 reads as follows:
“
5. On
18
th
September 2013 she was reviewed at
07h40, 11h30 and 17h40 (*The time (17h04) is obviously wrong regard
being had to the various
medico-legal reports and hospital records)
assessed as being in the latent phase of labour. This represents
sparse intrapartum
monitoring.
6. On
19
th
September 2013 at 04h40 she was found to be 6cm
dilated with ruptured membranes at about 23h00 18/06/2013. This
represents
a long period without foetomaternal monitoring.
7.
At 06h40 on 18
th
September she was
seen and her foetal heart rate was stated as 173-i.e. foetal
tachycardia.
8. The
records state she was diagnosed as having foetal distress at 06h40,
the criteria are not sated but
the prior recorded foetal tachycardia
gives credence to this diagnosis.
9. The
records show that the foetal heart was checked 1 hour apart until
delivery at 07h54.
10. Her
intrapartum monitoring was substandard - the recorded foetal heart is
not in relation to contractions.
11. Her
blood pressure elevation was not managed with urgency or significance
it requires in labour.
12. The
poor foetal outcome could have been avoided with appropriate
intrapartum foetal monitoring and earlier expedited delivery
for this
lady’s labour.”
20.
The
experts agreed that the monitoring of the plaintiff and her unborn
child at 07h40, 11h30 and 17h04 on 18 September 2013 when
she was in
the latent phase of labour
[10]
was
not as frequent as they should have been. The monitoring and
accordingly the care of the plaintiff and her unborn
child did not
meet the standard set out in the Guidelines. In terms of the
Guidelines a woman in the latent phase of labour
should have her
blood pressure, temperature and pulse rate recorded 4 hourly,
uterine contractions and foetal heart rate should
be recorded every 2
hours and a vaginal examination should be done every 4 hours.
21.
In this case there was no foetal heart
monitoring from 11h30 until 17h40 on 18 September 2013, a period
of approximately 6
hours. There was also no monitoring between
17h40 on 18 September 2013 and 04h40 on 19 September 2013,
a period
of approximately 11 hours. It means that during those
periods the child’s condition was unknown.
22.
When
the plaintiff was monitored at 04h40 on 19 September 2013 it was
noted that her cervix was 6 cm dilated. It means that
she was
in the active phase of labour.
[11]
According to the Guidelines, during that phase of labour the foetal
heart rate should be monitored every half an hour.
At 06h40 on
19 September 2013 (not 18 September 2013 as stated in paragraph
7 of the above joint minute) when the foetal heart
was monitored, it
was noted that it was in distress.
[12]
With the diagnoses of the child being in distress, there was a
greater need for the Guidelines to have been followed even
more
closely, namely that the foetal heart should have been monitored
every half an hour. However, the records show that
from 04h40
until the child was delivered by caesarean section at 07h54, the
foetal heart rate was not monitored every half hour.
It was
monitored 1 hourly.
23.
It was known to the medical and nursing
staff that the plaintiff had hypertension during her pregnancy.
A woman who is pregnant
for the first time, as was the position in
this case, is a high risk during labour due to the risk associated
with prolonged and
obstructed labour. Such a patient needs to
be monitored diligently so that if there are problems, they could be
identified
and specific measures applied to correct them and to
remove the risk of prolonged labour. Except for being pregnant
for the
first time with its associated risks, the plaintiff had an
added problem of hypertension which could result in complications for
both mother and foetus. One such problem is a compromised
placental blood supply which, in turn, compromises the oxygen supply
to the foetus.
24.
During the latent phase of labour a
maternal blood pressure should be recorded every 4 hours and during
the active phase 1 hourly.
In this case the records show that,
despite the plaintiff’s elevated blood pressure, she was not
monitored between 11h30
and 17h40 on 18 September 2013, and again
between 17h40 on 18 September 2013 and 04h40 on 19 September 2013.
During the above
periods the plaintiff required frequent monitoring
to assess her response to treatment. During that period it was
important
to test her urine for proteinuria. The monitoring and
testing did not take place.
25.
High blood pressure is defined as a
value of 140/90 mmHg or higher on two occasions at least 4 hours
apart. Normal blood pressure
is below 120/80 mmHg.
In this case the plaintiff’s blood pressure was recorded on
11 September 2013
as 166/99 at 09h05 and 159/102 at 11h55.
On 17 September 2013 it was recorded as 149/89 at 08h57 and
150/101 at
11h15. The blood pressure was not recorded at 11h30
and 17h40 on 18 September 2013. The plaintiff’s
blood
pressure was also not monitored 4 hourly on 18 September
2013. It was monitored only twice on that day. Her blood
pressure was recorded as 141/98 at 06h55 on 19 September 2013.
26.
The above facts demonstrate that the
experts were justified to agree that the elevation of the plaintiff’s
blood pressure
was not properly managed with the urgency or
significance it required while she was in labour. That
agreement is important
if regard is had to the fact that the
plaintiff was pregnant for the first time and had been diagnosed with
hypertension.
27.
I
am of the view that reasonable nurses in the position of the nursing
staff who treated the plaintiff on 18 and 19 September 2013
would
have foreseen the reasonable possibility of harm to the plaintiff and
her unborn child and would have taken steps to guard
against its
happening. Reasonable nurses would have foreseen that their
failure to regularly monitor the plaintiff and the
foetal heart rate
would harm the plaintiff and her unborn child. Regular
monitoring would have warned those nurses of a developing
injury to
the child’s brain if starved of oxygen during labour and that
such an injury would have adverse consequences for
the plaintiff and
her child. Such nurses would have taken reasonable steps to
guard against the plaintiff and her unborn
child being harmed by
performing an intrauterine resuscitation
[13]
and, depending on the plaintiff and her child’s response
thereto, the timeous delivery of the child by caesarean section.
The nursing staff in this case failed to take such steps. In
all the circumstances, I am satisfied that the plaintiff proved
on a
balance of probability that the nursing staff who treated the
plaintiff were negligent.
28.
The facts demonstrate that the experts
were justified to agree that the monitoring of the plaintiff and the
foetal heart rate while
the plaintiff was in (the latent and active
stages of) labour was substandard. The failure of the nursing
staff to measure
up to the reasonable standard of skill and care set
out in the Guidelines amounted to negligence. Their treatment
of the
plaintiff did not conform to the standard of care demanded by
the law.
29.
The
next issue to decide is whether the nurses’ negligence
factually caused the hypoxic ischaemic injury. For purposes
of
liability it is insufficient for a plaintiff to prove that a
defendant was negligent. The plaintiff must go further and
prove that such negligence caused him or her harm. In other
words, the plaintiff must prove a causal connection between the
defendant’s negligence and the harm suffered by him or
her.
[14]
30.
In my view the plaintiff has succeeded
to show that if the plaintiff and the foetal heart rate had been
monitored as set out in
the Guidelines, the probabilities are that
the result would have been different in that the nursing staff would
have been alerted
to the problems associated with a prolonged labour
and a delivery by caesarean section would have been arranged
earlier.
The injury to the child’s brain would probably
have been avoided.
31.
In all the circumstances, it is held
that the plaintiff has established on a balance of probabilities that
the defendant is liable
to her, in both capacities, for the hypoxic
ischaemic injury caused by the negligence of the nursing staff at the
Dr Malizo Mpehle
Hospital. There is no reason why
costs should not follow the result.
32.
In the result it is ordered that:
33.1 The
defendant is liable to pay 100% of all damages that the plaintiff, in
her personal and
her representative capacity for and on behalf of her
minor child, Onako, suffered as a result of the brain injury
negligently caused
to Onako by the defendant’s employees.
33.2
The determination of the quantum of the plaintiff’s damages
shall stand over for
determination at a later stage.
33.3. The
defendant shall pay the plaintiff’s costs of suit to date
hereof, such costs to include:
33.3.1
the costs of senior counsel;
33.3.2
the travelling and accommodation
expenses of the plaintiff’s legal representatives and witnesses
for purposes of consultation
and trial;
33.3.3
the costs incurred in obtaining
medico-legal reports, including any supplementary reports, addendums
and joint minutes, as well
as, where necessary, the qualifying,
attendance, reservation and preparation by the following experts:
33.3.3.1
Dr Kara;
33.3.3.2
Dr Chimusoro;
33.3.3.3
Prof Andronikou, and
33.3.3.4
Lesley Fletcher.
33.4. The
defendant shall pay interest on the aforesaid costs from date
of
allocatur
to date of payment thereof.
_________________________
G H
BLOEM
Judge
of the High Court
For
the plaintiff: Adv D T du Plessis SC, instructed by Nonxuba Inc,
Johannesburg and Potelwa and Co, Mthatha.
For
the defendant: Adv N James, instructed by Norton Rose Fulbright,
Johannesburg and Smith Tabata Attorneys, Mthatha.
Date
of hearing:
5 November 2019.
Date
of delivery of the judgment: 19 November 2019.
[1]
Institution
of Legal Proceedings Against Certain Organs of State Act, 2002 (Act
No 40 of 2002).
[2]
Prescription
Act, 1969 (Act No 68 of 1969).
[3]
Mtokonya
v Minister of Police
[2017]
ZACC 33
;
2017 (11) BCLR 1443
(CC);
2018 (5) SA 22
(CC) at para 10.
[4]
Section
50(1)(c) of the Criminal Procedure Act, 1977 (Act No 51 of 1977).
[5]
Truter
and another v Deysel
[2006]
ZASCA 16
;
2006 (4) SA 168
(SCA) at para 16.
[6]
Drennan
Maud and Partners v Pennington Town Board
[1998] ZASCA 29
;
1998 (3) SA 200
(SCA);
[1998] 2 All SA 571
(A) at
204F-G.
[7]
MEC for
Education, KwaZulu-Natal v Shange
[2012] ZASCA 98
;
2012 (5) SA 313
(SCA) at 319D-E.
[8]
Kruger
v Coetzee
1966 (2) SA 428
(A) at 430E-F.
[9]
BEE
v Road Accident Fund
[2018]
ZASCA 52
;
2018 (4) SA 366
(SCA) at para 73.
[10]
Latent
phase of labour is defined in the Guidelines as the period when the
woman’s cervix is less than 4cm dilated and more
than 1cm
long.
[11]
Active
phase of labour is defined in the Guidelines as the period when the
woman’s cervix is more than 4cm dilated and less
than 1cm
long.
[12]
Foetal
tachycardia
was recorded, which I understand to be that there was abnormal
rapidity of the child’s heart action.
[13]
The
application of specific measures with the aim of increasing oxygen
delivery to the placenta and umbilical blood flow, in order
to
reverse hypoxia and acidosis.
[14]
Minister
of Police v Skosana
1977 (1) SA 31
(AD) at 34E-G.