Wakilii

Freda Kasaira and Others v The Registered Trustees of Nebbi Catholic Diocese (Civil Suit No. 20 of 2016)

High Court · [2017] UGHC 137 · 2017 Judgment for Plaintiffs AI-generated summary ↓ Download Pin to watchlist Add to matter
Jurisdiction
Uganda
Case Type
First instance civil suit for damages for wrongful death arising from alleged medical negligence
Decision
Defendant found vicariously liable for medical negligence; damages awarded to plaintiffs and dependants

Observed later treatment

No later-treatment classification is recorded for this judgment.

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Holding

The court held that the surgical team at Angal St. Luke Hospital was negligent in failing to attach a pulse oxymeter before commencing surgery and in failing to adopt alternative anaesthetic methods after experiencing difficulty with intubation, resulting in the patient's brain death and subsequent death two days later. The deceased's dependants were awarded general damages of UGX 90,000,000, special damages of UGX 6,781,000, interest at 8% per annum, and costs.

Outcome

Defendant found vicariously liable for medical negligence; damages awarded to plaintiffs and dependants

Facts

The deceased, Ms. Angucia Lucy, was admitted to Angal St. Luke Hospital on 8 September 2015 with appendicitis. She underwent surgery on 10 September 2015. During the operation, the anaesthetist experienced difficulty with intubation after three attempts. The surgical team commenced the procedure without attaching a pulse oxymeter to monitor oxygen supply. When the surgeon made the first incision, he observed dark-coloured blood indicating lack of oxygen. Upon checking, the team discovered the ventilator was on but the monitor had not been turned on and the patient's oxygen circulation was low. The patient suffered cardiac arrest. Resuscitation efforts were attempted but the patient never regained consciousness. She was confirmed brain dead in the operating theatre. She was placed in recovery and later transferred to the ward on oxygen support with a tube still in place. She died two days later on 12 September 2015. A clinical audit found multiple failures: monitors not in place at commencement, difficulty with intubation not addressed by alternative methods, no records kept of major occurrences, inadequate handover to ward staff, and inadequate post-operative monitoring.

Issues

  1. Whether the defendant's agents were negligent in conducting the medical operation or procedure on the deceased.
  2. What remedies are available to the parties in the circumstances?

Orders

  • General damages of UGX 90,000,000 awarded and apportioned among the plaintiffs and dependants.
  • Special damages of UGX 6,781,000 awarded.
  • Interest on general and special damages at the rate of 8% per annum from the date of judgment until payment in full.
  • Costs of the suit awarded to the plaintiffs.

Rules and key headnotes

Medical Negligence — Standard of Care — Bolam Test
Medical professionals are required to conduct themselves at least in accordance with the standard of their professional peers. The test for negligence in medical treatment is whether the medical professional acted in accordance with practices regarded as acceptable by a respectable body of opinion in the profession, exercising the ordinary skill of a reasonably competent and skilled health care professional with a similar background and in the same medical community under the circumstances.
Medical Negligence — Informed Consent — Material Risks
Common law imposes a duty on a medical practitioner to warn a patient of material risks inherent in a proposed surgical procedure. A risk is material if a reasonable person in the patient's position, if warned of the risk, would be likely to attach significance to it. A consent form that does not indicate what information was given to the patient about the nature and range of significant risks does not constitute proof of informed consent.
Medical Negligence — Scope of Consent — Non-Inherent Risks
A patient's informed consent to a surgical procedure does not cover negligent techniques or mistakes that occur during surgery that are not inherent in the procedure itself. Failure to attach monitoring equipment before commencing surgery is not an inherent risk of the surgical procedure but a failure to meet the required standard of care.
Medical Negligence — Vicarious Liability of Employers
A hospital or health facility is vicariously liable for negligent acts of its employed medical professionals performed in the course of their employment, even if the acts are done contrary to orders, deliberately, wantonly, negligently, or criminally, provided the acts constitute a manner of carrying out what the employee was employed to do.
Causation — Chain of Causation — Intervening Causes
Where death occurs some time after a negligent medical act, the court must determine whether the negligent conduct was a substantial and operating cause of death. An intervening cause will break the chain of causation only if it is independent of the tortfeasor's acts and so potent in causing death. If at the time of death the effects of the original negligent act are still an operating and substantial cause, the death can properly be said to result from that negligence, even if some other cause is also operating.
Loss of Dependency — Calculation — Multiplier Method
In assessing general damages for loss of dependency following wrongful death, the court takes the deceased's last earnings as the starting point, assesses the pecuniary benefit regularly accruing to dependants, determines an appropriate multiplier based on the deceased's age and working life expectancy, and multiplies the annual lost benefit by the multiplier. The total is then apportioned among dependants, with younger children receiving relatively larger portions in recognition that their dependency would have lasted longer.
Special Damages — Proof — Documentary and Oral Evidence
While special damages must be specifically pleaded and strictly proved, strict proof does not necessarily always require documentary evidence. Where expenditure is of a nature for which receipts would not ordinarily be expected in the normal conduct of affairs, and the amounts claimed are not exaggerated, cogent oral evidence may sufficiently prove special damages to the required standard.

Cases cited (21)

  • Bolam v Friern Hospital Management Committee [1957] 2 All ER 118
  • Cuossens v Attorney General [1999] 1 EA 40
  • Benham v Gambling [1941] 1 All ER 7
  • Gulbanu Rajabali v Kampala Aerated Water Co Ltd [1965] EA 587
  • Jane Gaffa v Francis X S Hatega (Civil Suit No. 1158 of 1975)
  • Sarah Watsemwa Goseltine and Another v Attorney General (Civil Suit No. 675 of 2006)
  • Lusiya v KCC [1972] EA 240
  • Donoghue v Stevenson
  • Maynard v West Midlands Regional Health Authority [1985] 1 WLR 685
  • Muwonge v Attorney General [1967] EA 17
  • McGhee v National Coal Board [1973] 1 WLR 1
  • R v Smith [1959] 2 QB 35
  • Cheshire v R [1991] 3 All ER 670
  • People v. Lewis 57 Pac 470 (1899) (Cal SC)
  • Borham-Carter v Hyde Park Hotel [1948] 64 TLR
  • Masaka Municipal Council v. Semogerere [1998-2000] HCB 23
  • Musoke David v. Departed Asians Property Custodian Board [1990-1994] E.A. 219
  • Kyambadde v. Mpigi District Administration, [1983] HCB 44
  • Haji Asuman Mutekanga v Equator Growers (U) Ltd (Supreme Court Civil Appeal No. 7 of 1995)
  • Gapco (U) Ltd v AS Transporters (U) Ltd (Court of Appeal Civil Appeal No. 18 of 2004)
  • Awino and Four Others v Luwaga and Another (Civil Suit No. 139 of 2006)

Full judgment

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Freda Kasaira and Others v The Registered Trustees of Nebbi Catholic Diocese (Civil Suit No. 20 of 2016) [2017] UGHC 137 (26 October 2017)
Source: this page presents Wakilii’s issue analysis and metadata for a publicly reported Ugandan judgment. Any AI-generated summary is marked as such. Judgment text is sourced from the Uganda Legal Information Institute (ulii.org). Wakilii is not affiliated with ULII.