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Adverse events rise in Gauteng’s worst hospitals

Serious Adverse Events (SAEs) in Gauteng public hospitals have risen from 4170 in 2019 to 4701 last year, an increase of 13%, with Tembisa Hospital by far the worst with 1226 SAEs during this period.

This is revealed by Gauteng Health MEC Nomathemba Mokgethi in a written reply to my questions in the Gauteng Legislature.

A SAE is defined as an event that results in an unintended harm to the patient by an act of commission or omission rather than by the underlying disease or condition of the patient.

Hospitals with high numbers of SAEs for 2019 and 2020 include the following:

George Mukhari  – 1022

Chris Hani Baragwanath  – 883

Kalafong  – 850

Weskoppies  – 74

Charlotte Maxeke Johannesburg  – 632

Thelle Mogoerane  – 380

Mamelodi  – 362

Sebokeng  – 324

Helen Joseph  – 319

Leratong  – 258

Jubilee  – 204

The Rahima Moosa Mother and Child Hospital has the best record, with not a single SAE in 2019, and only 2 SAEs last year.

Steve Biko had the fewest SAEs of the four academic hospitals (the others are Bara, Charlotte Maxeke and George Mukhari), with 55 SAEs in 2019 and 200 SAEs last year.

Some hospitals saw sharp increases from 2019 to 2020. Edenvale hospital went up from 13 to 129, Leratong from 61 to 197, Helen Joseph from 102 to 217, and Sebokeng from 107 to 217.

The 747 SAEs at Weskoppies mental hospital are of concern as there is no surgery at this hospital.

Tembisa’s very number of adverse events highlights the poor judgement in choosing it as a Covid-19 treatment centre. This was a finding of the Medical Ombudsman when he investigated Shonisani Lethole’s death at this hospital.

Our health sector has been battered by the Covid-19 pandemic, and effective measures need to be taken to ensure medical negligence is minimised as much as possible. Proper staffing and resources is critical, as well as good training, and disciplinary measures for non-performance.

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Gauteng’s Most Dangerous Hospitals

Serious Adverse Events

The Chris Hani Baragwanath Hospital has the highest number of Serious Adverse Events (SAEs) affecting patients in Gauteng, with 62 SAEs reported in 2015.

This is according to information I have obtained from the Gauteng Health Department after submitting a request using the Promotion of Access to Information Act (PAIA).

A SAE is defined as an event that results in an unintended harm to the patient by an act of commission or omission rather than by the underlying disease or condition of the patient. This can involve negligence, staff incompetence and system failure.

Most Dangerous Hospital

Chris Hani Baragwanath Hospital compares poorly with the other academic hospitals which had the following much lower SAEs in 2015:

Charlotte Maxeke Johannesburg Hospital – 10 SAEs

George Mukhari Hospital – 9 SAEs

Steve Biko Hospital – 3 SAEs

Jubilee Hospital is the most dangerous hospital in Gauteng as it recorded 51 SAEs despite being much smaller than Baragwanath Hospital.

Other dangerous hospitals include the following:

Pholosong – 46 SAEs

Leratong – 30 SAEs

Kopanong and Odi – 28 SAEs

Pretoria West – 23 SAEs

Sebokeng – 22 SAEs

Far East Rand – 21 SAEs

Safest Hospitals

The safest hospitals with the lowest SAEs are as follows:

Heidelberg – 1 SAE

Edenvale – 2 SAEs

Tambo Memorial – 3 SAEs

Rahima Moosa – 4 SAEs

Medical Mistakes

The most improved hospital is Tembisa, which had 17 SAEs in 2015, down from 71 SAEs recorded from January 2012 to September 2013.

There was a total of 503 serious adverse events (SAEs) in Gauteng state hospitals in 2015.

More steps are needed to cut down medical mistakes and ensure that patients are healed  rather than injured in our state hospitals.

 

 

Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

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Fire At Steve Biko Hospital

I am relieved that no one was hurt by the fire at the Steve Biko Academic Hospital in Pretoria on Saturday night, but it highlights the need for regular fire inspections at Gauteng hospitals.

Last year there were three fires at Gauteng Hospitals:

  • A fire in the stores department of the Tambo Memorial Hospital on 30 May;
  • Cleaning department fire at Helen Joseph Hospital on 6 September; and
  • Fire caused by electrical fault at a washing machine at the laundry of the Bheki Mlangeni Hospital on 23 September.

According to a written reply by Gauteng Health MEC Qedani Mahlangu to my questions in the Gauteng Legislature in October last year, an inspection was last done at the Steve Biko Hospital in July last year. It found that exits were blocked and while non-compliance letters were given to management, the exits were still a problem.

The department says that the fire at Steve Biko may have been caused by a cigarette and most patients had to be evacuated. None were injured but about 13 employees were treated for smoke inhalation and discharged.

I think this was a close call as it could have been worse.

According to Mahlangu’s reply to my questions, the following hospitals are long overdue for their annual fire inspection:

  • Leratong Hospital – last inspected in August 2012;
  • George Mukhari Hospital – last inspected in April 2013;
  • South Rand Hospital – last inspected in May 2013;
  • Tara Hospital – last inspected in July 2013;
  • Sebokeng Hospital – May 2014; Carletonville Hospital –  last inspected in June 2014;
  • Edenvale Hospital – last inspected in July 2014;
  • Pholosong Hospital – last inspected in August 2014; and
  • Rahima Moosa Hospital – last inspected in September 2014.

The Gauteng Health Department should ensure that all fire inspections are up to date and action taken on the findings.

We cannot risk a fire that could injure or kill helpless patients.

 

Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

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Workmen’s Comp Owes R38m To Gauteng Hospitals

Gauteng public hospitals are owed R38.2 million by the Workmen’s Compensation Fund, with some claims dating back to 2001.

This shock information is revealed by Gauteng Health MEC Qedani Mahlangu in a written reply to my questions in the Gauteng Legislature.

In the last three years, 9061 claims were lodged by the Gauteng Health Department for a total value of R17.4 million, but only R3.34 million was paid out by the Fund.

Workers whose employers are registered with the Fund can claim if they are involved in an accident at work or develop an illness caused by working conditions.

According to Mahlangu, the under-recovery is due to insufficient information provided by the patient with regard to employers’ details, and employers not completing the relevant Employers report (WCL 2).

There is also a lack of response by the Fund to the claims submitted.

The largest amount (R7.5 million) is owed to the Steve Biko Hospital.

Other hospitals with more than R1 million outstanding include the following:

  • Charlotte Maxeke Johannesburg – R4.9 million;
  • Tembisa – R4.416 million;
  • George Mukhari – R4.399 million;
  • Thelle Mogoerane (Natalspruit) – R2.47 million;
  • Helen Joseph – R2.19 million;
  • Kalafong – R1.95 million;
  • Chris Hani Baragwanath – R1.78 million; and
  • Leratong – R1.37 million.

The hospital with least owing to it is Rahima Moosa Hospital, where only R5186 is outstanding.

The department appointed a service provider in November last year to assist in recovery of outstanding claims from the Fund, but this measure has clearly failed

It is outrageous that so much is owed from the Fund, as the money is desperately needed to improve treatment in our hospitals.

Effective measures should be taken to ensure that outstanding money is recovered as soon as possible.

 

Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

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20 Die And 1 533 Suffer From Hospital-Acquired Infections in Gauteng

Nosocomial

A total of 1533 patients got infections from Gauteng public hospitals in the last three years, and 20 died from these infections that are largely caused by poor hygiene.

These shock figures are revealed by Gauteng Health MEC Qedani Mahlangu in a written reply to my questions in the Gauteng Legislature.

The technical name for hospital-acquired infections is nosocomial, which refers to infections that are caught in hospitals, often caused by organisms that are resistant to antibiotics.

The number of nosocomial infections has increased alarmingly, rising from 236 in 2012, to 322 in 2013 and 975 patients in 2014.

Most Common Nosocomial Infections

Chris Hani Baragwanath Hospital is the worst hospital for infecting patients. Last year, 376 patients got nosocomial infections and 13 died, mostly babies from Klebsiella pneumonia.

Other hospitals with high infection rates in 2014 were as follows:

  • George Mukhari Hospital – 146 patients;
  • Steve Biko Hospital – 138 infections;
  • Leratong Hospital – 79 infections;
  • Helen Joseph Hospital – 77 infections;
  • Sebokeng Hospital – 26 infections; and
  • Natalspruit Hospital – 21 infections.

The most common nosocomial infections last year were as follows:

  • Klebsiella Pneumoniae – 294 infections;
  • Acinetobacter Baumanli – 226 infections;
  • Methicillin Resistant Staphylococcus Aureus (MRSA) – 145 infections;
  • Escheria Coli – 99 infections;
  • Pseudomonas Aeruginosa – 91 infections; and
  • Candida Albican – 51 infections.

According to Mahlangu, predisposing factors for nosocomial infections are:

  • Population growth which leads to overcrowding of patients;
  • Premature babies are vulnerable to acquiring micro-organisms in hospital because their immune system is not well-developed; and
  • The recommended standard for space between incubators is 91 cm apart.

She says that steps to bring down these infections include continuous monitoring and adherence to World Health Organization protocols, and involving the community in hand hygiene practices when they visit relatives in hospital.

Hygiene Must Improve Radically

I am disturbed by the increasing rate of nosocomial infections in Gauteng hospitals, and special attention needs to be paid to Chris Hani Baragwanath Hospital.

It is encouraging that there were only 8 nosocomial infections at the Charlotte Maxeke Johannesburg Hospital last year, which shows that infection rates can be kept down with proper care.

It is terrible that so many patients suffer from infections they get in hospitals, often because of poor hygiene, which needs to improve radically.

 

Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

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1000 Multi-Drug Resistant TB Cases in Gauteng

Multi-Drug Resistant TB Cases

There are an estimated 1000 Multi-Drug Resistant TB cases in Gauteng, but only 217 of these cases have been placed on treatment.

This information is revealed by Gauteng Health MEC Qedani Maglangu in a written reply to my questions in the Gauteng Legislature.

The number of diagnosed MDR-TB cases has risen over the last three years as follows:

  • 2012 –  747
  • 2013 –  857
  • 2014 – 1007

According to Mahlangu, the increase is because of population growth.

Of the 217 MDR-TB patients on treatment, 115 are at the Sizwe Hospital, and the others are at the following hospitals:

  • Pholosong Hospital – 43
  • Tembisa Hospital – 13
  • South Rand Hospital – 13
  • Tshwane District Hospital – 11
  • Johan Heyns CHC – 8
  • Helen Joseph Hospital – 4
  • Leratong Hospital – 4
  • Charlotte Maxeke Hospital – 3
  • Carletonville Hospital – 3

Cure Rate

The cure rate for MDR-TB is only 55%, and 238 people have died of MDR-TB in the last three years. I am concerned that only about one in five MDR-TB patients in Gauteng are being treated.

This means that about 800 people with MDR-TB are spreading infection to others because they have not been diagnosed and put on treatment in a hospital.

There needs to be a higher priority in tracing people with this virulent form of TB as they are a danger to others and need to be treated if they are to have a chance of survival.

 

Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

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Slow Aircon Company Keeps Getting Gauteng Hospital Contracts

The Gauteng Infrastructure Development Department has awarded four contracts worth R22.5 million to an air-conditioning company despite their failure to complete any project on time.Jack Blom DA Gauteng Shadow MEC for Health

Cool Breeze Air Conditioning and Refrigeration CC

This information concerning Cool Breeze Air Conditioning and Refrigeration CC has come to light in a written reply by Gauteng Infrastructure Development MEC Nandi Mayathula-Khoza to my questions in the Gauteng Legislature.

In the worst case, their incompetence led to all surgery being halted at the Pretoria West Hospital for two-and-half years because they took so long to do a 5 month job installing air-conditioning in the operating theatres.

Gauteng Hospitals Affected

Contracts awarded to this company are as follows:

  • Air-conditioning for Leratong Hospital theatres in 2010/11 for R7.995 million;
  • Upgrade of air-conditioners at neo-natal ICU at Chris Hani Baragwanath Hospital in 2011/12 for R3 million;
  • Installation of chiller plant at Pretoria West Hospital in 2012/13 for R5.64 million; and
  • Additional oxygen and vacuum points at Charlotte Maxeke Johannesburg Hospital in 2013/14 for R5.8 million.

Unreliable Companies Getting Contracts

According to Mayathula-Khoza, penalties have been imposed and the company has been put on terms to complete the Pretoria West installation on a revised date.

My concern is that this unreliable company keeps getting contracts even though it has never finished any hospital contract on time, leading to major disruption for staff and patients.

I suspect that there may be a political connection that assists the company in getting contracts despite repeated non-performance.

This company should be barred from any further hospital contracts.

 

Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

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64 Essential Medicines Short at Gauteng Hospitals

A total of 64 essential medicines are unavailable or in short supply at Gauteng public hospitals, causing severe problems for patients who need them.

This is revealed by Gauteng Health MEC Qedani Mahlangu in a written reply to my questions in the Gauteng Legislature.

According to Mahlangu, 86% of Vital medicines and 76% of Essential medicines are available.

Varying Shortages

Medicine shortages vary at different hospitals, depending on the level of care that is given.

Chris Hani Baragwanath Hospital is the worst affected, with 51 drugs out of stock, followed by Leratong Hospital (50 items) and Kalafong Hospital which is short of 49 medicines.

The shortages at other major hospitals are as follows:

  • Helen Joseph Hospital –                 46
  • Steve Biko Academic –                  45
  • Edenvale Hospital –                       39
  • Charlotte Maxeke Johannesburg –   37
  • South Rand Hospital –                   28

Out of stock medicines include:

  • Paracetomol tablets 500mg
  • Atenolol tablets
  • Amoxycillin acid suspension
  • Pethidine hydrochloride injection
  • Rantidine hydrochloride injection
  • Ibuprufen suspension 100mg
  • Calcium carbonate tablets
  • Zinc sulphate syrup
  • Lactulose syrup
  • Omeprazole capsules

(Full list available on request)

MEC Blames National Tenders

I am aware of cases where patients are given a script and told to buy from a private pharmacy, but many cannot afford to do this.

Mahlangu says that if stocks are low, patients get a one month supply instead of the usual 3 month supply, and that institutions assist each other where medicines are in short supply.

She blames the non-availability of medicines on national tenders and the failure of suppliers to build up the necessary stock levels to meet the province’s needs.

It is scandalous that nearly one in four essential medicines are not available in Gauteng public hospitals and clinics.

This appalling situation has dragged on for far too long and requires effective measures to ensure that medicines are always available.

 

Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

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