MEC for Health, Gauteng v M.C.C - Appeal (10242/2017) [2023] ZAGPJHC 1384 (28 November 2023)
- Citation
- [2023] ZAGPJHC 1384
- Status
- Judgment
- Jurisdiction
- South Africa
- Court
- South Gauteng High Court, Johannesburg
- Panel
- SC Mia
- Case number
- 10242/2017
More details
- Court
- South Gauteng High Court, Johannesburg
- Panel
- SC Mia
- Case number
- 10242/2017
On this page
Professional case brief
Research organized from the available case record
01
Holding and result
The court found that the applicant had demonstrated reasonable prospects of success on appeal. The applicant raised substantial grounds regarding the prescription period and the nature of the alleged negligence, specifically whether liability could be attributed for an injury possibly occurring outside the pleaded period and whether the complication was a recognised risk of the procedure. The court considered the submissions of both parties and the principles governing medical negligence and leave to appeal. It concluded that the applicant should be granted leave to appeal to the Full Court, as the issues raised warrant further judicial consideration.
Court disposition
Leave to appeal granted to the Full Court of this Division with costs to be costs in the appeal.
Orders
- The applicant is granted leave to appeal to the Full Court of this Division.
- Costs to be costs in the appeal.
02
Material facts
Parties
MEC for Health, Gauteng
Applicant Counsel: T MasevheM[…] C[…] C[…]
Respondent Counsel: C Cremen03
Procedural history
Posture
Leave to Appeal / Application for Leave to Appeal After Judgment and Costs Order
04
Questions and positions
Legal issues
- 01
Whether the applicant should be held liable for the severance of the respondent's sphincter muscle allegedly occurring during delivery or subsequent surgery.
- 02
Whether the claim based on the episiotomy had prescribed before summons was issued.
- 03
Whether the applicant's surgeon was negligent in failing to recognise harm caused to the respondent's sphincter muscle.
- 04
Whether the court erred in its findings regarding the normal complications of fistulectomy and the standard for medical negligence.
- 05
Whether reasonable prospects of success exist for an appeal.
Party arguments
- Applicant
- The applicant argues that liability for the severance of the respondent's sphincter muscle should not be attributed to them, as the injury could have occurred during the delivery of the respondent's baby on 28 March 2013, which is outside the three-year prescription period before summons was issued on 27 March 2017. The applicant further contends that the court failed to consider the respondent's case as set out in the particulars of claim, which alleged negligence by the applicant's surgeon on 7 February 2014. The applicant asserts that the court erred in finding liability for an injury that the respondent specifically excluded from their claim and that severance of the sphincter muscle is a recognised complication of fistulectomy, not necessarily indicative of negligence.
- Respondent
- The respondent maintains that the applicant's surgeon was negligent in failing to recognise and treat the harm caused to the sphincter muscle on 7 February 2014. The respondent asserts that their claim did not include injuries arising from the delivery or the episiotomy performed on 28 March 2013, and that the applicant was afforded an opportunity to defend itself against the claim as pleaded. The respondent argues that the court correctly found liability based on the facts and evidence presented.
05
Court’s reasoning
Legal principles
- 01
Hucks vs Cole [1968] 118 New LJ at 469
A doctor is not to be held negligent simply because something went wrong during surgical operations or medical treatment; complications may occur even with the best will in the world.
- 02
Section 17(1)(a) of the Superior Courts Act 10 of 2013
Leave to appeal may only be granted where there is a reasonable prospect of success or compelling reasons exist, such as the interests of justice.
- 03
Mont Chevaux Trust v Goosen 2014 JDR 2325 (LCC); Ramakatsa and Others v African National Congress and Another [2021] ZASCA 31
The test for leave to appeal is whether reasonable prospects of success exist, as articulated in Mont Chevaux Trust v Goosen and Ramakatsa and Others v African National Congress and Another.
06
Ratio, limits and disposition
Ratio decidendi
The court found that the applicant had demonstrated reasonable prospects of success on appeal. The applicant raised substantial grounds regarding the prescription period and the nature of the alleged negligence, specifically whether liability could be attributed for an injury possibly occurring outside the pleaded period and whether the complication was a recognised risk of the procedure. The court considered the submissions of both parties and the principles governing medical negligence and leave to appeal. It concluded that the applicant should be granted leave to appeal to the Full Court, as the issues raised warrant further judicial consideration.
Obiter and limits
- The court noted that distinguishing anatomical structures during surgery may be complicated by sepsis, and complications such as sphincter muscle severance are recognised risks.
- The interests of justice may require that appeals be entertained even where prospects of success are not clear-cut, provided compelling reasons exist.
Court disposition
Leave to appeal granted to the Full Court of this Division with costs to be costs in the appeal.
- The applicant is granted leave to appeal to the Full Court of this Division.
- Costs to be costs in the appeal.
Source and reliance status
South Gauteng High Court, Johannesburg
This page organises the available record for research. Confirm quotations, current status, and subsequent treatment against the official source before relying on the case.
Judgment reading view
Judgment text
The complete available source text.
South Gauteng High Court, Johannesburg
Judgment
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
GAUTENG LOCAL DIVISION, JOHANNESBURG
Case Number: 10242/2017
REPORTABLE: NO
OF INTEREST TO OTHER JUDGES:NO
Date: 28 November 2023
In the matter between: THE MEC FOR HEALTH, GAUTENG Applicant And M[…] C[…] C[…] Respondent
JUDGMENT
[1] The applicant appeals against the whole judgment and costs order delivered on 25 April 2023. The applicant appeals on the basis that the court erred on various grounds :
By holding the applicant liable for severance of the respondent’s sphincter muscle, that event could have occurred at the time of delivery of the respondent’s baby during the cutting and suturing of the episiotomy. When such delivery occurred on 28 March 2013, the period falls outside the prescription period of three years before the issue of summons on 27 March 2017. A claim based on the episiotomy would have accordingly prescribed on 28 March 2016. It contends the applicant ought not to be held liable for such injury, which could possibly have occurred 4(four) years earlier than the issue of the summons.
[2] The applicant contends that the court failed to consider the respondent's case, as articulated in the particulars of the claim; the applicant's surgeon was negligent in failing to recognise the harm they caused to the respondent's sphincter muscle on 7 February 2014. Furthermore, the court erred in holding the applicant liable for severance of the respondent’s sphincter muscles that could have occurred at the time of delivery of the baby during the cutting and surturing of the episiotomy. The delivery occurred on 28 March 2013. As such, this period occurred outside of and before the issue of the summons. A claim based on the episiotomy would accordingly have prescribed on 28 March 2016. The applicant could not be held liable for such injury, which occurred four years earlier than the issue of summons.
[3] It is also contended that the court erred in failing to consider the respondent’s case as set out in the particulars of the claim, where it alleged that the applicant’s surgeon was negligent in failing to recognise the harm caused to the sphincter muscle on 7 February 2014. The court erred in finding the applicant liable for the sphincter injury that occurred at the time of delivery when the respondent specifically excluded that period from its particulars of claim, opening address and during the trial. Thus, it denied the applicant an opportunity to defend itself against a claim based on cutting or suturing of the episiotomy.
[4] The court erred in finding that Dr Francis did not see the red-striated muscle of the internal anal sphincter. Dr Francis explained it was difficult to distinguish between anatomical structures as sepsis distorted them. Dr Francis said that despite the distorted anatomy, he could see the red sphincter muscle. The court erred in failing to accept that severance of the sphincter muscles is a recognised and normal complication of a fistulectomy. The surgeon cannot be held liable for the causation of such a normal complication. Thus, the court did not consider the trite principle in medical negligence cases that “ with the best will in the world things sometimes went amiss in surgical operations or medical treatment. A doctor was not to be held negligent simply because something went wrong”[1].
[5] The established test for leave to appeal encompassed in section 17(1)(a) of the Superior Courts Act 10 of 2013 posits whether reasonable prospects of success exist; the tests refer to are the oft-cited Mont Chevaux Trust v Goosen[2] and Ramakatsa and Others v African National Congress and Another[3] where the Supreme Court of Appeal indicated that there might be reasons to entertain an appeal:
[10] Turning the focus to the relevant provisions of the Superior Courts “Act[5] (the SC Act), leave to appeal may only be granted where the judges concerned are of the opinion that the appeal would have a reasonable prospect of success or there are compelling reasons which exist why the appeal should be heard such as the interests of justice.[6]
[6] I have considered the submissions made by both counsel, which I thank them for. Having considered the reasons in my judgment dated April 2023 and counsel submissions, I am of the view that the applicant has reasonable prospects of success on appeal.
ORDER
[7] Consequently, I grant the following order:
1. The applicant is granted leave to appeal to the Full Court of this Division with costs to be costs in the appeal.
SC MIA
JUDGE OF THE HIGH
COURT
JOHANNESBURG
For the Applicant: T Masevhe Instructed by State Attorney For the Respondent: C Cremen Instructed by Houghton Haper Inc Heard: 03 November 2023 Delivered: 28 November 2023
[1] Lord Denning MR in Hucks vs Cole [1968] 118 New LJ at 469
[2] 2014 JDR 2325 (LCC) at para 5 and 6
[3] [2021] ZASCA 31 (31 March 2021) Para 10
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