On Thursday, October 31, the Nelspruit Magistrate’s Court heard spine-chilling evidence from the trauma doctor who declared Letisia Niemann dead five years ago.

This 38-year-old Mbombela businesswoman was killed in a harrowing hit-and-run incident outside Mustangs – The Dancing Place in September 2019. The accused, Johan Louwrens (28), allegedly hit Niemann with his white Toyota Hilux bakkie, before reversing over her and fleeing the scene.

Niemann was taken to hospital in a critical condition. She clung to life for about two hours while the trauma team fought valiantly to save her, before ultimately bleeding out internally.

On Thursday, the court heard how blunt force trauma had caused organ rupture, which led to internal bleeding and eventual cardiac arrest and death.

Although the trauma team was able to bring her back from the first cardiac arrest, the internal bleeding caused her heart to stop for a second time, from which she was unable to recover. This happened before the team was able to perform a computed tomography (CT) scan to locate the source of the bleeding and repair it in theatre.

ALSO READ: Hit-and-run: Five years and still no justice for Letisia

Dr Mukadi Kabamba, who at the time of the incident had already amassed 20 years’ experience as a casualty doctor, gave a detailed description of the condition he had received Niemann in and the life-saving procedures they performed. He told the court Niemann was brought to the Kiaat Private Hospital by ambulance at 23:56 on September 28, 2019, in a critical condition. She had sustained multiple injuries, was in a coma and was unstable. Unable to sufficiently breathe on her own, Niemann was being manually ventilated with an Ambu bag.

Kabamba told the court he assessed her and observed that her blood pressure was unreadable. She had a heart rate of 40 beats per minute and a respiratory rate of 10 cycles per minute. Her extremities were cold, the oxygen saturation had dropped to an alarmingly low 56% and her Glasgow Coma Scale reading was three (out of a possible 15), indicating she was unresponsive.

Both Niemann’s pupils were dilated and non-reactive to light. She also had multiple bruises on her forehead and chin, a bruised right middle finger and an abrasion on her left forearm.

Amid Niemann’s sister, Lizel Boshoff’s sorrowful sobbing echoing from the gallery, Kabamba told the court about the horrific degloving injury she had sustained to the right side of her chest – thought to be caused by the movement of the bakkie wheel as it rolled onto her chest, peeling off the skin.

The court further heard that a urinary catheter was inserted immediately after the assessment to drain urine and, in an effort to improve her oxygen saturation, Niemann was intubated with a 6.5mm endotracheal tube and connected to a ventilator. That is when the first of the two cardiac arrests occurred. Kabamba told the court she was also administered adrenaline to help restart the heart, and the team performed two cycles of cardiopulmonary resuscitation before he eventually declared her dead at 01:20 the next morning.

Although she had consistently been receiving fluids via an peripheral intravenous (IV) line to keep blood circulating through her body, it was not enough, and Niemann’s heart eventually pumped on empty, which caused it to stop for the last time.

The matter was postponed to November 21 for further arguments and possible judgment in the trial-within-a-trial related to the admissibility of an admission made by the accused.

ALSO READ: Key testimony in Mbombela trial for 2019 hit-and-run case