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SAMJ: South African Medical Journal

On-line version ISSN 2078-5135
Print version ISSN 0256-9574

SAMJ, S. Afr. med. j. vol.98 n.5 Pretoria May. 2008




Probe into alleged treatment refusal



Chris Bateman



A consultancy servicing Acacia Park's Netcare emergency unit in Pretoria has launched a confidential probe into the alleged refusal by one of their doctors to treat a policeman shot in the chest, and the ensuing shut-down of the unit.

Dr Niel Prinsloo, chairperson of the consultancy, Acacia Net 24, disputed Netcare's claim that his group had pulled the doctor from any further duties at Acacia after the 6 March incident, saying Netcare had decided he would no longer work there.

He confirmed that Netcare was treating the incident as breach of contract and that they had placed the emergency unit on divert status until the following morning.

'I can't say how long the investigation will take. I've spoken to the doctor involved and he doesn't wish to talk until the probe is over. He is still working but just not there (Acacia) any longer.' Prinsloo declined to comment on how long the probe would take and would say nothing further, except that the doctor had 'a case to make'.

Sergeant Steven Mahlaule, of Pretoria's Crime Combating Unit, and his partner were on patrol in Soshanguve when they were alerted to the robbery of two Chinese businessmen by two gunmen. They spotted a car fitting the description of the getaway vehicle on the Soutpansberg Road and gave chase, forcing the vehicle off the road and ordering the occupants out. However, one suspect opened fire on them, hitting Mahlaule in the chest. Izindaba sources said that while they were uncertain what vehicle was used to rush the wounded police sergeant to the Netcare Acacia Clinic, its staff was phoned to alert them of the incoming patient.

Doctor 'off duty'

The doctor had allegedly told hospital staff who handled the call that he was off duty and they were unable to get back to the caller to divert the patient. When the patient arrived, the doctor reportedly again refused to treat him. Nearby Netcare 911 advanced life-support paramedics took over, rushing him to the nearby Montana hospital.

Senior staff at Netcare Acacia Park Clinic resolved their ensuing capacity impasse by placing the unit on divert status from about 22h00 that night until the following morning.

Netcare spokesperson, Ms Mandy Toubkin, said that the patient was 'at no stage compromised. The emergency unit was immediately placed on divert in order to rectify the situation.' The policeman had since made a full recovery.

Toubkin said the doctor's peers had 'taken the appropriate action with regard to the continued service of the doctor - they have decided that he will not work in the (emergency) department until the matter has been fully investigated'.

A Netcare insider said both their company policy and its values had been breached by the EMS provider. While the doctor group continued to provide services to the Acacia Clinic, the matter was being viewed in an extremely serious light and was being held as a breach of contract. EMS practitioners spoken to by Izindaba said that unless there had been another doctor on hand, the ethical choice was a 'no brainer'.

Long hours no excuse

'You do get this from time to time, but usually at provincial hospitals where there's a geographical zoning issue and the patient is redirected, sometimes with exhausted doctors getting difficult. But I must say this one sounds, on the face of it, like a no-brainer - it also doesn't matter how long one has been on shift.'

Another said doctors did have the right to refuse treatment, but only under very specific circumstances. The doctor being investigated would have to provide 'very firm reasons' as to why he refused to treat the patient. The Netcare insider said it was possible the service provider had been short staffed. This would however provide no mitigation for the breach of contract and very little for the alleged offender.

An HPCSA media spokesperson did not respond to queries as to whether an official complaint had been laid.

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