Home | News | WIDOW WINS E1.6M SUIT AGAINST PSYCHIATRIC CENTRE

WIDOW WINS E1.6M SUIT AGAINST PSYCHIATRIC CENTRE

15/04/2014 04:27:00 BY PHEPHILE MOTAU

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MBABANE – A widow who was suing the National Psychiatric Hospital for over E1.6 million for negligence has won the case at the High Court.
Ncamisile Eunice Tsela was demanding E1 690 922 from the institution after she was injected in the arm and later had to be amputated because of complications emanating from the injection.

The claim was predicated on negligence of the staff of the psychiatric centre, who were acting within the cause and scope of their employment and administered an injection in Tsela’s artery, which caused here severe vascular injury, leading to gangrene and amputation of her right arm.
The judgment was delivered by Justice Esther Ota and the plaintiff was represented by M.S Dlamini, while Sanele Khuluse appeared for the Crown.

According to court documents, On November 27, 2007, Ncamisile was praying and speaking in tongues, and was suspected by her relatives to be mentally unstable. Her mother, Mthengwa Tsela and her uncle, with the help of some police officers, took her to the National Psychiatric Hospital in Manzini.

The medical report showed that Ncamisile was violent towards her relatives, laughing to herself and praying for people continuously.
“At the hospital, two injections were administered on the plaintiff by a nurse, one in her right arm and the other in her buttocks. Plaintiff and her mother told the court that the plaintiff’s right hand was normal when they arrived at the hospital and prior to the injection.

“They also told the court that before the nurse administered the injection on plaintiff’s right arm, she made a comment as to whether she would be able to find a vein. This notwithstanding, the nurse proceeded to administer the injection,” reads the court document.

The judge said she came to the conclusion that the psychiatric centre staff members failed to employ the requisite care and skill required of the members of the medical profession in administering the injection.

Negligent

“I find that the staff of the first defendant were negligent in administering the injection into the plaintiff’s artery, which caused her severe vascular injury leading to gangrene and the consequent amputation of her right arm. The defendants are thus, liable for the injury occasioned to the plaintiff,” Judge Ota concluded.
Witnesses for the plaintiff in the matter were Mthengwa and Dr M Jere, an Orthopaedic surgeon at the Mbabane Clinic. The defendant called only one witness, Dr Violet Mwanjali, a Psychiatrist based at the National Psychiatric Hospital.
Justice Ota said from the totality of the evidence led, when Ncamisile was taken to the psychiatric hospital, she had no physical injuries on her right arm.

“Doctor Jere, who is a qualified Orthopaedic Surgeon and registered as such to practice in Swaziland since 1995, and who in my view has adequate experience in this field of endeavour, testified that in his opinion the gangrene must have been caused by the injection of the plaintiff into an artery which caused severe arterial vascular injury or consequent, compartment syndrome that caused loss of blood supply,” Justice Ota said.
The doctor’s evidence carried that there are different types of injections.

There is the Intramuscular injection given through the muscle and the supercutaneous injection given through the tissue just below the skin between the skin and the muscle.
There is also intravenous injection, selectively given through the vein and in very rare occasions, there is intra-arterial injection given through the artery.
This is given in selected circumstances and is usually given by doctors. Dr Jere also submitted that if a patient came to the hospital with a swollen arm, the proper procedure would be for the nurses to consult the doctors to ascertain the nature of the swelling before administering any injections.
Dr Mwanjali, testified that while Dr Jere’s opinion may be correct, it fails to address the issue of blunt trauma.

She stated that there are two main types of injuries, namely; perforated injury, whereby a wound is visible and blood comes out and blunt injury where an injury is not visible and there is no blood coming out. She further testified that blunt injury is common among violent patients, for example, when such patients strike furniture with their body parts.

“As the case lies, there is no evidence led by the first defendant in proof of the fact that they employed the requisite care, skill and precaution expected of members of the nursing profession in administering the injection. The medical evidence by Dr Mwanjali does not qualify as such. It merely tells us what may have caused the injury but does not explain what was done during the treatment,” the judge said.

Ncamisile also gave evidence that she started feeling pain continuously in the arm after the injection was administered.
She complained to the nurse who bandaged her arm and hung the bandage around her neck to support it. She was also given some Panado to ease the pain, but they did not help.
Hospital
“On December 2, 2007 her right forearm was swollen and the finger tips were discolouring. She was taken to the Mbabane Government Hospital but did not get any assistance as the X-ray machine was dysfunctional.
“On December 3, 2007, she was taken to the Raleigh Fitkin Memorial Hospital (RFM), where her arm was X-rayed and put in cast. The pain, however, became excruciating and the cast was removed the following day by which time most of the arm was black. The doctors recommended that the arm should be amputated which was eventually done,” reads the judgment.
Ncamisile was attended to by Dr Jere on June 13, and he prepared a Medico legal report based on the history given to him by the patient.
“It can be deduced from the history and outcome of this phenomenon that Ncamisile E.Tsela suffered severe arterial vascular injury as a direct result of the injection or consequent compartment syndrome to cause loss of ischemia (loss of blood supply to the tissues of the forearm) leading to gangrene (death of tissues),” Dr Jere concluded.