These are anecdotes about alleged poor care and negligence at Groote Schuur Hospital and other public sector health facilities in the Western Cape and around the country as and when I hear about them. I'll occasionally include stories about poor service in other public service fields.
I was told these stories by friends and family of affected patients or experienced them myself. I accepted their veracity at face value, or if it occurred to me or my family, vouch for their authenticity. I'm not in a position to verify second hand accounts, and even if I was, the hospital or other service providers would not provide details due to confidentiality and not wishing to publicise poor service. There may be sound, mitigating explanations for some of these accounts. But I shall stick to the facts as I understand them.
These stories are unlikely to be known to or covered by the media which tends to concentrate on the sensational, facile, "racism" and other politically expedient matters, and decline, as Groundup and Daily Maverick to name two did, to report human interest stories like these unless it advances their tendentious and biased agendas and narratives. Here they are:
Teenager brain-dead and dies after admission to Groote Schuur (2016)
A 16 year-old girl was declared brain-dead a few days after having been admitted to Groote Schuur Hospital in August 2016. She - her body - died a week later after life-support was removed.
Tatum* (not her real name), our neighbour's child, was taken to the hospital's emergency room on a Saturday evening after feeling unwell. She was in good spirits and spoke to her parents before the doctors saw her. The doctors told her parents to leave the examination room and have a "smoke" while they examined her. When the parents returned an hour later, she was unconscious and on full life-support, the medical team trying to revive her.
Over the following days the team including a professor performed more than one brain shunts to relieve pressure on her brain. Although she was diabetic, that was ruled out as a cause. Viral meningitis was suspected, but dismissed. A few days later, she was brain-dead. A week after she was admitted, life-support was removed.
A family member later recounted the doctors gave her parents a "hard time", apparently, suspecting them of neglect or causing their daughter's ailment. But the professor told the parents, "Perhaps we performed too many shunts on her brain", i.e., as they understood, that contributed to her death.
Tatum's death was declared "unnatural causes". A week or so later they were summoned to Woodstock police station. They thought it was to be given information about her death but it was merely to give a statement. Although they spoke to the pathologist who performed the post-mortem, he gave no details about her death. To this day, they don't know why she died. A few months ago the police investigator told the child's mother there was something amiss about her death. The docket is still open.
Usually, with unnatural causes deaths, inquests are held. But for Tatum, the senior state prosecutor of Cape Town did not call for one. The parents appeared unaware inquests may be referred for such deaths when told, but for Tatum's case, don't know why one wasn't held.
As far as the family are concerned, they will never get answers. Tatum's death badly affected her younger brother who lost the remainder of the school year as he suffered from stress. Recently, the mother said she's unimpressed with the police and prosecutor and has no confidence in them.
Stomach cancer patient chokes to death on vomit (2017)
A Groote Schuur patient with stomach cancer whose medical chart stated he had to receive fluid meals only was given chicken.
He ate, threw up and choked to death on his vomit.
When I brought this and the previous one of the teenager to Premier Helen Zille's attention on social media late last year, she promised to "get to the bottom" of it. Note in one of her Daily Maverick columns last year she boasted of the praise she has received from Western Cape's health service's patients. But she did not and does not acknowledge poor and negligent care, as if it never happened. We can take her promises for what they're worth - a politician's and bureaucrat's empty and dishonest promises.
When I brought this and the previous one of the teenager to Premier Helen Zille's attention on social media late last year, she promised to "get to the bottom" of it. Note in one of her Daily Maverick columns last year she boasted of the praise she has received from Western Cape's health service's patients. But she did not and does not acknowledge poor and negligent care, as if it never happened. We can take her promises for what they're worth - a politician's and bureaucrat's empty and dishonest promises.
Doctors deny stroke patient life-support (2018)
In a case with close similarities to my mother's a 70-odd year-old woman was admitted to Groote Schuur after suffering a stroke. While she survived, doctors informed the family that if she had breathing difficulties, they would not place her on "life-support", presumably, they meant intubation.
Over the course of the day or night, the hospital contacted the family. When they arrived they were told their mother had died.
The doctors' alleged action and decision to refuse a patient life-support is contrary to health legislation and guidelines. First, doctors' primary duty is to preserve life, not take it.
Second, decisions about treatment, options available and risks and benefits thereof including withholding and withdrawing treatment and life-support must be taken in consultation with the patient and her proxies if she's unable to make decisions on her own. Treating doctors must ensure the patient/relatives can make an informed decision. This is called informed consent. In countries around the world including South Africa the absence of informed consent is tantamount to assault (Castell v De Greef 1994).
Third, removing life-support can only be taken after consent is given, except in the case when the patient has gone into arrest and there's no hope of resuscitation. But withholding life-support, e.g., a breathing tube when the patient is in respiratory arrest, is not such a case.
From the bare facts of this case, doctors had warned the family they would not under any circumstances provide life-support. It's impossible to say without knowing more if the patient had gone into an arrest from which recovery was improbable, or as the doctors indicated, they would withhold life-support as a general rule.
If the latter, does it mean Groote Schuur doctors are taking on God's role, and see themselves more as Charon taking souls across the Styx and Acheron? Are they or have they become Doctors of Death, and is it official hospital and Western Cape health department policy?
Emergency room procedures set out how patients must be treated on arrival. Like all emergency rooms everywhere, Groote Schuur triages patients. It has a three-level colour-coded system to determine if conditions and ailments are life threatening that requires immediate medical intervention, intermediate and non-emergency. On arrival, if a patient is not in a serious, life-threatening condition, a nurse takes basic vitals, e.g., blood pressure, heart rate (ECG) and temperature until a doctor arrives to examine the patient. Often, the doctor is the first to see the patient.
Incredibly strong, aggressive and resisting pleas to leave, he scared the living daylights out of me, a household of women including my 90 year-old late mom, who had a panic attack, and a baby of two. We called the police.
Elderly man left unattended in hospital corridor dies (2017?)
An 80 year-old man had a seizure, probably a stroke, at home. His wife called the Western Cape's state ambulance service, which arrived eight hours later. They took him to Groote Schuur Hospital.
On arrival, he was wheeled into the emergency room's corridor while he and his wife waited for doctors to attend to him. Three hours passed and no doctors came and eventually his desperate wife demanded of a clerical worker that a doctor see him. A doctor came and took him into the examination ward.
His wife returned home. A few hours later the hospital phoned her. There a doctor led her to a room that contained other deceased patients. His body was in a terrible state, which further upset his wife. The doctor told her he had expired.
Emergency room procedures set out how patients must be treated on arrival. Like all emergency rooms everywhere, Groote Schuur triages patients. It has a three-level colour-coded system to determine if conditions and ailments are life threatening that requires immediate medical intervention, intermediate and non-emergency. On arrival, if a patient is not in a serious, life-threatening condition, a nurse takes basic vitals, e.g., blood pressure, heart rate (ECG) and temperature until a doctor arrives to examine the patient. Often, the doctor is the first to see the patient.
In this story it appears the patient had been forgotten or neglected in the corridor until his wife raised their plight. Perhaps the ER was exceptionally busy that day. But even if that was the case, a suspected stroke patient, which presumably the paramedics would have confirmed and relayed to the medical staff, is a serious medical condition that required immediate attention. There is thus no excuse for what happened. It's possible the three-hour delay in obtaining medical care contributed to his eventual death.
Child given wrong drip (2018)
At Red Cross Hospital a child was put on a drip. His mother who was at his bedside asked the doctors what the medicine was. Only then they discovered it was the wrong medicine.
Such mistakes do happen. In Kenya recently a surgeon performed brain surgery on the wrong patient.
But in Western Cape and presumably South African hospitals there's a paper trail for each test, procedure and medicine ordered which is matched to the patient's folder placed at the foot of his/her bed. Often nurses administer medicines, other times doctors. I don't know who gave the boy the drip, but the mistake was inexcusable and potentially life threatening.
Police fail to take statement from armed robbery and hijack victim (2018)
An employee of a Philippi animal welfare organisation was hijacked and robbed at gunpoint immediately after leaving the premises to bank the day's cash takings. Apparently they knew she was coming. I was reported but three weeks later the Philippi police station had not taken the statement. The station is about a kilometre from the organisation.
Three weeks go by and the deputy-chairman of the organisation phones the police colonel (probably the head of detectives). The colonel insists the statement was taken. It was not. He promises to do so the following day.
Another week goes by and they don't take the statement. The deputy-chairman phones a private investigative agency who says they'll make a call. The following day the police take the statement.
This scenario happens frequently across the country regarding the South African Police Service. When there's a crime or alleged crime the victim's/complainant's statement is necessary and required to start the investigation and criminal justice process. If there's no statement, theoretically, there was no crime. If there's no crime, there's no investigation or eventual prosecution. Perhaps the police prefer it that way. Without reported complaints they keep crime statistics down and don't have to expend resources investigating.
But the statement is the easiest, mandatory first step of the investigation. The police - station level or management - don't offer explanations why cases like this one happens, and so often. Is it lack of manpower, resources, time or what?
In my mother's case I posted elsewhere on this blog, detectives of two stations were unavailable and unobtainable to take my statement and never, or hardly ever, returned my calls and emails when tried to find out why. After two months I proactively made a sworn statement to the detective with a copy to the Director of Public Prosecutions (DPP) so later the police can't say they never received it (dockets going "missing" is a frequent experience, like the postmen who didn't deliver the mail).
In January 2018 I complained to the Western Cape provincial police commissioner who got the implicated station and detective (Lansdowne) to "investigate themselves". I rejected this and my complaint went nowhere. But for the cheek of it, they asked me to sign a document stating my complaint had been attended to!
(Update to my mother's case, in September 2018 a Woodstock detective came to see me to obtain additional statements, the first time I saw him and the first time it was done proving neither they nor the DPP properly investigated the case. In fact, at an early stage, without investigating and collecting no evidence, the police stated there were no criminal charges, which the DPP confirmed. It's no wonder the DPP declined to prosecute - without a statement of complaint, there is no crime.)
In January 2018 I complained to the Western Cape provincial police commissioner who got the implicated station and detective (Lansdowne) to "investigate themselves". I rejected this and my complaint went nowhere. But for the cheek of it, they asked me to sign a document stating my complaint had been attended to!
(Update to my mother's case, in September 2018 a Woodstock detective came to see me to obtain additional statements, the first time I saw him and the first time it was done proving neither they nor the DPP properly investigated the case. In fact, at an early stage, without investigating and collecting no evidence, the police stated there were no criminal charges, which the DPP confirmed. It's no wonder the DPP declined to prosecute - without a statement of complaint, there is no crime.)
Police refuse to give chase to home invader (c2015)
A meth (tik) addict invaded invaded our home, literally pushing his way in the door, looking for his "wife" he believed we were hiding. He was a known petty criminal and had been in Pollsmoor Prison.
Incredibly strong, aggressive and resisting pleas to leave, he scared the living daylights out of me, a household of women including my 90 year-old late mom, who had a panic attack, and a baby of two. We called the police.
Fortunately, he didn't stay long. The police arrived less than five minutes after he left. We pointed the road he went and told them they could catch up with him as he was only about 500m away. The two officers listened, shrugged and got in their van and drove off, not going after the culprit. They must've thought no harm was done, and besides, what's a little scare to an elderley woman with a heart condition and a baby.
A few months ago we heard the man who terrorised us was stabbed to death, apparently in a street fight.
Does the Western Cape public health service lack resources?
I acknowledge the fact that the public health services provides healthcare for 80% of the population that doesn't have medical aid/insurance. Patient numbers are higher and overall facilities are not of the same standard as private hospitals and clinics. As with all public-private sectors, comparisons are invidious.
But the public health service does offer a comparable technical medical standard to the private sector. After all, public hospitals train doctors, most of whom eventually go to the private sector.
The Western Cape especially under the DA has prided itself on offering a better standard of health and other services than ANC-run provinces (the City of Cape Town's management of the water crisis is perhaps the one exception). The DA may be overall better administrators than and not prone to corruption (again, corruption allegations about Mayor Patricia de Lille and suspended transport chief seems to be among the few exceptions, but who really knows) like the ANC. But their health service's users tell a different story.
In the South African Health Review 2016 (2017 is now available) patients rate the Western Cape's service 53%, third last (Gauteng is 52%) where the national average is 59%. It's behind poor and poorly resourced ANC-run provinces like Eastern Cape (63%). So I don't how Zille can extrapolate a few compliments to the conclusion it's excellent. Politician hyperbole, no doubt.
I'm a user, and a recent one at that, of the WC's health service, Groote Schuur Hospital to be exact. They have resources - medical staff, medicines, equipment and supplies - to diagnose and treat all manner of ailments and injuries. Of course, patient numbers and loads are high but that's no different to any public hospital in developed countries, and exceeds the capacity and resources in less developed ones.
But if there are limitations and constraints, it's more the inefficient and ineffective utilisation of human resources, failing to follow medical procedures and guidelines, and sometimes, incompetence.
I was at the hospital's emergency room for 18 hours in October 2017. It took fours hour after the senior attending doctor authorised a scan for me to be sent for it. During this period one of the many junior doctors on duty and assigned to my care came to my stretcher twice to confirm the scan but didn't immediately do so (was she second guessing her superior?).
But the patient beside me was sent for the same scan immediately after the senior doctor authorised it. Both of us arrived at the hospital within a couple of hours of each other. Until that point we had been waiting an average eight hours for the next medical stage - when the superior doctor came on shift, apparently, a senior doctor not been available 24 hours a day. It made more sense and was more efficient to send patients who need similar tests at roughly the same time. After my scan, I waited another four hours for the results and report so unnecessarily occupied space for almost eight hours that could have been given to another patient.
Thus the ER is filled with patients, say about half, who wait all day and sometimes all night to be discharged, and only one head of department in a 24-hour period to do so, a hopelessly inefficient system that must be responsible for the system being backed up. The other related problem is the ineffective work flow, as I describe above with my scans, of medical staff. As a former engineer and accountant I know a little about production work flow and observe the inefficiency.
During this time a patient remarked of the doctors, "They walk around a lot". I replied, "I know what hell is like". Two nursing sisters were responsible for our patient overflow area - those waiting for results or to be discharged - of about six stretchers, doing nothing. So they have staff to spare. And more doctors than they need. In a visit to the ER in July 2018 it took three nurses an hour and half to triage - take blood pressure, temperature and if necessary ECG, which all together take a few minutes - three patients, by which time more had arrived. Why? There was a lot of walking around, on what and to where, I don't know. I told the head nurse this and she was not amused.
My general practitioner volunteered at Somerset Hospital but left because "they waste people's time", i.e. patients and staff. Instead,last year she volunteered for three months abroad with an international medical non-profit. She told me "they [Somerset] need an engineer to show them how to improve" the flow. I agreed because they were my thoughts exactly. In August last year I mentioned these problems to a Groote Schuur ER doctor who was due to return there after rotation. He shook his head in the negative when I asked if he was looking forward to it. He said the place is "too busy". But when I mentioned the issues, only said "there are a few models". Obviously models that don't work well, but my guess from observation, they're not been implemented.
But the patient beside me was sent for the same scan immediately after the senior doctor authorised it. Both of us arrived at the hospital within a couple of hours of each other. Until that point we had been waiting an average eight hours for the next medical stage - when the superior doctor came on shift, apparently, a senior doctor not been available 24 hours a day. It made more sense and was more efficient to send patients who need similar tests at roughly the same time. After my scan, I waited another four hours for the results and report so unnecessarily occupied space for almost eight hours that could have been given to another patient.
Thus the ER is filled with patients, say about half, who wait all day and sometimes all night to be discharged, and only one head of department in a 24-hour period to do so, a hopelessly inefficient system that must be responsible for the system being backed up. The other related problem is the ineffective work flow, as I describe above with my scans, of medical staff. As a former engineer and accountant I know a little about production work flow and observe the inefficiency.
During this time a patient remarked of the doctors, "They walk around a lot". I replied, "I know what hell is like". Two nursing sisters were responsible for our patient overflow area - those waiting for results or to be discharged - of about six stretchers, doing nothing. So they have staff to spare. And more doctors than they need. In a visit to the ER in July 2018 it took three nurses an hour and half to triage - take blood pressure, temperature and if necessary ECG, which all together take a few minutes - three patients, by which time more had arrived. Why? There was a lot of walking around, on what and to where, I don't know. I told the head nurse this and she was not amused.
My general practitioner volunteered at Somerset Hospital but left because "they waste people's time", i.e. patients and staff. Instead,last year she volunteered for three months abroad with an international medical non-profit. She told me "they [Somerset] need an engineer to show them how to improve" the flow. I agreed because they were my thoughts exactly. In August last year I mentioned these problems to a Groote Schuur ER doctor who was due to return there after rotation. He shook his head in the negative when I asked if he was looking forward to it. He said the place is "too busy". But when I mentioned the issues, only said "there are a few models". Obviously models that don't work well, but my guess from observation, they're not been implemented.
An emergency room is similar to a very busy restaurant. But the difference is that staff at Groote Schuur, and presumably, other WC health facilities, lack the work flow ability and efficiency to handle above a certain number of patients despite there being adequate staff. This leads to oversights and mistakes like the case of a suspected stroke patient been "forgotten" in the corridor, dying. Don't believe it if they tell you different. But try telling these bureaucrats, most of whom have never worked in a for-profit private sector where time means someone else's money, how they might do it better and you'd get ignored and treated like an idiot.
Super villians 'Doctors of Death' strike again?
A 70 year-old man had an operation on his knee at Groote Schuur Hospital. He died a day later. His family said nothing was wrong with him medically.
Surgery for the elderly poses special risks. But it's not known if the doctors told the patient and family of them so they make an informed decision.
In other news, a 50 year-old man has a mild heart attack. At Groote Schuur the ER doctor dismisses his GP's letter that contains his medical history as "irrelevant".
Patient says he was given a headache tablet for brain tumour
In this article published in IOL, Groote Schuur Hospital patient Faried Jassiem said he was "misdiagnosed after he complained of headaches and was vomiting blood, given a headache tablet and told to go home. After much discomfort and efforts by his wife to get proper help, he was diagnosed with a brain tumour at Groote Schuur".
Lincoln said, “There were many instances in which she was treated badly. She was basically sent home with morphine. In the last two weeks before she passed away they told us she had cancer which spread to her lungs".
But hospital CEO Bhavna Patel rejected claims of negligence. The article by Athina May said "As more people complain about the treatment and service they get from Groote Schuur Hospital, the facility is at pains to explain the challenges it faces".
But other reports - here, here, here and here - paint a picture of the Western Cape's public health service that's in trouble. Blunt denials of problems by hospitals and the health department is not going to remedy it.
But other reports - here, here, here and here - paint a picture of the Western Cape's public health service that's in trouble. Blunt denials of problems by hospitals and the health department is not going to remedy it.
Updated 10/02/2019
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