Health authorities in the Eastern Cape are liable for damages to a widow after her husband fell out of the fifth floor window of the Livingstone Hospital in Gqebera.
The incident was found to have been due to the negligence of staff who under-medicated him and did not properly monitor him for his apparent psychosis.
George Williams was admitted to hospital while suffering from severe alcohol withdrawal, a condition known as delirium tremens. He also appeared to have been suffering from secondary schizophrenia.
Williams died of his injuries hours after he had fallen out of the glass window from the fifth floor at the nurses’ tearoom.
His wife, Jeanine Williams, instituted a claim for damages in the Eastern Cape High Court, stating that if the nursing staff were vigilant and not negligent, her husband could still have been alive.
Acting Judge I Bands found that had the deceased’s medication been adjusted, it could be gainsaid that he would have been reduced to a calm and lightly dozing state.
“This would have enabled the medical and nursing personnel to monitor his vital signs and his condition appropriately until such time the delirium tremens had abated. He would not have been pacing up and down the ward in a confused, restless, and disoriented state,” the judge said.
Had this state of affairs been prevented, the deceased, on a balance of probabilities, would not have fallen from the fifth floor of the hospital, resulting in his untimely death, the judge said.
The deceased, said to have been a known alcoholic, complained of visual disturbance, dizziness, hallucinations and sleeplessness when he was admitted to hospital. He was on several occasions, within hours apart, administered calming drugs, such as Valium, but this simply had no effect on him.
He appeared confused, was up and about, and still restless.
Although it was said that the nursing staff was afraid of him as he walked up and down the passage in the ward, they never told the doctor on duty that these drugs had not taken effect on him.
He eventually broke the glass door and window of the nurses’ tearoom and fell from the fifth floor to the ground floor. As a consequence of the fall, he suffered hypovolemic shock, and died a few hours later.
A medical expert called to testify on behalf of his widow explained that delirium tremens was a medical emergency and that immediate management of the condition was necessary. Given that the deceased, on admission was said to have delirium tremens, it was reasonable to expect the medical staff to know that he would have been experiencing, among others, anxiety, insomnia, visual and auditory hallucinations, confusion, and disorientation, she testified.
Thus, the court was told, he had to be monitored closely and given sufficient medication until he was calmer.
As these patients tend to be delusional, confused, and disoriented, the expert said a nurse also had to reorientate the patient at regular intervals as to where he is and why he is in hospital.
The role of the nurse would be to administer the medication as prescribed; and monitor the patient’s response to the it to ensure that the patient had the expected response. In the event of the patient not responding – as in this case – it is the duty of the nurse to inform the doctor. It was found that the nursing staff had failed to do this.
“Not only was the deceased under-sedated, but there is no evidence that the initial dose, which had no effect, was ever increased as per the published guidelines.
“This despite multiple entries in the hospital records that the patient remained confused, disoriented, restless, and was walking up and down the passages, and that his symptoms were worsening over time,” the judge said.
The nursing staff feared that he would assault them by the time that Williams fell from the fifth floor, yet they did not call the doctor on duty for help, the judge said. The amount of damages due to the widow will be decided at a later stage.