Cerebral Palsy Malpractice Claims in South Africa

Cases of cerebral palsy are shockingly high in South Africa – and medical malpractice is a common cause of birth or pregnancy complications that lead to cerebral palsy.

An estimated 50% of medical negligence claims against the government are cerebral palsy malpractice claims.

In this article, we explore:

• preventable cerebral palsy stats in South Africa
• causes of cerebral palsy
• lifelong effects of cerebral palsy
• cerebral palsy malpractice claims in South Africa.

Statistics: preventable cerebral palsy in South Africa

According to Dr Thembi Katangwe, a paediatric neurologist and PhD candidate at Stellenbosch University’s Department of Paediatrics and Child Health, 10 out of every 1,000 babies born in South Africa have cerebral palsy.

This is significantly higher than the global average of one to four babies per 1,000. The figure in South Africa might be even higher. New research is needed to confirm the latest figures.

The exceptionally high number of medical negligence claims against the government for preventable cerebral palsy cases suggests the high rate has not changed in recent years.

Medically, cerebral palsy can have several causes. Only cases caused by oxygen shortages during the delivery process (called intrapartum hypoxia) are typically considered preventable.

Comparison to developed countries

According to recent statistics, only 10 to 14% of cerebral palsy cases in developed countries involve intrapartum hypoxia.

By comparison, a 2022 paper published in The South African Medical Journal stated that “…in the CP [cerebral palsy] population undergoing investigation for litigation in SA, 71% of cases were due to hypoxic ischaemic injury”. This suggests they could have been prevented by competent medical care.

A more recent 2024 study – based on cases spanning 10 years at Tygerberg Hospital – confirmed that “…CP in a South African setting is associated with a high burden of potentially preventable causes”.

What causes cerebral palsy?

Cerebral palsy can be caused by several factors, including physical injuries, lack of sufficient oxygen, infections, pre-term delivery, developmental issues or even genetics.

It can occur during pregnancy, during birth or even after birth.

Lifelong effects of cerebral palsy

Cerebral palsy causes brain damage or abnormal development in the parts of the brain that affect movement. It can affect a child’s ability to control his or her muscles, can impact motor skills and the ability to speak.

Children with cerebral palsy commonly need lifelong medical care, attend special schools and may live in care facilities.

Cerebral palsy malpractice claims

Data from provincial departments of health were examined by the Clinton Health Access Initiative. Their findings suggest that 50% of all medical malpractice claims against the government are cerebral palsy claims.

When malpractice is indicated

Cerebral palsy isn’t only caused by medical negligence. For a successful cerebral palsy malpractice claim, there has to be evidence that healthcare providers were negligent and that their actions caused or contributed to the cerebral palsy.

Examples of negligent actions or failures by healthcare providers include:

• failure to detect infection or abnormalities prior to birth
• failure to act appropriately when the umbilical cord is wrapped around the baby’s neck
• failure to deliver by Caesarean section when required
• failure to detect signs of foetal distress
• delays in inducing labour where necessary
• failure to manage a breech birth
• use of excessive force when delivering a baby with forceps.

Also noted in this 2021 paper, medico-legal cases involving cerebral palsy in SA courts are mainly judged on magnetic resonance imaging (MRI) findings and cardiotocography (CTG) to assess causation and liability.

Who can be sued in cerebral palsy cases?

If it’s possible to prove that substandard care led to your child’s cerebral palsy, your legal team may sue the doctors, nurses, hospital staff, the hospital itself or the Department of Health (in claims against the government), depending on who was responsible. 

Types of compensation that may be awarded

Compensation for a successful cerebral palsy malpractice claim in South Africa usually covers one or more of the following:

• past and future medical costs
• cost of on-going care (professional or by a family member)
• loss of past and future earnings due to time off work
• general damages for pain and suffering.

Average compensation awarded in cerebral palsy cases

Compensation will vary significantly depending on the severity of the cerebral palsy and the level of care needed. Payouts awarded for past claims have been as high as R10.9 million.

According to a report by the Actuarial Society of South Africa, the average compensation awarded in claims involving cerebral palsy is R5.5 million per case.

Why pay-outs for cerebral palsy claims are so high

Pay-outs for cerebral palsy cases tend to be high because children with cerebral palsy need specialised, lifelong care. 

This can include special educational services, medical care and full-time carers, or live-in care facilities. Many children will also need specialised wheelchairs and mobility aids.