Family sues Mediclinic Swakopmund over woman's death

The High Court is considering whether Mediclinic Swakopmund and a doctor can be held liable for the death of a Swakopmund woman in 2018 after her family alleged that the hospital failed to diagnose and treat a life-threatening pulmonary embolism in time.

The hospital has denied any wrongdoing, saying the fatal blood clot had already formed before she arrived and that earlier treatment would likely not have changed the outcome.

The woman's husband and two daughters are suing Mediclinic Swakopmund (Pty) Ltd and Dr Christoff Coetzee for damages arising from her death while she was receiving medical care at the hospital.

The family alleges that the hospital and its medical staff failed to recognise the signs of a pulmonary embolism, a condition in which a blood clot blocks blood flow to the lungs, and failed to provide timely treatment that could have prevented her death.

The matter before High Court judge Orben Sibeya focuses on whether the patient would have survived if a pulmonary embolism had been suspected, diagnosed and treated earlier.

According to agreed fact, the woman arrived at the hospital's emergency unit on 12 July 2018 in the afternoon, accompanied by her daughter.

She complained of severe vomiting, dizziness, shortness of breath, chest pain and heaviness, sweating and diarrhoea. She also informed medical staff that she had recently undergone knee surgery, which can increase the risk of developing blood clots.

Admission and diagnosis

Nursing staff reportedly assessed her at 14:45 and classified her condition as "orange" under the hospital's triage system, indicating that she required urgent medical attention. Her initial observations showed a heart rate of 106 beats per minute, blood pressure of 100/62 and oxygen saturation of 99%.

Dr Coetzee was allegedly contacted at about 14:50 and diagnosed her with acute gastroenteritis with dehydration. He instructed nurses to administer intravenous fluids, medication for nausea and pain relief.

The hospital says this diagnosis was reasonable based on her symptoms and condition at the time.

However, the patient's condition deteriorated shortly afterwards.

According to court documents, the woman became restless at about 15:35, removed her IV cannula and experienced a drop in oxygen levels. Oxygen therapy was started, but by around 16:10 she was in severe distress despite treatment.

An electrocardiogram performed shortly before showed features suggestive of right ventricular strain, which can be associated with pulmonary embolism.

She was moved to the resuscitation room, where doctors attempted to revive her through chest compressions, intubation, oxygen therapy and medication. She was pronounced dead at about 16:50, with doctors suspecting a pulmonary embolism.

Court testimony

Dr Gregory Promnitz was summoned to court to testify as an expert witness. The doctor indicated that her symptoms, including shortness of breath, chest pain and her recent knee surgery, should have raised suspicion of a pulmonary embolism.

He testified that earlier treatment with anticoagulants such as heparin or Clexane could have improved her chances of survival and given her a "fighting chance".

Mediclinic disputes this, saying she suffered a catastrophic pulmonary embolism caused by a blood clot that had already formed before she arrived at the hospital.

Two of the hospital's expert witnesses testified that anticoagulants would not dissolve an existing clot or prevent a clot that had already formed from breaking loose.

The defence further argues that the patient deteriorated rapidly, collapsing within approximately 90 minutes of arriving at the hospital, leaving little time for investigations or treatment that could have altered the outcome.

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