Union wants doctors back at work

The South African Medical Association Trade Union (Samatu) in Mpumalanga slammed the health minister, Dr Aaron Motsoaledi, and his department for suspending two doctors at the Evander Hospital.

This came after the two doctors allegedly performed a caesarean section on a teenage woman in the labour ward of the hospital.

The 19-year-old Ms Sesi Malaza was in labour when she was admitted to the Evander Hospital on 6 July.

Her family members were later informed that the baby had died and that Ms Malaza was flown with a helicopter to a private hospital in eMalahleni.

Ms Malaza later died in the private hospital.

Dr Motsoaledi suspended the doctors and said the suspension was based on the seriousness of the allegations levelled against the two doctors and the department believes that their presence at work might jeopardize the probe into the alleged misconduct.

“We regard the alleged conduct of these doctors as serious as they point to gross negligence and therefore an investigation must be launched to determine the facts before an appropriate action is taken,” he said.

Samatu said the two doctors made a brave decision after Ms Malaza had intractable seizures and did not respond to accepted standard management measures and went into cardiac arrest in the ward while emergency services where waited to transfer the patient to a higher level of care.”

They said there was insufficient time to transfer the patient to the operating theatre, because every second that elapsed resulted in diminishing chances of survival for both mother and baby.

Ms Karen Baumgart, Lowveld Branch of Samatu, said without any maternal heartbeat, the doctors duly commenced CPR to try and revive the heart of the mother.

“An immediate decision was made that an emergency caesarean section was required if there was to be any chance of saving the life of the baby, who still had a heartbeat and was alive at the time.

“It was further appreciated that the immediate delivery of the baby held the only accessible chance of stopping the seizures that the mother had been suffering from, which at that time had led to cardiac arrest.

“In other words, the deterioration and cardiac arrest forced the attending doctors to do on an immediate basis what they knew would be done at the receiving centre of higher care, because of the progressive deterioration in the maternal condition.”

Ms Baumgart said the statement published by the Department of Health which said that the doctors concerned have a “tendency to disregard clinical instructions” with impunity, is an unfounded, prejudicial and highly accusatory statement that simply cannot be made without formal investigation and due process.

“Instead of an objective, unbiased appraisal of the relevant facts, the published reports have emphasised aspects of the patient’s management that are likely to be viewed negatively by members of the public, irrespective of whether they were appropriate or necessary in this particular case.”

She said unilateral reporting of selected details of this event in the media by the Department of Health is very misleading and borders on sensationalism, calculated to demonize the attending doctors in the eyes of the public before any formal investigation or proceedings have even begun.

“A visit to the institution concerned by the Health Ministry without the knowledge or presence of the doctors concerned cannot be regarded as being a part of any formal investigation.

“The limited information publicised by the Ministry of Health is likely to form negative impressions of these doctors’ actions in the minds of those members of the public who do not have access to sources of current obstetric information or formal training in this specialised field.

“A balanced and responsible report would have informed that the practice of a perimortem çaesarean section in cases where the mother appears lifeless, is well documented in medical and obstetric literature and that the specific situations in which it is indicted are comparable to the one that these doctors were confronted with.”

Samtu further said both doctors involved are experienced clinicians, the senior one having 15 years of clinical experience and are the only doctors in the institution who have diplomas in obstetrics, an intensive post-graduate practical obstetric qualification that is second in academic ranking to a formal specialist qualification in obstetrics and gynaecology) and are thus formally trained in this field to a higher degree than any other doctor who is not a specialist in obstetrics and gynaecology, including those in the management of the institution who have called these doctors’ conduct into question.

“Both doctors are trained in the essential steps in the management of obstetrics emergencies (Esmoe) course, which is the standard that guides the management of obstetric emergencies at district level hospitals in South Africa.

“The senior doctor involved is in fact a master trainer at Esmoe and is fully familiar with the theory and practice of these guidelines.”

Ms Baumgart said the trade union is deeply disappointed by the reckless utterances by Dr Motsoaledi, which suggest that these doctors should be criminally charged.

“Samtu regards these statements as premature and misguided.

“It is irresponsible and unprocedural for the Minister of Health, who is vested with state authority to make such pronouncements in the media because this has the potential to unduly influence the outcome of any investigation into the case.

“The Minister, in his utterances, charges and convicts these doctors without any regard for the due process.

“No objective consideration had been taken into account when making such an inflammatory statement which seeks to sensationalise what really transpired.

“It is procedurally unacceptable to preempt findings of an investigation that is ongoing.”

Samwu demanded that these doctors should be fully reinstated to their positions and that all criminal charges laid against them be withdrawn pending the outcome of an appropriate investigation.

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