Retinopathy of Prematurity and Medical Malpractice Claims

Retinopathy of prematurity (ROP) malpractice claims are common in South Africa, according to Advocate Ronel van Zyl, a senior state law adviser at the South African Law Reform Commission.

ROP is largely treatable. However, if newborn babies with this disorder are given too much oxygen, they can be left permanently blind. Failure to screen for and properly manage this disorder can lead to permanent loss of vision.

What is retinopathy of prematurity?

ROP is an eye disorder unique to premature babies. It causes the blood vessels in the retina to develop abnormally.

If it’s not promptly diagnosed and treated, blood can leak from the vessels, resulting in scarring of the retina. When the scars harden or shrink, they pull the retina away from the eye, causing partial or total blindness.

A treatable disease

Only 15% of ROP cases progress to a stage where treatment is required. Of that, 85% of cases are successfully resolved through the use of cryotherapy and retinal laser surgery.

With proper screening and the rapid roll-out of appropriate treatment, only 2% of newborns diagnosed with ROP will experience total blindness.

The reality in South Africa tells a different story.

According to research published a decade ago in the South African Medical Journal, retinopathy of prematurity is “one of the most common causes of preventable blindness in preterm neonates”. It is “…emerging as a ‘third epidemic’ in middle-income countries including South Africa”.

ROP as a leading cause of blindness in South Africa

Reliable, up-to-date statistics aren’t available, but according to a 1995 study, ROP accounted for as much as 10.6% of blindness in children in schools for the blind.

As survival rates for premature babies have increased, so has the incidence of ROP leading to blindness.

Retinopathy of prematurity and medical malpractice claims

Medical malpractice is a key factor contributing to the high incidence rate of ROP-associated blindness in South Africa.

In order to successfully sue for damages on behalf of an injured child, a claimant must demonstrate that the medical provider’s treatment did not meet the accepted standards of care.

One or more of the following acts or omissions may constitute medical negligence by a healthcare provider or hospital:

• improper administration of oxygen after the birth
• failure to consistently screen high-risk newborns for ROP
• failure to diagnose ROP timeously
• failure to treat ROP promptly and according to accepted standards
• failure to refer the newborn for follow-up eye examinations.

Examples of successful South African ROP malpractice claims

Here’s a quick overview of a few ROP malpractice claims that have succeeded in the courts.

AVM vs. KZN Health Department

The court found that the oxygen saturation levels of the newborn were consistently above the required levels and no action was taken to reduce the levels.

As a result, the hospital failed to prevent the development of ROP. The Member of the Executive Council was held liable for all damages arising from the infant’s blindness. The quantum is yet to be determined.

Lochner vs. MEC for Health and Social Development in Mpumalanga

In this case, the court awarded a total of R13,335,130 in damages, plus costs, to the mother of a newborn. The MEC accepted liability on the grounds the hospital had failed to diagnose and treat ROP in the baby girl.

Issa Simela vs. the Gauteng Health Department

The mother of an infant child, who contracted ROP due to the administration of high levels of oxygen at birth, claimed R20 million in damages.

The court found that the inappropriate use of oxygen, failure to screen for ROP and failure to advise the mother about possible blindness was sufficient grounds to find the MEC liable for all damages. The amount is still to be determined.

Screening guidelines for ROP in South Africa

Screening for ROP is recommended for infants born at 32 weeks or earlier, or with a body weight of less than 1.5 kg.

Larger infants, weighing up to 2 kg and born between 32 and 35 weeks, should also be screened when there’s an increased risk of developing ROP.

What to do if you have a claim

If your baby developed ROP and is partially or totally blind as a result, you may be able to claim for compensation.

These types of claims are complex and require evidence and testimonies from medical experts to support the claim. It’s essential to recruit the services of an experienced medical malpractice lawyer.

A good lawyer investigates each case, reviews medical records and interviews healthcare providers to get a clear picture of what, or what did not, happen before, during and after the birth.

If your case has merit, the lawyer will institute a claim on your behalf and get adequate compensation to provide your child with the best possible specialised care.