N.K v Member of the Executive Council for Health, Eastern Cape - Application for Leave to Appeal (502/2017) [2023] ZAECBHC 24 (15 August 2023)
- Citation
- [2023] ZAECBHC 24
- Status
- Judgment
- Jurisdiction
- South Africa
- Court
- Eastern Cape High Court, Bhisho
- Panel
- Zilwa
- Case number
- 502/2017
More details
- Court
- Eastern Cape High Court, Bhisho
- Panel
- Zilwa
- Case number
- 502/2017
On this page
Professional case brief
Research organized from the available case record
01
Holding and result
The applicant failed to provide expert psychiatric or psychological evidence to substantiate her claim of psychological injury resulting from the traumatic birth and subsequent care of her brain-damaged child. The court held that lay evidence and the reports of non-psychiatric experts were insufficient to prove a detectable psychiatric lesion, as required by established precedent. The authorities cited make clear that damages for psychological injury require expert evidence, and the applicant's failure to provide such evidence was fatal to her claim. The court further found no reasonable prospect of success on appeal, nor any compelling reason to grant leave, and dismissed the application with costs.
Court disposition
Application for leave to appeal dismissed with costs.
Orders
- The application for leave to appeal is dismissed.
- The applicant is ordered to pay the costs of the application.
02
Material facts
Parties
N[...] K[...]
Applicant Counsel: Dugmore SC with MalungaMember of the Executive Council for Health, Eastern Cape
Respondent Counsel: Kunju SC03
Procedural history
Posture
Leave to Appeal / Application for Leave to Appeal Following Dismissal of Personal Damages Claim in Medical Negligence Action.
04
Questions and positions
Legal issues
- 01
Whether the applicant established a prima facie case for leave to appeal against the dismissal of her personal damages claim.
- 02
Whether the absence of expert psychiatric evidence precluded the upholding of the applicant's personal claim for psychological injury.
- 03
Whether the court a quo erred in its treatment of undisputed evidence and relevant precedent.
- 04
Whether costs were correctly awarded against the applicant in respect of her personal claim.
Party arguments
- Applicant
- The applicant contended that the court a quo failed to properly consider undisputed evidence supporting her personal claim, including her diagnosis of depression following the traumatic birth and ongoing care of her brain-damaged child. She argued that the court erred by requiring expert evidence for her psychological injuries, referencing the Nkamela case, and that the reports of Drs Ebrahim and Redfern should have been considered as supporting her claim. She further submitted that costs should not have been awarded against her as no additional costs were demonstrated.
- Respondent
- The respondent maintained that the applicant failed to discharge the onus of proof for her personal claim, as no expert psychiatric or psychological evidence was led to substantiate the alleged psychological injury. The respondent argued that lay evidence alone is insufficient for such claims, and that the authorities require proof of a detectable psychiatric lesion. The respondent further contended that the costs order was appropriate given the failure of the personal claim.
05
Court’s reasoning
Legal principles
- 01
Barnard v Santam Bpk [1998] ZASCA 84; 1999 (1) SA 202 (SCA) at 216E-F
A claimant seeking damages for psychological or psychiatric injury must prove a detectable psychiatric lesion, typically through expert evidence.
- 02
Road Accident Fund v Sauls 2002 (2) SA 55 (SCA)
Liability for psychiatric injury requires proof of a recognisable psychiatric lesion, not mere nervous shock or trauma.
- 03
Komape v Minister of Basic Education 2020 (2) SA 347 (SCA)
In claims for psychological injury, expert psychiatric evidence is generally required to substantiate the existence of the injury.
- 04
Section 17(1)(a) of the Superior Courts Act 10 of 2023
Leave to appeal may only be granted where there is a reasonable prospect of success or some other compelling reason.
- 05
Four Wheel Drive Accessory Distributors CC v Rattan NO 2019 (3) SA 451 (SCA) at 463F
The focus in leave to appeal applications is whether there is a sound, rational basis for concluding that the appeal has reasonable prospects of success.
- 06
MEC for Health, Eastern Cape v Mkhitha and Another (1221/2015) [2016] ZASCA 176 (25 November 2016)
Leave to appeal should not be granted unless there truly is a reasonable prospect of success or another compelling reason.
06
Ratio, limits and disposition
Ratio decidendi
The applicant failed to provide expert psychiatric or psychological evidence to substantiate her claim of psychological injury resulting from the traumatic birth and subsequent care of her brain-damaged child. The court held that lay evidence and the reports of non-psychiatric experts were insufficient to prove a detectable psychiatric lesion, as required by established precedent. The authorities cited make clear that damages for psychological injury require expert evidence, and the applicant's failure to provide such evidence was fatal to her claim. The court further found no reasonable prospect of success on appeal, nor any compelling reason to grant leave, and dismissed the application with costs.
Obiter and limits
- The court declined to follow the result in Nkamela obo Okuhle Nkamela v MEC for Health, Eastern Cape Province to the extent that it conflicted with Supreme Court of Appeal authority.
- A mere possibility of success or an arguable case is not sufficient for leave to appeal; there must be a sound, rational basis for concluding reasonable prospects of success.
Court disposition
Application for leave to appeal dismissed with costs.
- The application for leave to appeal is dismissed.
- The applicant is ordered to pay the costs of the application.
Source and reliance status
Eastern Cape High Court, Bhisho
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.
Eastern Cape High Court, Bhisho
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
IN THE HIGH COURT OF
SOUTH AFRICA
(EASTERN CAPE DIVISION, BHISHO)
CASE NO. 502/2017
REPORTABLE:YES/NO
In the matter between: N[…] K[…] Plaintiff and THE MEMBER OF THE EXECUTIVE COUNCIL FOR HEALTH, Defendant
EASTERN
CAPE
JUDGMENT ON
APPLICATION FOR LEAVE TO APPEAL
ZILWA J
[1] Pursuant to the dismissal of the applicant’s damages claim in her personal capacity in a medical negligence action in which she had brought an action, both in her personal as well as in her representative capacity on behalf of her minor child, the applicant seeks leave to appeal to the Full Court of this Division.
[2] The basics upon which the leave to appeal is sought are the following:
2.1 The Court a quo failed to have any or sufficient regard to the undisputed evidence before Court supporting on a balance of probabilities the existence and merits of the plaintiff’s personal claim.
2.2 The Court a quo failed to have any or sufficient regard to the undisputed evidence from the plaintiff that she had been diagnosed with depression in consequence of the traumatic events relating to the birth of her child and the ensuing onerous duties of caring for a brain damaged child, and that the plaintiff had been receiving medical treatment in respect of such depression.
2.3 Having found that by reason of the negligence of the servants of the defendant the plaintiff had endured a severely complicated intrapartum stage and birth process, and that it was evident and undisputed on the record that following the birth of the plaintiff’s severely brain damaged child with far-reaching sequelae placing a burden on the plaintiff as the primary caregiver of the minor child, the Court erred in failing to uphold the plaintiff’s personal claim.
2.4 The Court a quo erred in failing to apply the salutary approach to the issue of the plaintiff’s personal claim as contained in the similar matter of Nkamela obo Okuhle Nkamela v MEC for Health, Eastern Cape Province (308/2018) [2022] ZAECBHC 15 (31 May 2022) especially at paragraph [13].
2.5 The Court a quo erred in the circumstances of this matter, in holding that the plaintiff’s personal claim could not be upheld without expert evidence.
2.6 The Court a quo erred in not having any or sufficient regard to the contents of reports from the witnesses Ebrahim and Redfern, which were tendered in evidence, which reflects on the condition of the plaintiff’s child and the consequences thereof on the plaintiff.
2.7 The Court a quo erred in failing to uphold the plaintiff’s personal claim on the evidence before it.
2.8 The Court a quo erred in awarding costs in respect of the plaintiff’s personal claim against the plaintiff in circumstances where no additional costs relating to the conduct of this claim were demonstrated or shown to exist.
[3] As indicated in paragraph [3] of the judgment the applicant’s claim in her personal capacity is premised on the contention that in consequence of the respondent’s pleaded negligence she had experienced severe psychological and / or psychiatric shock and trauma and will continuously experience same in future.
[4] On trite legal principles in order to succeed in such claim the applicant had the onus to prove her claim and damages at the required scale of the balance of probabilities.
[5] There was a duty on the applicant to substantiate her claim by proving the alleged severe psychological and / or psychiatric shock and trauma that she claimed to have suffered and will allegedly continued to experience in the future.
[6] Such proof would, of necessity, entail the leading of expert evidence. To succeed, in her claim the plaintiff had to prove that she sustained a detectable psychiatric injury which is not trivial.[1]
[7] The applicant is a lay person and there is no suggestion that she has any expertise that would enable her to diagnose herself of the alleged ailments. A Claimant cannot simply make bald and unsubstantiated allegations of psychological and / or psychiatric shock and trauma that allegedly exists in the present and that will persist in the future. This requires proper accompanying diagnosis from relevant experts such as psychiatrists and psychologists.
[8] It is common cause that in this case no such expert evidence from any psychiatrists or psychologists has been led by the plaintiff to substantiate her claim of having sustained the alleged psychological and / or psychiatric shock and trauma. The mere ipse dixit by the lay applicant to have suffered such injuries has no evidential value that would ground a damages award in her favour for such alleged but unsubstantiated injuries. This is a specially so where the applicant in her evidence had alleged that there are many things that cause her depression. The condition of her child whose claim was upheld in the trial, is one of them.
[9] There is a faint suggestion in the applicant’s notice of application for leave to appeal that the evidence of the expert witnesses, Drs Ebrahim (Obstetrician and Gynaecologist) and Redfern (Paediatrician) about the condition of the plaintiff’s child and the consequences thereof on the plaintiff should somehow be used as proof that the plaintiff has suffered the alleged psychological and psychiatric shock. None of those experts claimed to have any expertise in psychological or psychiatric issues and there was no suggestion in their expert notices that their testimony would be also used to also prove psychological and psychiatric shock and trauma on the part of the plaintiff. It is hardly surprising that in argument Mr Dugmore SC did not attempt to rely on their testimony as expert proof of the alleged psychological and psychiatric shock and trauma on the applicant. Such argument would have been totally devoid of basis or merit.
[10] In Barnard v Santam Bpk[2] it was held that the existence of a recognisable psychological lesion in a claim that is based on a serious psychiatric injury should, as a rule, be proved by supporting psychiatric evidence. No such evidence was led in this case.
[11] In Road Accident Fund v Sauls[3] it was held that in order to be successful in a claim such as the one in issue herein the applicant has to prove, not mere nervous shock or trauma, but that she had sustained a detectable psychiatric injury.
[12] In Komape v Minister of Basic Education[4] the SCA held at paragraph 45 that liability (in a case such as the present) can only follow if there is a psychiatric lesion. As indicated above no such evidence has been led in casu.
[13] During argument reference was made by applicant’s Counsel to the case of Nkamela obo Okuhle Nkamela v MEC for Health – Eastern Cape Province[5] and in particular to paragraph [13] thereof. The factual matrix in that judgment for the upholding of the plaintiff’s claim in her personal capacity is not apparent in the judgment itself. In any event, in the event that the factual matrix therein is similar to the one in casu I would respectfully decline to follow the result therein in so far as it would be at odds with the SCA judgments and other judgments
referred to above.
[14] Section 17(1)(a) of the Superior Courts Act 10 of 2023 provides that leave to appeal may only be given where, inter alia, the Court is of the opinion that the appeal would have a reasonable prospect of success. In Four Wheel Drive Accessory Distributors CC v Rattan NO[6] it was held that the focus of the Court must be on whether the appeal would have a reasonable prosect of success. There must be a sound, rational basis for any conclusion to that effect.
[15] I am not persuaded that the applicant would have a reasonable prospect of success on the contemplated appeal.
[16] In MEC for Health, Eastern Cape v Mkhitha and Another[7] the SCA reiterated that leave to appeal must not be granted unless there truly is a reasonable prospect of success or there is some other compelling reason why the appeal should be heard. A mere possibility of success, an arguable case or one that is not hopeless, is not enough. There must be a sound, rational basis to conclude that there is a reasonable prospect of success on appeal.
[17] For the reasons stated above I am not in the least persuaded that the present contemplated appeal would have a reasonable prospect of success or that there is some other compelling reason why it should be heard.
[18] In the result the application for leave to appeal is dismissed with costs.
P ZILWA
JUDGE OF THE HIGH
COURT
BHISHO
Counsel for the Applicant: Adv. Dugmore SC with Adv Malunga Instructed by: Messrs Sakhela Inc. 54 Steward Drive Baysville
EAST
LONDON Counsel for the Respondents: Adv. Kunju SC Instructed by: The State Attorneys Old Spoornet Building 17 Fleet Street
EAST
LONDON Date Heard: 04 August 2013 Judgment Delivered: 15 August 2013
[1] Bester v Commercial Union Versekeringsmpy van Suid Afrika Bpk 1973 (1) 769 (A) at 782 and 799.
[2] [1998] ZASCA 84; 1999 (1) SA 202 (SCA) at 216E - F
[3] 2002 (2) SA 55 (SCA).
[4] 2020 (2) SA 347 (SCA).
[5] (308/2018) [2022] ZAECBHC 15 (31 May2022).
[6] 2019 (3) SA 451 (SCA) at 463F.
[7] (1221/2015) [2016] ZASCA 176 (25 November 2016).
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