Toddler amputation was unavoidable

Friday, December 11, 2009

Pretoria - An investigation on the circumstances led to the amputation of the legs of a toddler treated for burns to her hands was unavoidable.

A preliminary report of a team set up to probe the circumstances leading to the amputation was submitted to Gauteng MEC for Health and Social Development Qedani Mahlangu on Thursday.

The report also dismisses allegations that the child developed gangrene on both her legs because of intravenous drips inserted on her feet.

Thembisa Nikelo, 2, was admitted at Far East Rand Hospital with burn wounds on her hands and face in September this year.

She later developed gangrene on both her legs and was transferred to the Charlotte Maxeke Johannesburg Academic Hospital, where her legs were amputated.

The six-member team of investigators, led by Professor Joe Veriava expressed concern about the standard of care the child received at the Far East Rand Hospital.

The team's primary concern relates to a failure by doctors to recognize the severity of the child's clinical condition, the degree of senior supervision, oversight and involvement.

According to a report, there was inadequate communication and interaction between the surgeons and the paediatricians relating to the management of the child.

"There was also no consideration given to treat Thembisa in a high care or an intensive care unit with paediatricians playing a major role in her management," the report stated.

The team also found that the child should have been transferred to Charlotte Maxeke Hospital much earlier.

"When Thembisa arrived at the hospital (Charlotte Maxeke) gangrene of both legs below the knee was well established and amputation was unavoidable," the report said.

However, it found that the gangrene was definitely not due to the insertion of intravenous line into a vein in the foot.

"The team said it could not find any problem in the care that the child received at Charlotte Maxeke Hospital.

"A more in-depth investigation will now be conducted and the team will have to report in January," department spokesperson Simon Zwane said.