HARARE — The High Court of Zimbabwe has absolved Medical Investments (Private) Limited, trading as Avenues Clinic, from a US$520,000 wrongful death claim after finding that the plaintiffs failed to establish a prima facie case of medical negligence against the hospital.
The ruling was delivered in a case brought by Sheila Nyadundu and her two children, Mutsa and Takunda Nyadundu, following the death of their husband and father, Francis Nyadundu.
Background
Francis Nyadundu was admitted to Avenues Clinic in March 2024 after being diagnosed with liver cirrhosis. The plaintiffs alleged that he fell from his hospital bed, sustained severe head injuries, and died as a result.
They claimed US$520,000 in damages, citing negligence by the hospital and its employees, including leaving him unattended, failing to alert his doctor timeously, failing to ensure adequate equipment and manpower, and concealing the cause of his death.
The defendant denied negligence, maintaining that the deceased was accorded the requisite level of care consistent with his treatment plan and that his doctor's instructions were promptly obtained and followed.
Evidence led
The third plaintiff testified that his father fell off his hospital bed at around 3am on 10 March 2024. The family received a call from the hospital stating his condition had deteriorated and later learned he had died.
A post-mortem examination concluded that the cause of death was subarachnoid haemorrhage, skull vault fracture, and head trauma, and that it was not due to natural causes.
The first plaintiff testified that her husband fell off his bed at around 10.30pm, died at 3am, and she was only notified at around 4am.
Defendant's application
At the close of the plaintiffs' case, the defendant applied for absolution from the instance, arguing that no prima facie case of medical negligence or a sustainable basis for the quantum of damages had been established.
The defendant submitted that the plaintiffs failed to provide expert evidence to substantiate their claim that its conduct fell short of a documented industry-wide standard, and that without such evidence, the court could not determine negligence.
Court's analysis
In its judgment, the High Court said the central issue in an application for absolution from the instance in a negligence claim is whether a plaintiff has provided evidence to substantiate the particulars of negligence and the essentials of the claim.
The court applied the test from Claude Neon Lights (SA) Ltd v Daniel, which states that the question is whether there is evidence upon which a court, applying its mind reasonably, could or might find for the plaintiff.
Key findings
The High Court found that the plaintiffs failed to lead expert medical evidence to establish the applicable standard of care and whether the defendant's conduct fell below it.
On the allegation that the deceased was left unattended and unmonitored, the court found that while the nurses' notes revealed the deceased was a fall risk and measures were taken, the plaintiffs failed to show that the defendant's conduct fell below acceptable medical standards.
The court said the monitoring intervals recorded in the nursing notes were not conclusive evidence of breach, and no evidence was led on the monitoring regime required for a patient in the deceased's condition.
On the allegation that the defendant failed to timeously inform the deceased's family of the fall, the court found the particular was poorly pleaded and failed to establish a causal link to the death.
Regarding the failure to employ an alternative doctor, the court said no evidence was led to show that prompt intervention by an alternative doctor might have saved the deceased's life.
On the concealment of the cause of death, the court noted that concealment occurs after death and cannot have caused it.
Post-mortem report
The High Court said the post-mortem report showed the deceased died of subdural haemorrhage but did not show fault on the part of the defendant as it did not speak to whether the defendant was careless and caused the fall.
The court said expert evidence from a neurologist or pathologist was required to show that the cause of death was a direct result of blunt force trauma from the fall rather than pre-existing conditions.
Damages claim
The court found that the second and third plaintiffs did not plead or lead evidence regarding the factual and legal basis of the duty of support owed to them by the deceased, nor did they allude to the actual financial loss they suffered.
The High Court said these shortcomings weakened their claim and were fatal at the absolution stage.
Disposition
Having failed to satisfy the fault element, the court found the defendant had nothing to rebut and was entitled to absolution from the instance.
The court ordered that the defendant's application for absolution be granted, and the first, second, and third plaintiffs pay the defendant's costs of suit, jointly and severally.
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