In the recent judgment LPM obo LM v MEC for Health: North West Provincial Government (2058/2019) [2026] ZANWHC 92 (31 March 2026), the High Court dealt with a medical negligence claim arising from injuries sustained during childbirth at Klerksdorp Hospital. The plaintiff brought the claim in her representative capacity as mother and natural guardian of her minor child, seeking to hold the defendant vicariously liable for the negligent conduct of its employees.
The minor child was born on 31 August 2013 at Klerksdorp Hospital and was subsequently diagnosed with cerebral palsy, mental retardation and epilepsy, consequent upon a hypoxic-ischaemic insult due to birth asphyxia and/or hypoxia. The child further presents with developmental delays, speech deficits and behavioural problems.
The plaintiff alleged that the defendant owed a duty of care to ensure that its employees provided medical treatment with the diligence reasonably expected of qualified medical practitioners and nursing staff, and that hospital staff were negligent in their treatment of her and the minor child during labour and delivery. The defendant denied that the plaintiff was in labour at the time of admission, denied that a caesarean section was warranted, pleaded that both the plaintiff and the minor child were adequately monitored throughout labour, which it contended lasted 22 hours and was not prolonged.
The defendant also raised a plea of contributory negligence on the basis of the plaintiff's alleged failure to exert sufficient maternal effort, her late attendance at antenatal care and the presence of a vaginal infection treated with antibiotics in early labour.
The Court found that the injury probably occurred intrapartum, shortly before delivery. The hospital staff did not adequately monitor the plaintiff or the fetal condition, effectively leaving her unattended. Despite a diagnosis of fetal tachycardia, the doctor on call failed to review her condition after being alerted by nursing staff. The staff misinterpreted the CTG tracings and failed to diagnose fetal distress. As a result, they administered oxytocin when contraindicated, failed to diagnose or exclude cephalopelvic disproportion (CPD) and failed to initiate intrauterine resuscitation or perform an emergency caesarean section. The Court held that a reasonable person in the position of the defendant's employees would have foreseen the risk of harm and taken steps to prevent it.
The defendant's contributory negligence argument was rejected. The agreement between the paediatricians, confirmed by the obstetrician-gynaecologists, established that there were no antenatal risk factors for a hypoxic-ischaemic injury. This excluded any suggestion that the plaintiff's failure to attend antenatal care contributed to the outcome.
Accordingly, the defendant was found liable for 100% of the plaintiff's proven or agreed damages arising from the hypoxic-ischaemic brain injury, manifesting as cerebral palsy, sustained as a result of the negligent conduct of the medical and nursing personnel at Klerksdorp Hospital.
In light of the defendant's conduct throughout the proceedings, described by the Court as “shocking” and reflecting an ill-conceived and constantly shifting stratagem to frustrate the process, a punitive costs order was granted on the attorney-and-client scale.
The judgment serves as a reminder that medical practitioners must monitor patients diligently throughout labour and act decisively upon warning signs. A defence based on lack of maternal effort will not avail a defendant where objective expert evidence establishes systemic failures in care. This case is one of many reflecting the documented rise in medico-legal claims against public hospitals. At a broader level, this trend reflects a misalignment between legal accountability and system capacity, resulting in preventable errors in an under-resourced healthcare system.
