The Committee continued with its hearing on the petition lodged by Ms Nobuntu Fuzane in relation to her daughter Tamara’s treatment at Groote Schuur Hospital on 1 August 2011 and at Khayelitsha Hospital in February 2014. Members asked clarity-seeking questions of the delegation from the Department of Health of Western Cape (DOH), Groote Schuur Hospital, and Khayelitsha Hospital. On 1 August 2011, Tamara was discharged from Groote Schuur Hospital after an operation. Ms Fuzane and a social worker saw that Tamara still looked ill, and they asked the nurse not to discharge her. The nurse allegedly threw “the bedsheet and two nightdresses” and told Ms Fuzane to wrap her daughter in them and go. Ms Fuzane went to the media. The hospital met with Ms Fuzane to address the incident. Tamara was hospitalised at Groote Schuur again. Ms Fuzane stated in her complaint against Groote Schuur that the doctors were “rude” to her. On 4 February 2014, Tamara was admitted to Khayelitsha Hospital and was discharged on 13 February. Ms Fuzane noticed scars on Tamara’s upper shoulder that were not there when Tamara was admitted. Ms Fuzane asked hospital staff about the scars but was told that nobody knew how Tamara received the scars. Ms Fuzane went to the police, who took pictures of the scars.
Ms Fuzane opened a complaint against Khayelitsha Hospital on 18 February 2014. A public prosecutor received the case and decided not to prosecute because of lack of evidence that Tamara’s injuries were caused by abuse. Dr Beth Engelbrecht, the Head of the Western Cape Government: Health Department (WCGH) presented the Department’s case in a Memorandum. Dr Engelbrecht stated that the Department performed investigations on Tamara’s treatment. The investigation did not reveal how Tamara received the scars, but concluded that she was likely injured in Khayelitsha Hospital. Dr Engelbrecht emphasized that she took responsibility for the incidents.
Dr Werner Viljoen, an independent family physician, wrote a report investigating Tamara’s injuries and concluded that it was “extremely unlikely that an intentional assault took place”. Dr Viljoen’s report also said that there have been no similar complaints against Khayelitsha Hospital.
Several members expressed dissatisfaction that the Department’s Memorandum did not include more statements from the nurses who treated Tamara. Members wanted to clarify exactly when and how Tamara received the scars. The delegation stated that the cause of Tamara’s scars was not documented.
Members also asked why the nurses who treated Tamara were not present at the Committee meeting to answer questions. Dr Engelbrecht stated that the nurses made statements but that she could speak for them as head of department. The Committee insisted that all these statements should be made available to the Committee.
Dr Engelbrecht and Dr Anwar Kharwa, CEO of Khayelitsha Hospital, noted that the department had implemented recommendations for meticulous recordkeeping after the complaint.
The Chairperson announced that the Committee would soon deliberate and render a public decision on the case.
Fuzane Petition (Alleged assaults on child whilst in a public hospital): hearing continued
The Chairperson called on Members to ask clarity-seeking questions to the delegation from the Department of Health, Groote Schuur Hospital, and Khayelitsha Hospital. Members first questioned Dr Anwar Kharwa, CEO of Khayelitsha Hospital.
Questioning of Khayelitsha Hospital CEO
Mr Julius (DA, Gauteng) asked how Dr Viljoen came to the conclusion in his report that it was “extremely unlikely” that Tamara’s injuries were “intentionally” caused? This was a very strong conclusion.
The Chairperson requested that Mr Julius locate the page number of this recommendation.
Mr Julius noted that Dr Viljoen’s opinion was under “bullet point three” on the last page of Dr Viljoen’s report. He then asked whether Khayelitsha Hospital has implemented the recommendations for improvement that Dr Viljoen listed in his report. Third, the Fuzane family stated that “they were very rude to me because I went to the media”. This is potentially serious because this was a vulnerable family that was allegedly exposed to offensive behaviour. Was this investigated, and if so, is the family satisfied by the outcome?
Dr Anwar Kharwa, CEO of Khayelitsha Hospital, responded that the investigation on Tamara’s injuries was commissioned by his office. Dr Viljoen carried out the investigation. Dr Kharwa’s office discovered that Tamara did sustain injuries “over and above” those detailed in Dr Viljoen’s report. Dr Kharwa’s office tried to identify the causes of all of Tamara’s injuries, but, sadly, could not. Regarding Dr Viljoen’s recommendations, Khayelitsha Hospital has installed upon staff the practice of meticulous record-keeping “over and above” turning and washing protocols.
Mr Julius asked for further clarification about the alleged rude behaviour towards the family. Did this occur at Groote Schuur or at Khayelitsha? He clarified that the question related to the family’s treatment at Groote Schuur but was also a broader question for the entire Department of Health. It is important for patients to feel empowered. If a family lodges a complaint and experiences negative behaviour afterwards, “it sends the wrong message”.
Dr Kharwa replied that Dr Engelbrecht would provide a comprehensive overview and talk through the Memorandum. The Memorandum includes equality initiatives and patient-centred policies.
A committee member stated that in her understanding, when a patient is admitted to hospital, he or she is checked from head to toe. This information is very important and would help the Committee determine how Tamara was injured, but the Committee does not have this information. Ms Fuzane stated that Tamara was admitted in “side ward”. A ward with two beds is usually described as a “side ward”. However, Dr Viljoen’s report described the ward as “spacious” She does not think that a mother would see a huge ward yet say it only had two beds. Finally, the summary did not indicate what treatment the doctor in the ward ordered when Tamara was admitted.
The Chairperson clarified that there were three questions. First, are there any reports on the patient’s condition when she was first admitted? Second, what is the understanding regarding the allegations that Tamara was in a two-bed ward, and third, what kind of treatment was administered?
Dr Kharwa replied that Ms Fuzane’s discovery of Tamara’s injuries at Khayelitsha is of deep concern to the hospital. It is deeply regrettable that no one noticed the injuries until Ms Fuzane drew the hospital’s attention to the problem. Tamara was admitted to a two-bed cubicle. Dr Kharwa then asked for the last question to be rephrased.
The MP clarified that her last question was why there was no information on what treatment Tamara received upon admission at Khayelitsha.
Dr Kharwa responded that this information was in the hospital folders.
The Chairperson asked whether this information could be provided so that members did not ask questions that have already been clarified.
Dr Kharwa responded that Tamara had four different admissions with comprehensive folder notes and prescription charts. That information will be forwarded.
A committee member asked for clarity and said that scars result from wounds. If scars were found on Tamara, then she must have previously had wounds. Why was there no mention of wounds or scars in the report? A document mentioned abrasions and cuts on Tamara. Did these cuts become the scars later observed on Tamara’s upper shoulder? In addition, why did the Public Prosecutor conclude that there was no one to prosecute in this case?
Dr Kharwa reiterated that it was unfortunate and regrettable that Tamara sustained these injuries. The hospital performed an investigation but it did not reveal the cause of the scars. Khayelitsha Hospital concluded that Tamara may well have received these injuries at Khayelitsha. The hospital therefore established the need for meticulous record-keeping. Dr Kharwa said he could not respond to the prosecutor’s statements. If the prosecutor reopened the case, the hospital and department would be cooperative.
Ms T Mokwele (EFF, North West) stated that, according to her understanding, when a patient is admitted to a health institution, the patient is checked or examined every 2 or 3 hours.
The Chairperson interrupted this statement by asking Dr Kharwa how long it generally takes to examine patients when in hospital.
Dr Kharwa said the Head of the Department of Health would clarify this policy.
The Chairperson requested that Dr Kharwa provide an answer now for the Committee’s understanding. The hospital has a specific mandate on how it sees patients.
Dr Kharwa responded that observing a patient depends on the medical condition of the particular patient. In a general ward, a stable patient is checked every four to six hours by the nurses.
Ms T Mpambo-Sibhukwana (DA, Western Cape) stated that she was once admitted to a public hospital in South Africa and that when she was a patient, she was checked at least once every three hours. The policy of timely check-ups likely applies to all public hospitals. How did no one notice Tamara’s wounds before they became scars? The hospital’s failure to notice the scars seemed like “negligence”. In addition, why did Dr Viljoen state in his report that there was likely no intentional assault? Dr Viljoen also stated in the report that there was no similar complaint during this time period. Did Khayelitsha take the Fuzane complaint “lightly” because it was the only report presented to them?
Ms Mpambo-Sibhukwana then referred to the Point 9 on the Memorandum by Dr Engelbrecht, which said it was “regrettable that no one noticed these injuries until Ms Fuzane drew our attention to the problem”. Is it only when ordinary members of the public complain about matters that the HOD takes note of them?
The Chairperson intervened to say that the Memorandum Ms Mpambo-Sibukwana mentioned would be presented by Dr Engelbrecht later in the session. For now, the Committee was still dealing with matters from Dr Kharwa.
A committee member asked whether the hospital has a policy for turning patients. In addition, do nurses make reports when they turn patients? Which nurses were on duty on 14-15 February and did they write a report?
Dr Kharwa replied that the hospital does keep documents on turning patients and includes them in the patients’ folders. The second question on turning related to the nursing staff. A team of nurses turns the patient and documents observations. Those documents are available in the client’s medical folders.
Ms Mpambo-Sibukwana referred to a document which stated that the Public Prosecutor instructed Khayelitsha to provide hospice for Tamara. Will the Committee be given a document from the Public Prosecutor that shows that hospital was instructed to help Ms Fuzane find a hospice for Tamara?
The Chairperson interjected that the Committee would address issues in the Public Prosecutor’s report on its own during deliberations.
Dr Kharwa commented that Khayelitsha facilitated and assisted with the placement of community service and home-based care for Tamara.
Mr D Ximbi (ANC, Western Cape) asked whether Dr Kharwa “wanted the house to believe” that no hospital staff noticed Tamara’s injuries.
The Chairperson clarified the question by asking whether whomever reported to Dr Kharwa did not notice that Tamara had scars.
Dr Kharwa replied that it is incumbent upon any professional nurse or clinician to document their clinical observations and findings. It is regrettable that Tamara’s injuries were indeed not documented until Ms Fuzane brought them to the hospital’s attention.
Ms G Manopole (ANC, Northern Cape) referred to photos of Tamara’s scars in the document submitted by the family and asked what the outcome of the assessment of the photos were.
Dr Kharwa responded that the investigation was commissioned by his office and that the DOH has further reflected on the findings. The investigations did not find what caused Tamara’s injuries but Dr Kharwa’s accepted Tamara might have been injured at Khayelitsha. He reiterated that Dr Engelbrecht would comment further when she provided input on the matter.
Ms T Wana (ANC, Eastern Cape) raised a similar point to Ms Manopole’s. When Ms Fuzane noticed Tamara’s scars, she notified hospital staff. When patients are admitted to hospital for specialized diagnoses, there are specialized doctors attached to that patient. Did the doctor attached to the patient make a report about the injuries?
Dr Kharwa responded that Khayelitsha Hospital arranged follow-up reviews of Tamara. The findings were in the patient’s folders.
Mr Ximbi said the chronology of events was concerning. He read from the Memorandum written by Dr Engelbrecht. Tamara was admitted at Khayelitsha Hospital presenting with swollen feet and loss of appetite. In February 2014, she was transferred to GSH for a CT scan and returned the next day. The documents that Khayelitsha provided did not list the date that Ms Fuzane discovered the injuries.
He read from the Memorandum that Tamara might have sustained her injuries whilst in Khayelitsha hospital. This is a concession by the hospital that the injuries did occur in the hospital. Tamara was a patient in a hospital. Unless she sneaked out and was harmed elsewhere, she must have been injured in the hospital.
The Chairperson reminded members that the Committee was only asking clarity-seeking questions at this point and to retain questions on the Memorandum for Dr Engelbrecht’s presentation.
Mr Ximbi stated that the various documents listing the chronology of events were confusing.
The Chairperson responded that Dr Engelbrecht’s presentation of the Memorandum might clear up this confusion.
Ms Mokwele said she believed the provided documents were incomplete.
The Chairperson replied that the Committee would hear from Dr Engelbrecht first and then would see if they need more information afterwards. He requested that Dr Engelbrecht, HOD of Health in Western Cape, present her office’s Memorandum.
Head of Health Department in the Western Cape submission
Dr Beth Engelbrecht suggested that she read through the memorandum and then answer questions.
Dr Engelbrecht read through the Memorandum in full. Notable points include the following:
- Tamara was treated for Hydatid disease as a child.
- The main type of treatment was to surgically place shunts to drain fluid from Tamara’s brain. Shunts surgically placed, drew fluid from brain. Without the shunts, the pressure to her brain would have been fatal.
- In July 2011, Tamara was admitted to Groote Schuur hospital. She was operated on and was well enough for discharge a few days later.
- Tamara was admitted to Groote Schuur again in August 2011. When Tamara was stable, the hospital needed beds for more patients. The decision was made to discharge Tamara. Ms Fuzane had to take Tamara home without her own clothes or transport.
- Tamara was admitted to Khayelitsha in February 2014 presenting weakness and loss of appetite. Ms Fuzane discovered Tamara’s injuries next day.
- These injuries were of deep concern to the DOH.
- Dr Kharwa’s office commissioned an investigation to discover the cause of her injuries, but, sadly, could not.
- The injuries may well have been caused in Khayelitsha Hospital.
- Meticulous record-keeping has been instilled in staff.
- If the investigation is re-opened, the DOH will comply fully.
The Chairperson asked if there were any clarity-seeking questions.
A committee member stated that she found it disturbing that the department apologized for Tamara’s injuries but could not find the cause. If a patient's treatment is not in line with human rights, the HOD and clinical staff should take responsibility. More staff members in the hospital should have taken responsibility and made statements. She asked to see what steps were taken by staff who were on duty
The Chairperson interrupted to tell members to save these observations for the Committee’s deliberation. He then clarified that the Member's question was why Dr Engelbrecht was unable to inform the committee about steps that she and the DOH took towards those in the hospital who failed to act correctly.
Dr Engelbrecht replied that the question was valid. She agreed with the Member’s point that the DOH should have included more staff statements in the report. Accountability is a strong value in the DOH. At every step, the department took statements from hospital staff. The DOH did not want to belabour the report by including the statements of all of the staff. Dr Engelbrecht then asked Dr Patel, the CEO of Groote Schuur, to expand on the complaint process.
Dr Bhavna Patel, CEO of Groote Schuur Hospital, stated that Groote Schuur sees 60 000 to 70 000 patients per year. Things do sometimes go wrong. When the hospital gets a complaint, it collects statements from all staff. It gives warning letters to staff and dismisses staff members if necessary. However, she stressed that the hospital is dependent on what the specific complaint says. The complaint is the only form of objective evidence the hospital has. The complaint here was that Ms Fuzane was unhappy with the way Tamara was discharged in August 2011 from Groote Schuur. Groote Schuur Hospital agreed that the nurse's behaviour was not patient-centred.
The Chair interrupted Dr Patel to ask her to succinctly respond to the question being asked in the interest of time. The question was why staff statements of accountability were not brought to the Committee.
Dr Patel replied that the Memorandum was a summary and did not provide all the statements to the committee. Those statements were part of the hospitals' internal investigation.
The Chairperson interrupted to say that the Committee was part of Parliament and has the right to receive any information, whether public or private. Statements from the department’s internal investigation cannot be kept from the committee.
Dr Patel replied that she was addressing the question and the Chairperson had misunderstood her. She had not said that the statements could not be provided to the committee. An internal investigation was performed, and a decision was made.
The Chairperson wanted to know the decision.
Dr Patel replied that the investigation’s decision was that the nurse did not act in a patient-centred way. The hospital would have talked with the nurse about the way she discharged Tamara. A social worker also apologized to Ms Fuzane.
A committee member said the DOH wanted to blame Khayelitsha Hospital, but Khayelitsha is the responsibility of the DOH. The HOD has a responsibility to exercise her authority so the committee members can do their jobs. Tamara was a well-known patient of Groote Schuur and the staff knew her specialised disease. The staff’s actions indicate that they did not treat Tamara in a specialised way. The Memo clearly shows the DOH apologizing. However, the Committee should be given a report showing the steps taken for those staff on duty when these events occurred.
The Chairperson interjected to say the member’s observation was a statement but that it illustrated a question showing what would be appreciated.
Mr Ximbi asked Dr Engelbrecht when did she receive the complaint. It seemed that the department was hiding something.
Dr Engelbrecht replied that she became aware of case when the petition was raised. She was not HOD at the time these events happened. However, she still takes responsibility for these events.
Mr Ximbi asked a follow up question. He stated that one of the investigators (Dr Viljoen) was a private investigator.
Dr Engelbrecht said the investigator (Dr Viljoen) was a doctor in the public service at another hospital. He was well-respected and was the best person to objectively answer what the cause of the injuries were. His only task was to find the cause of Tamara’s injuries, not to provide treatment.
A committee member asked Dr Engelbrecht why she told nurses not to come to Parliament and why Dr Engelbrecht instead spoke on the nurses’ behalf to the committee.
Dr Engelbrecht responded that she received an invitation to address the committee and a request for some clinical staff to attend. Her department judged that it was not necessary to bring hospital nurses to Parliament. The nurses and other staff are accountable to the DOH, so the department decided to speak on their behalf. The only clinician present was Dr Taylor.
Mr Ximbi said that the invitation extended to whomever was involved, including nurses. Why did the nurses not come to the Committee to explain "who beat" Tamara?
Dr Engelbrecht responded that an investigation was conducted which found that there were no proper records of Tamara’s treatment.
A committee member said that that lack of nurses’ statements was undermining the Committee. The HOD belongs to Parliament. If the Committee cannot be given the info it needs, how can it be accountable to society at large?
The Chairperson clarified that members were dissatisfied. After the HOD received the petition from Ms Fuzane and the summons from Parliament, it would have been ideal for her to state that it did not bring staff members to Parliament because the HOD had already dealt with them.
Dr Engelbrecht responded that the DOH holds the nurses accountable. They spoke with the nurses. The HOD was responding in the place of the technical staff.
The Chairperson interrupted and said that if the nurses were here, the Committee could trace their actions to discover what happened to Tamara. People who were supposed to advise the committee and help it arrive at a conclusion were not there.
Dr Engelbrecht replied that the intention was not to block the committee but to give all necessary information to the committee. The injuries were already a few days old. The DOH does not know exactly when Tamara’s injuries occurred. Ms Fuzane was very clear that Tamara did not have the scars when she entered Groote Schuur. The only person they can get is the nurse-manager statement. The doctor is no longer with the department.
The Chairperson asked where the nursing staff were that were in the meeting on the 13th.
Dr Engelbrecht responded the nursing staff were asked to contribute but could not contribute "at that time". The HOD agreed that additional information is required for Parliament.
Mr Ximbi said was he not sure if HOD was “aware that she was speaking to Parliament”. This is a serious case. Those nurses were summoned; Dr Engelbrecht said she talked to them. When he Committee asked who these nurses were; the HOD said she had to check the record, but she does not have the report. The Committee needs documents that give the names of nursing staff.
Dr Patel replied that there are four shifts of nurses, as the HOD said. The documents of their identities will be presented to Parliament.
An MP raised the point that Tamara had no folder in the hospital.
The CEO responded that once one nurse completes her care, her shift changes. The hospital will provide the full set of staff and the reports of the incidents to the HOD.
The Chairperson responded that information on the nurses’ identities was supposed to be presented to the committee today. The Committee could not finish this hearing because the delegation left some information out.
A committee member said, according to the report, it looks like there is no meticulous record keeping in the hospitals.
The Chairperson clarified the member’s question and asked if there was meticulous record keeping in the hospital.
Dr Engelbrecht said the Member highlighted one area the HOD was concerned about. The HOD is concerned about the records of how Tamara was turned, washed, and cared for.
The Chairperson asked if it was true that there was no proper recordkeeping.
Dr Engelbrecht said that the recordkeeping was present, but incomplete.
The Chairperson said that if the recordkeeping was present, it should show what happened to Tamara.
Dr Engelbrecht said there was no record of the injury and that that is the HOD’s “shame”.
The Chair again asked if the hospital had proper record keeping and asked for a yes or no answer.
Dr Engelbrecht replied that, regrettably, the recordkeeping was not properly done.
The Chairperson said that the HOD spoke “like a lawyer, not a doctor”.
Mr Julius made a point of order. He said that the Chair was “acting as though he was in a court of law”. The Select Committee agreed to seek clarity. The Chair did not stop any speakers who already made assumptions. The chairperson was “crisscrossing and jumping in”. The Committee did need to see information about the nurses, but the Committee does not need to “get emotional” and jump from issues. The committee is on a fact-finding mission. The MP asked the chair to allow him to finish.
The Chairperson responded that Mr Julius' statement was not a "point of order”. A point of order is directed to a particular point where a member is out of order. The point here was questioning whether there was proper recordkeeping. The Chairperson asked what is out of order about that point.
Mr Julius replied that he had stated the Chairperson was out of order. The proceedings were not happening as they should. The point of order was that the Chairperson was acting as if he were in a court of law. The Chairperson was “interrogating” the delegation and not fact-finding.
The Chairperson interrupted that this concern was not a point of order.
Mr Julius responded that it was a point of order.
The Chairperson replied that he was ruling that the statement was not a point of order.
A committee member agreed with Mr Julius and said the Committee was not there to “play judge and jury”. It gives the Committee some level of reassurance that there is some clarity and an investigation. Was there a retrospective appeal and what could be done.
Dr Engelbrecht welcomed this statement. It would not be impossible to do a retrospective investigation and that it would be a good idea. The department would make use of that.
A committee member said she had asked a question that was not answered. When someone looks at the Summary of Events, there are unanswered issues. An assault case was opened in March 2014. Where was that report? It was clear that there were people who already made other affidavits.
The Chairperson reminded the member to stick to clarity-seeking questions.
The member thanked the Chairperson for his guidance. She rephrased her question. Why were the reports not sent to the Committee?
The Chair asked the HOD if the question was clear and restated that the question was what the HOD did with the reports from the internal investigation.
Dr Engelbrecht replied that an investigation and reports were done with the relevant nurses. A follow-up meeting happened with Ms Fuzane. A meeting was conducted on how to improve on this issue.
A committee member said she is sure HOD agrees with the Committee that there is an issue here. Nurses take an oath and misbehaviour means the nurse must be charged with misconduct. To say that there was nobody to charge because there were four shifts is not true. There is a nursing manager for each ward. That manager is accountable for misconduct that occurs. Where there is “death,” mistreatment, and the development of sores, the nurse manager must take full responsibility. The member asked why the nursing manager was not charged.
The Chairperson clarified that the question was why the nursing manager on Tamara’s ward was not charged.
Dr Engelbrecht responded it was important to clarify one point. There was no relation between the incident on 13 February 2014 and the death of Tamara in March 2015. It was necessary to be fair. In addition, accountability is important. That is why the HOD was in front of the Committee.
Ms C Ncube-Ndaba (ANC, Gauteng) asked how a hospital can treat a patient if that patient does not have a file. She asked if she could be correct in saying that “they killed the patient deliberately because the family was pestering them”.
The Chairperson interrupted that the Committee could deliberate on that at another time.
Ms Ncube-Ndaba responded that if the HOD is “competent”, then information must have been available.
A committee member stated that the MPs must not be treated as though they do not know what is going on. Whatever happens in an emergency unit of a hospital, the HOD is indeed ultimately responsible for the incident, but the question remains why the nursing managers were not present at the Committee. The reason the committee requested the nurses and nursing managers was to gain information from them. The absence of information causes frustration on both sides.
The Chairperson interrupted the Committee to ask whether members still had strictly clarity-seeking questions. He wished to move forward. If MPs were not asking clarity-seeking questions, the Chair will apologize and stop them.
Mr Ximbi referred to the record, saying that Dr P S Mawisa (not present) performed part of the investigation. Dr Mawisa concluded that Tamara had been assaulted.
A committee member responded to Mr Ximbi that “assault” is a strong word that implies malicious intent and that clarity of language was needed.
Several members expressed dissatisfaction that there was insufficient information on the actions of the specific nursing staff.
A committee member said it was possible that the hospital “wanted to silence” the patient.
The Chairperson interrupted that this issue should be saved for the Committee’s deliberations and was not a clarity-seeking question. He asked for clarity seeking question only. The purpose of the hearing was to gain evidence and clarity. The delegation was given an opportunity to provide certain information (the nurses’ statements) and did not. He wants the Committee to make a balanced and fair deliberation. The Committee could not be blamed after its decision if the delegation did not provide all necessary information.
The HOD clarified that the Committee only requested certain information from the department. She now hears that the Committee would like additional information. She reiterated that the hospital records were incomplete, but present.
The Chairperson thanked Khayelitsha and Groote Schuur Hospitals, the Provincial Department, the National Department of Health, Ms Fuzane, the national group, and everyone who presented information. He stated that the Petitions Select Committee will meet with the Portfolio Committee and will arrive at a determination. The decision will be public information, so it will be available to the delegation. The Chairperson also appealed to anyone who might have additional information to contact the committee.
The Chairperson asked the committee secretariat to collect the documents from the DOH so that by the time committee next sits, it has all relevant information. The information will allow the committee to deal with the matter and resolve the issue so they can fairly determine and make conclusion without favour or prejudice.
Mr Ximbi reiterated that the Committee wanted information about the nurses who treated Tamara. Who was the nurse in charge? This was one of the first questions asked.
The Chairperson interrupted the member and asked the HOD if the DOH would forward this information to the Committee.
Dr Engelbrecht replied that this information would be provided.
The Chairperson determined that there would not be another hearing.
Ms Mokwele expressed dissatisfaction that specific information on nurses was not provided. She wanted to give the delegation the benefit of the doubt. However, the report provided read like an essay. She requested an additional week so the delegation could provide the information.
A committee member asked what the outcome of the national department’s investigation was.
The Chairperson said that he wanted to wrap up this part of the meeting.
Dr Engelbrecht responded that the national investigation revealed that there were certain places for improvement.
Members reiterated that the Committee needed the patient’s folder to make a determination.
Dr Engelbrecht replied that the forthcoming documents sent to the Committee would include the patient’s folder.
The Chairperson called for a seven-minute break, after which the national group will speak on the case.
Reconvening, the Chairperson invited that national delegation to present their findings .
National Department of Health submission
Dr Terence Carter, Deputy Director-General: Hospitals Tertiary Service in the National DOH, said he was given the responsibility to investigate the matter. He looked at the photographs provided. He is a medical doctor but is not an expert in these matters, so he decided to get expert opinion on the photographs. He sent them to Professor Simon, an expert head of forensic medicine at the University of Pretoria. Dr Carter has Dr Simon’s report with him. For sake of time, Dr Carter summarized the report. Prof Simon said these injuries were most likely caused by deliberate assault with a stick or a cane. The report explains how Prof Simon came to that conclusion. The assault probably happened before Tamara was discharged. During the investigation, no nurses admitted anything. All nurses said they knew nothing. Dr Carter said he found this odd. As a supervisor himself, he believed someone must have seen something. It is possible that discharge from Tamara’s wounds stained the bedsheets. Someone would have seen this.
Dr Carter did not believe that no one witnessed how Tamara was injured. He thought future investigation was needed. He received the names of all nurses on duty. He also collected the names of all patients in the hospital at the time. If the nurses would not talk, perhaps the patients saw something. He spoke to Ms Fuzane. Tamara was in a side ward with only two beds. The only other person able to see something was the second patient in that ward.
According to Dr Carter, Ms Fuzane had spoken with the second patient. That patient had said that nurses would draw a screen around Tamara. Therefore, the other patient could not see Tamara. The police are best equipped to answer questions about the injuries because the assault had been reported to them. The prosecutor’s investigation on this case was closed but re-opened on 15 May. The prosecutor believed there was not enough evidence to prove assault beyond reasonable doubt.
Several members agreed with Dr Carter that the pictures clearly showed that Tamara was “hit” or “beaten”.
The Chairperson interrupted that members should ask only clarity-seeking questions.
A committee member asked Dr Carter about the continued investigation.
Dr Carter replied that he had told the special prosecutor of the new evidence that Professor Simon found.
Members reiterated that more information was needed for a full determination.
The Chairperson thanked the Members and apologised if they wanted to say more than time allowed. The Committee would decide on the date for a meeting for the purpose of deliberations. The meeting was adjourned until further notice.
- Investigation regarding complaint of alleged assault of Tamara Fuzane (KHA 62508768)
- Nobuntu Gladys Fuzane - Groote Schuur Hospital
- Memorandum from Office of the Head of Health Department of the Western Cape
- Adv R de Kock Director of Public Prosecutions: Western Cape Government letter
- Nobuntu Gladys Fuzane Complaint Against KDH, Khayelitsha
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