Eastern Cape High Court (Port Elizabeth) Acting Judge Nicholas Mullins has heard that a cascade of events that left a newborn baby with severe brain injuries was preventable by the administration of a medical product easily available to a paediatrician.

Chris Mouton SC, representing the parents of the child, now 10, said the first 48 hours after the girl was born in November 2008 were crucial and will form the basis of the R23m lawsuit against Netcare Greenacres Hospital and specialist paediatrician Dr Charmaine van Heerden.

According to a report in The Herald, Mouton told the court a reasonable paediatrician would have administered a surfactant timeously which, he claimed, added to the negligence. A fluid secreted by the alveoli in the lungs is a surfactant and contributes to the elasticity of the lungs and air passages.

The girl born at 32 weeks was about eights weeks premature and, according to Mouton, was in a good condition but was shortly after birth diagnosed with hyaline membrane disease (HMD) by Van Heerden. HMD almost always occurs in premature babies when there is not enough surfactant produced but it is easily treated pre-birth or shortly thereafter.

The primary focus (of this case) is the failure to administer surfactant timeously,’ Mouton said.

Part of the claim is that Van Heerden allegedly did not order a further chest X-ray after diagnosing the baby with HMD or an arterial blood gas test in time to determine the oxygen level in the child’s blood.

After diagnosing the baby with HMD, Van Heerden allegedly ordered that she be treated with a continuous positive airway pressure intervention, which Mouton claimed could be deadly for a baby.

Full report in The Herald (subscription needed)