N.O.B and Another v Member of the Executive Council for Health of the Limpopo Provincial Council (10146/2022) [2025] ZALMPPHC 115 (17 June 2025)

81 Reportability

Brief Summary

Medical Negligence — Duty of care — Breach of duty resulting in injury — Plaintiffs, parents of a minor child, claimed damages from the MEC for Health, alleging negligence in the medical treatment provided during childbirth, leading to global hypoxic ischemic injury to the child’s brain. The Plaintiffs contended that the medical staff failed to timely diagnose a breech presentation and did not perform a necessary caesarean section, resulting in significant harm to the child. The Defendant denied negligence, asserting that proper care was provided and that the First Plaintiff contributed to the situation by bearing down prematurely. The court found that the Defendant breached its duty of care by failing to diagnose the breech presentation and not taking appropriate action, leading to the injuries sustained by the minor child. The Defendant was held liable for the damages suffered by the Plaintiffs.

Comprehensive Summary

Case Note


B[...] N[...] O[...] v The Member of the Executive Council for Health of the Limpopo Provincial Council

Case Number: 10146/2022

Date: 17 June 2025


Reportability


This case is reportable due to its implications for medical negligence and the standards of care expected from healthcare professionals in South Africa. The judgment addresses the legal duties of medical practitioners and the consequences of failing to adhere to established medical protocols, particularly in cases involving breech presentations during childbirth. The case highlights the importance of timely and accurate medical assessments and the potential for significant harm when these duties are neglected.


Cases Cited



  • Van Eeden v Minister of Safety and Security (Women’s Legal Centre Trust as amicus curiae) 2003 (1) SA 389 (SCA)

  • Minister of Safety and Security v Van Duivenboden 2002 (2) SA 431 (SCA)

  • Kruger v Coetzee 1966 (2) SA 428 (A)

  • Mukheiber v Raath & Another 1999 (3) SA 1065 (SCA)

  • S v Mokgethi 1990 (1) SA 32 (A)


Legislation Cited



  • Civil Proceedings Evidence Act, Act 25 of 1965


Rules of Court Cited



  • Rule 33(4)

  • Rule 39(9)(a) and (b)


HEADNOTE


Summary


The case revolves around a claim for damages by the parents of a minor child who suffered a global hypoxic ischemic injury during birth due to alleged negligence by the medical staff at FH Odendaal Hospital. The plaintiffs contended that the medical personnel failed to diagnose a breech presentation in a timely manner and did not take appropriate action to expedite delivery, leading to significant injuries to the child.


Key Issues


The key legal issues addressed in this case include the standard of care expected from medical practitioners, the legal duty to act in preventing harm, and the implications of failing to diagnose and manage a breech presentation appropriately.


Held


The court found in favor of the plaintiffs, determining that the defendant was liable for 100% of the damages suffered by the minor child due to the negligence of the medical staff in failing to diagnose and manage the breech presentation properly.


THE FACTS


The first plaintiff, the mother of the minor child, was admitted to FH Odendaal Hospital shortly before the child's birth. Despite being informed during prenatal visits that the child was in a breech position, the medical staff failed to act accordingly. The minor child was born with significant injuries due to asphyxiation caused by the failure to perform a timely caesarean section. The plaintiffs claimed damages based on the breach of the defendant's legal duty to provide appropriate medical care.


THE ISSUES


The court was tasked with determining whether the defendant breached its legal duty to provide proper medical treatment and whether this breach resulted in the damages suffered by the plaintiffs. The court also needed to assess the standard of care expected from the medical practitioners involved in the case.


ANALYSIS


The court analyzed the evidence presented by both parties, including expert testimonies that highlighted the standard procedures for managing breech presentations. The court found that the medical staff failed to conduct proper examinations and did not adhere to the expected protocols, leading to the minor child's injuries. The court emphasized that the failure to diagnose the breech presentation in a timely manner directly contributed to the adverse outcomes.


REMEDY


The court ordered the defendant to pay the plaintiffs' proven or agreed damages in full, along with the costs of the proceedings, including the costs associated with expert witnesses. The court also stipulated that the costs would include the fees for two counsel due to the complexity of the case.


LEGAL PRINCIPLES


The judgment established key legal principles regarding medical negligence, including the necessity for medical practitioners to adhere to established standards of care, the legal duty to prevent harm, and the implications of failing to act in accordance with medical protocols. The court underscored that negligence is actionable when it results from a breach of a legal duty to act, particularly in circumstances where harm is foreseeable.


SAFLII Note: Certain personal/private details of parties or witnesses have been redacted from this document in
compliance with the law and SAFLII Policy

REPUBLIC OF SOUTH AFRICA



IN THE HIGH COURT OF SOUTH AFRICA
LIMPOPO DIVISION, POLOKWANE

CASE NUMBER: 10146 /2022
(1) REPORTABLE: YES/NO
(2) OF INTEREST TO THE JUDGES: YES/NO
(3) REVISED.
DATE 17 June 2025
SIGNATURE

In the matter between:

B[...] , N[...] O[...]
1ST PLAINTIFF
B[...] , P[...]
2ND PLAINTIFF
-and-

THE MEMBER OF THE EXECUTIVE COUNCIL FOR DEFENDANT


HEALTH OF THE LIMPOPO PROVINCIAL COUNCIL

Delivered : 17 June 2025
This judgment was handed down electronically by circulation to
the parties’ legal representatives by e -mail. The date and time
for hand down of the judgment is deemed to be 17 June 2025
at 00:00 am .
Date heard : 17 and 18 March 2025
Coram : Bresler A J

JUDGMENT

BRESLER AJ:

Introduction:

[1] The First Plaintiff is the mother and natural guardian of the minor child,
T…N…B…B (the ‘minor child’) , born on the 19th of July 2019. She sues in her
personal capacity and in her representative capacity aforesaid. Likewise, the
2nd Respondent sues in his capacity as father and natural guardian of the minor
child. He abandoned the claim in h is personal capacity and the ob jection
against his locus standi as father and natural guardian was abandoned by the
Defendant after receipt of a report from a pathologist confirming his paternity.

[2] The Defendant is cited in her capacity as MEC responsible for the
administration of the Department of Health of the Limpopo Provincial
Government.


[3] The First and Second Plaintiff (jointly referred to the ‘Plaintiffs’) claims damages
from the Defendant predicated on the Defendant ’s breach of its legal duty to
render proper and appropriate medical treatment and exercise the degree of
skill and care which can reas onably be expected of a nurse or medical
practitioner in the prevailing circumstances.

[4] It is the Plaintiffs ’ case that during the period after the First Plaintiff’s admission
to FH Odendaal Hospital, and before the minor child’s birth on 19 July 20 19,
and thereafter until the time of his discharge, the minor child suffered a global
hypoxic i schemic injury to his brain (the ‘injury). As a result of the brain injury,
the minor child suffers from the following conditions, and which conditions were
not pre sent in the minor child as an unborn foetus :

4.1 Pseudobulbar palsy;
4.2 Cognitive impairment with behav ioural difficulties; and
4.3 Dyspraxic clumsiness.

[5] The crux of the Plaintiffs’ case is premised on the failure by the nursing and
medical staff t o correctly diagnose the br eech presentation of the minor child
timeously and to immediately expedite delivery by caesarean section . The
Plaintiffs furthermore plead that the nursing and medical personnel at FH
Odendaal Hospital failed to keep proper and accurate records relating to the
care and treatment o f the minor child. The actions and / or failure to act by the
nursing and medical personnel therefore caused the damages being suffered by
both the minor child and the Plaintiffs.

[6] The Defendant essentially pleaded a denial of the breach of the legal duty. The
Defendant furthermore pleads that the Defendant’s medical staff acted with the
utmost care and diligence towards the First Plaintiff and the minor child, and
that access was provided to adequate healthcare and emergency medical
treatment.


[7] Curiously, the Defendant appears to plead that the First Plaintiff had an
obligation to inform the medical sta ff that the minor child was in a breech
presentation upon arriving at FH Odendaal Hospital, which she failed to do. No
legal basis is however pleaded for this alleged obligation. Be that as it may, the
Defendant furthermore pleads that a breech presentation can still be delivered
vaginally . When the First Plaintiff was about to be taken to the theatre for an
emergency caesarean section , the doctors observed that it was no longer a
viable option, and the First Plaintiff was then moved to the labour ward for a
vaginal delivery.

[8] It is the Defendant’s case that the First Plaintiff caused the caesarean to no
longer be a viable option as she expedited the vaginal birth by bearing down
after being told not to do so.

[9] At the commencement of the Trial, Adv Maritz SC on behalf of the Plaintiffs,
recorded inter alia :

9.1 That the parties have reached agreement as to the separation of issues,
provided the Court approved, as stated in paragraph 2 of the Pretrial
minute pertaining to the Pretrial meeting held on the 3rd of February
2025;

9.2 The Plaintiffs and the Defendant have furthermore agreed that the joint
minutes between the vario us experts be placed on record as formal
admissions, as contemplated in the Civil Proceedings Evidence Act,
Act 25 of 1965 .

9.3 The parties furthermore agreed that, with reference to the discovered
medical records kept by and obtained from the Defendant, including
ultrasound scan printouts , pathology reports , hospital records and the

notes and observations of the nursing personnel and doctors who
attended to the First Plaintiff and the minor child at the Town Clinic
Modimolle and the FH Odendaal Hospital and contained in the trial
bundle , that such documents may be produced by the Plaintiff as
evidence in the trial and as constituting prima facie proof of the truth of
their content, without being required to call the author of such
document, but subject t o the parties’ right to lead oral evidence to rebut
the correctness of any fact, observation or finding recorded in such
document.

[10] Adv. Monthso -Moloisane SC confirmed the submissions. She furthermore
confirmed that the crux of the dispute is enunciated in paragraphs 7.8 and 7.9 of
the Plaintiffs’ Particulars of Claim wherein it is pleaded by the Plaintiff s that the
First Plaintiff was not referred to the hospital for medical assessment and
management after being diagnosed with a breech pres entation of the foetus
during her antenatal visits at the clinic, and the nursing personnel at FH Hospital
failed to palpate carefully for breech presentation and incorrectly diagnosed a
cephalic presentation with an engaged foetal head.

[11] The determinat ion of the issues was separated as agreed upon by the parties
and evidence was lead on the merits only.

Issues that require determination:

[12] This Court is only called upon to determine if the Defendant breached its legal
duty to render proper and appropriate medical treatment and exercise the
degree of skill and care which can reasonably be expected of a nurse or
medical practitioner in the pre vailing circumstances, resulting in damages being
suffered by the Plaintiffs as contemplated in the particulars of claim.


[13] As stated herein before, the determination of the quantum will be determined in
due course.

The Plaintiff’s witnesses:

[14] The First Plaintiff testified that she is the mother of the minor child. During her
34-week prenatal visit at the clinic, she was informed that the foetus (minor
child) was in a breech presentation . She did not receive an explanation as to
the meaning of ‘breech presentation’. She conducted online research to find
further information and learn ed that ‘breech presentation’ presupposes that the
baby has ‘turned around’.

[15] During her 38 -week visit at the clinic , she was told that her blood pressure was
high, and she recorded that her fingers are excessively swollen. There is no
record of any ob servation of the breech presentation.

[16] On the 19th of July 2019, she was taken to hospital after evidencing a bloody
excretion. She was advised by her aunt to go to hospital. Upon her arrival, she
handed the nurse her clinic card. The nurse did a vaginal examination
whereafter the First Defendant was informed that the ‘baby is still far’. At that
stage she was under the impres sion that the minor child has ‘turned around’
and that the birth would be uncomplicated.

[17] At approximately 8h45 am she was examined again. The nurse informed her
that she could not feel the baby’s head and the doctors had to be called.
Shortly hereafter , the doctor arrived and conducted a sonar. The First Plaintiff
was then informed that the minor child is in a breech presentation. She was
asked to complete and sign forms to perform a caesarean section .

[18] Hereafter, the was again examined by the doctor. She was then informed that
she will be moved to the labour ward so that she can be assisted with the labour

process. The First Plaintiff categorically denied that she was told not to bear
down. She was informed that if she has the urge to bear down, she should do
so.

[19] After some time, the doctor attended to her. She observed that she felt being
‘cut’ and the doctor’s hands ‘pulling the baby out ’. The minor child was shown
to her very briefly whereafter the nurse left with the minor child. No explanation
was proffered at this stage as to the health of the minor child.

[20] At approximately 12:00, a nurse collected her and took her to the ward. She
also informed the First Plaintiff that a doctor will take her to see her baby. At
21h00 pm, Dr . Malatji attended the First Plaintiff. This was the first time that
First Plaintif f was informed that the minor child was sti llborn and had to be
resuscitated. Dr. Malatji also informed the First Plaintiff that the minor child was
not doing well at all.

[21] During cross examination, the First Plaintiff did not waiver in her testimony
regarding the incident in question. This Court found the First Plaintiff a reliable
witness and accepted her testimony as truthful.

[22] The Plaintiffs hereafter called Dr. Dianne Philomin a du Plessis to testify. Dr. Du
Plessis testified as to her experie nce and knowledge in the field of midwifery.
She also confirmed that a joint expert report was compiled with the Defendant’s
expert, Prof. Livhumane Muthelo . Of particular importance is her testimony that
one must pay specific attention to the position o f a baby during the 34 – 36-
week prenatal visit. An experienced practitioner can easily ascertain the
position of the baby from an external examination. Experts of this calibre is
however seldom found at state hospitals. Midwifes are however obliged to call
a doctor to assist if they are unsure.


[23] Dr. du Plessis also testified that, h aving regard to the clinic records of the First
Defendant, it is clear that no proper examination was conducted as none was
recorded during the 36- or 38 -week prenatal visit. This information is critical to
record as it serves as a pre -indication that the birth may be difficult or
complicated and preventative measures can then be taken accordingly.

[24] Dr. Du Plessis further testified that it is extremely unlikely that a baby will turn or
change position after 36 weeks. At 36 weeks gestation, the head of the baby is
normally engaged in the pelvic area which makes it virtually impossible for the
baby to withdraw his / her head from the pelvic area and turn aroun d. A proper
assessment must therefore be done to ensure that the baby is still in the ideal
birth position (with his / her head facing downwards) . It does not appear from
the records that a proper assessment was done. In the absence of any
recorded information, it must be assumed that this was not done.

[25] Dr. Du Plessis conducted herself in a professional manner and displayed a
clear understanding of her area of expertise. No questions were initially posed
in cross examination of the witness. The Court allowed redirected questioning
after certain questions were posed by the Court. This redirected questioning
did not deter from the acceptability and reliability of the witnesses’ testimony.
Her testimony also aligned with her findings contained in her expert report and
the joint expert report referred to herein before , rendering her evidence
acceptable and reliable .

[26] Hereafter, the Plaintiff called Prof. J Anthony to testify. Prof. Anthony is a
registered Maternal and F oetal Medicine subspecialist and a registered
Obstetrician and Gynaecologist. He com piled a joint expert report in
conjunction with the Defendant’s expert, Dr. M Mbokota , a registered
Obstetrician and Gynaecologist.


[27] Prof. Anthony confirmed his observations and findings as set out in his expert
report and the joint expert report. It was put to Prof. Anthony during evidence in
chief that the First Plaintiff was informed at the 36 – 38-week prenatal visit, that
the baby was in a breech presentation. This evidence was not challenged as
being untrue or not credible. Prof. Anthony confirmed that the breech
presentation was correctly diagnosed when the sonar was taken at the hospital
on the 19th of July 2019.

[28] He also testified that , to facilitate an uncomplicated birth, the largest structure
must ideally be delivered first. This is the head. In some circumstances there
may be a discrepancy between the head and the buttocks leading to the
buttocks being stuck , but this does not jeopardize the baby’s health.

[29] In a breech presentation, the problem is that the feet are delivered first, leading
to the head being stuck in the vagina and being subject to compression. This is
what causes the potential complications to the baby. Prof. Anthony furthermore
testified that, in casu it was a feet breech presentation (as opposed to a buttock
breech presentation), which would not have caused an excessive urge to ‘push’
or ‘bear down’. There is no head or buttocks pushing down. In his view, even
where the feet can be observed , a caesarean can still be performed and is, in
fact, a dvisable to do specifically to avoid a situation where the head of the baby
may be stuck, causing asphyxiation.

[30] With reference to the literature bundle presented by the Plaintiffs during the
course of the trial, Prof. Anthony made specific reference to the Guideline for
Maternity Care in South Africa: A Manu al for Clinics, Community Health Centres
and District Hospitals (4th Edition, 2015) . He testified that this manual contained
the principles that should be applied and that there is an expectation tha t the
nurses and medical staff are familiar with it.


[31] According to Prof. Anthony’s observation, the failure to detect the breech
presentation led to a foreseeable chain of events . Had the First Plaintiff been
correctly diagnosed at the clinic , she would have been referred to the hospital
for counselling and to offer a caesarean. The manual referred to herein before
explicitly provides for a course of management to be performed once a patient
is diagnosed with a breech presentation in early labour . This includes the
transfer of the mother from a clinic or community health centre to hospital and
ensuring that the breech position is correctly diagnosed.

[32] Prof. Anthony also testified that the assessment that was done at approximately
4h38 am was incorr ect as it is impossible for the head to be engaged and within
a few hours for the baby to be a breech presentation. Assuming they
diagnosed the breech presentation correctly, the doctor would have been called
immediately, and the caesarean section would h ave been attended to shortly
thereafter . At the time when the First Plaintiff was presumably informed that the
minor child’s feet are showing and that a caesarean is no longer available, the
advice was also incorrect . The caesarean would only not be avai lable once the
torso is also out and only the head remains. It is clear that this was not the
case with the First Plaintiff.

[33] As the minor child’s head was stuck in the vaginal area , it resultantly led to
asphyxiation as it is the part that sustains life. The failure to adhere to the
minimum standard to be applied in instances of a breech presentation, directly
caused the unfortunate resulting brain damage to the minor child. Prof.
Anthony also testif ied that asphyxiation for a period exceeding 20 minutes may
lead to brain damage in 85% of babies. It is thus foreseeable that such a child
may suffer lasting damages. In Prof. Anthony’s view, the documentation
presented by the Defendant clearly shows th at they did not do what they were
supposed to do and when it was expected .


[34] During cross examination it was presented to Prof. Anthony that an inspection
of a patient must only be conducted every 4 hours and this was indeed done.
Prof. Anthony however h ighlighted that this applies only to normal
uncomplicated birth scenarios. Once a breech presentation has been
diagnosed, special precautions should be taken . In this instance, the failure to
diagnose and correctly identify the breech presentation led to a chain of events
that should have been foreseeable.

[35] It was furthermore put to Prof. Anthony that there w ere no prior diagnoses of
breech presentation. He categorically stated that it was highly improbable that
the recorded diagnosis was correct. The actions of the doctors and medical
staff did not constitute a n error of judgment. In re -examination he confirm ed
that an error of judgment is when it was a reasonable judgment, but it eventually
turned out to be wrong. In casu there was no reasonable judgment that was
exercised – the actions of the nursing and medical staff were simply wrong and
substandard .

[36] This Court also formed a favourable impression of Prof. Anthony. His evidence
was elucidating as to the fact that the records are incomplete, clearly showing
that the minimum care and skill was not displayed. The Court has no basis to
question the veracity of the evidence lead by this witness or that his expert
opinion is justified and correct, having regard to the factual synopsis .

[37] The Plaintiffs hereafter closed their case.

[38] The Defendant only called one witness, being Dr Chinono Tshilindo , the
medical practitioner who was on duty on the 19th of July 2019. She confirmed
that shortly before 9h00 am she was called by Sister Dikgomo from the
Maternity Ward. She conducted an examination on the First Defendan t and
saw that the baby was in a breech presentation. The First Defendant was
approximately 3 cm dilated at that stage. Dr. Tshilindo advised that a

caesarean section should be performed. For purposes thereof they required at
least three doctors. The F irst Defendant was re -examined by Dr. Kubjane who
advised that the feet are already out and that labour should therefore be
progressed with naturally .

[39] Dr. Tshilindo then took control of the First Defendant ’s delivery process. Once
she realised that the head was stuck, she called Dr. Ledwaba to assist. Dr.
Ledwaba took over the resuscitation of the neonate (minor child) after his birth.

[40] As to the monitoring of the foetal heartrate, she testified that she constantly
monitored the heart rate although no record was kept hereof. According to her
there was no paper in the machine and thus no reports could be printed.

[41] During cross examination, Dr. Tshilindo confirmed that, although she received
training in breech presentation births, she had no personal experience therein.
She also has no knowledge if Dr. Kutumela has any experience – she simply
accepted the advice that the birth should progress vaginally. She also accepted
that her failure to correctly note what transpired in detail, was wrong. There is
thus no record as to when Drs. Kutumela and Ledwaba were called or what
their observations or diagnosis was. Notwithstanding being confronted with the
evidence from the expert witnesses, Dr. Tshilindo persisted in her view that the
decision not to continue with the caesarean section was the correct decision at
the time as the baby’s feet was already out .

[42] Herea fter, the Defendant’s case was also closed.

[43] The Court did not find the witness to be of exceptional assistance to the
defence pleaded. The witness was obviously only performing instructions
provided to her by a senior colleague. She did not properly j ustify her decision
or rebut, in any way, the assumptions of negligence created by the expert
testimony.


The Applicable Legal Principles:

[44] There is no dispute that the Plaintiff s bear the onus regarding the disputed
issues. As to the question of negligence, the onus would be discharged were
the Plaintiff s to establish, on a balance of probability, that a reasonable medical
practitioner in the circumstances in which the nurses and/ or doctors at the
hospital found themselves would have foreseen the likelihood of harm occurring
(in this matter the likelihood of harm occurring to minor child ) and would have
taken steps to guard against its occurrence, and the practitioners concerned
failed to take such steps1. In the case of an expert, such as a surgeon, the
standard is higher than that of the ordinary layperson and the court must
consider the general level of skill and diligence possessed and exercised at the
time by the members of the branch of the profession to which the practitioner
belongs .2

[45] In Van Eeden v Minister of Safety and Security (Women’s Legal Centre
Trust as amicus curiae)3 it was clearly stated in respect of omissions:

‘The appropriate test for determining wrongfulness [of an omission] has
been settled in a long line of decisions in this court. An omission is
wrongful if the defendant is under a legal duty to act positively to prevent
the harm suffered by the plaintiff. The test is one of reaso nableness. A
defendant is under a legal duty to act positively to prevent harm to the
plaintiff if it is reasonable to expect of the defendant to have taken positive
measures to prevent the harm. ’

[46] In Minister of Safety and Security v Van Duivenboden4 Nugent JA said:

1 See Kruger v Coetzee 1966 (2) SA 428 (A)
2 See Mukheiber v Raath & Another 1999 (3) SA 1065 (SCA)
3 2003 (1) SA 389 (SCA) at 395


‘[12] Negligence as understood in our law, is not inherently unlawful – it
is unlawful, and thus actionable, only if it occurs in circumstances that the
law recognizes as making it unlawful. Where the negligence manifests
itself in a posi tive act that causes physical harm it is presumed to be
unlawful, but it is not so in case of a negligent omission. A negligent
omission is unlawful only if it occurs in circumstances that the law regards
as sufficient to give rise to a legal duty to avoi d negligently causing harm.
It is important to keep that concept quite separate from the concept of
fault. Where the law recognizes the existence of a legal duty it does not
follow that an omission will attract liability – it will attract liability only if the
omission was also culpable as determined by the application of the
separate test that has consistently been applied by this court in Kruger v
Coetzee, namely whether a reasonable person in the position of the
defendant would not only have foreseen t he harm but would also have
acted to avert it. While the enquiry as to the existence or otherwise of a
legal duty might be conceptually anterior to the question of fault (for the
very enquiry is whether fault is capable of being legally recognized),
never theless, in order to avoid conflating these two separate elements of
liability, one might often be helpful to assume that the omission was
negligent when asking whether, as a matter of legal policy, the omission
ought to be actionable.’

[47] According to Neethling and Potgieter5 the Appellate Division has now
expressed itself in favour of a flexible approach, in terms of which there is no
single criterion that can be applied to all situations.

[48] With reference to S v Mokgethi6 the learned writers stated that the basic
question is whether there is a close enough relationship between the

4 2002 (2) SA 431 (SCA) at para [12]
5 Neethling et al Neethling – Potgieter – Visser Law of Delict 7th edition Lexis Nexis at 200

wrongdoer’s conduct and its consequence for such consequence to be imputed
by the wrongdoer in view of the policy considerations based on reason ableness,
fairness and justice. The reasonable foreseeability of the damages is therefore
one of the factors that may be taken into consideration when determining if the
alleged wrongdoer should be held liable as long as justice prevails in the end.

[49] This Court is of the view that the nursing and medical staff of the Defendant
failed to correctly and timeously diagnose the breech presentation (first at the
clinic and thereafter at the hospital) , resulting in little to no preventative care
being taken as contemplated in the prescribed procedures. If the breech
presentation was properly identified and documented, it would have resulted in
the correct treatment being applied. The Defendant had numerous
opportunities to correct the course of treatment. The First Plaintiff was advised
that a caesarean section should be performed, only to be informed thereafter
that it was impossible as the birthing process has progressed too fa r. At this
stage, only the feet were showing. It is evident from the expert testimony that
this still allows for a successful caesarean section to be performed and, in fact,
would have prevented the resulting brain damages suffered by the minor child.

[50] As to the testimony of the Defendant’s sole witness, this Court is not convinced
that her actions in continuing with a vaginal birth, constitutes an error of
judgment. First and foremost, it was her testimony that she did not elect the
course of action. She was essentially instructed by a senior doctor to do so.
The Defendant elected not to call these critical witnesses to explain their
reasoning behind the decision. The law pertaining to errors of judgment are
clear:


6 1990 (1) SA 32 (A)

‘If a surgeon fails to measure u p to that standard in any respect ( ‘clinical
judgment’ or otherwise), he has been negligent and should be so
adjud ged.’ 7

[51] It is evident from the expert evidence that the unfortunate turn of events could
have been avoided. This Court agrees with the findings of the experts . The
eventual damages were caused because of asphyxiation. If the minor child was
born by means of a caesarean section, his head would not have been stuck in
the vaginal area, as a result whereof he would have been born without any
complications or adverse consequences. The actions of the employees of the
Defendant simply fell short of what can be reasonably be expected from
practitioners in their position and was negligent.

[52] The Court is therefore satisfied that the Plaintiffs have shown, on a balance of
probabilities, that the omissions and acts of the Defendant have resulted in the
Plaintiffs and the minor child suffering damages.

Costs:

[53] There is no reason why the cost order should not follow the outcome of the
proceedings. Both parties made use of senior counsel in this matter. Having
regard to inter alia the nature of the matter, the level of expertise required and
the importance of the case to the parties , costs consequent upon the
appointment of two counsels on Scale C is warranted.


Order:

[54] In the result the following order is made:

7 Per Lord Edmund Davies in Whitehouse v Jordan [1981] 1 All ER 267 at 121, cited with approval in
Pringle v Administrator, Transvaal 1990 (2) SA 379 (W)


54.1 In terms of the provisions of Rule 33(4) the issues arising from the
following paragraphs of the Plaintiffs’ particulars of claim and the
Defendant’s plea thereto, are hereby separated for initial
determination:

54.1.1 Paragraphs 1, 2, 3, 4, 5, 6, 7 and the introductory portion of
paragraph 8 (up to and including “suffered the injury and
consequent conditions” in that paragraph) and paragraph
14;

54.1.2 Paragraph 2 to 39 (insofar as paragraph 39 deals with the
introductory portion of paragraph 8 of the particulars of
claim) of the Defendant’s amended plea ;

54.1.3 The remaining paragraphs of the Plaintiffs’ pa rticulars of
claim dealing with the quantum of the plaintiffs’ claim, and
the remaining paragraphs of the Defendant’s plea,
including any future amendments to these paragraphs, to
be postponed sine die.

54.2 The Defendant is liable for 100% of the Plaint iffs proven or agreed
damages in the First Plaintiffs’ personal and representative
capacity and the Second Plaintiffs’ representative capacity as
parents of the minor child, T[...] N[...] B[...] B[...] , who was born on
the 19th of July 2019, which dama ges were suffered as a result of
the injury sustained by the minor child and consequences as
pleaded in the paragraphs of the particulars of claim referred to in
paragraph 1.1 above.


54.3 The Defendant is ordered to pay the Plaintiffs’ taxed or agreed
party and party costs on the High Court Scale up to date of this
order, which costs will include , but not be limited to:

54.3.1 The costs consequent upon obtaining the medico legal
reports and expert summaries and the reasonable
qualifying fees (if any) of:

54.3.1.1 Prof. J Lotz, neuro -radiologist;
54.3.1.2 Dr. S O’Hagan , neuro -radiologist;
54.3.1.3 Prof J Anthony, specialist obstetricia n and
gynaecologist and maternal and fetal specialist;
54.3.1.4 Dr. D du Plessis, nursing expert;
54.3.1.5 Prof. J Smith, paediatrician and neonatologist;
54.3.1.6 Dr. M Lippert, paediatric neurologist;
54.3.1.7 Dr. G Gericke, paediatrician and geneticist;
54.3.1.8 Dr. I Ferreira, pathologist

Of whom the Plaintiffs have given notice in terms of the
provisions of Rule 39(9)(a) and (b);

54.3.2 The costs consequent upon the employment of two
counsel on Scale C.

54.4 The following provisions shall apply regarding determination and
payment of the Plaintiffs’ abovementioned taxed costs:

54.4.1 The Plain tiffs’ attorney shall timeously serve the notice of
taxation on the Defendant’s attorney of record;


54.4.2 The Plaintiffs’ attorney shall allow the Defendant 30 (thirty)
days to make payment of the taxed costs from date of
settlement or taxation thereof;

54.4.3 Should payment of the Plaintiffs’ taxed or agreed costs not
be affected timeously, the Plaintiffs will be entitled to
recover interest at the mora interest rate, calculated from
the 31st calendar day, after the date of the Taxing Master’s
allocatur, or after the date of settlement of the costs, up to
date of final payment.


M BRESLER AJ
ACTING JUDGE OF THE HIGH COURT,
LIMPOPO DIVISION, POLOKWANE


APPEARANCES :

FOR THE PLAINTIFFS : Adv. NGD Maritz SC
Adv. MM Lingenvelder SC

INSTRUCTED BY : Josephs Inc
Johannesburg
mjoseph@josephs.co.za
marinda@josephs.co.za
benhardt@prattluyt.co.za

FOR THE DEFENDANT : Adv. LM Montsho -Moloisane SC
Adv. M Kgare


INSTRUCTED BY : The State Attorney
Polokwane
NonMnisi@justice.gov.za