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04/10/2007 11:17 AM - (SA) Lack of oxygen played 'vital role' in Heloïse's death 05/10/07
The aim of the hearing is to establish if negligence on anyone's part caused the young woman's death in January 2003, after an allergic reaction to prescribed medicine, containing penicillin, led to cardio-pulmonic arrest and caused massive brain damage. Evidence was earlier heard that a Metro ambulance which arrived on the scene first, did not have oxygen. Although oxygen had been available at a doctor's surgery, located just opposite a pharmacy where the girl had collapsed, this was never utilised. "I put it to you, that you went to no trouble to fetch the oxygen in your surgery," Mrs Van Heerden told medical practitioner, Dr Johan Eloff, at the hearing this week. He had testified that he was having lunch at a nearby restaurant with his receptionist, Jolene McLaren and Prof Johan Joubert, when he was called to assist the pharmacist with a patient who was struggling to breathe. He helped the pharmacist carry the patient to her mother's car so she could be rushed to hospital, but her heart and breathing stopped when they put her into the car. He then applied mouth to mouth resuscitation and CPR, expecting his receptionist at any minute to come and unlock the door, after he had called out in the pharmacy for someone to fetch her. She never arrived. "Doctor, you were trained to act calm in emergencies," Mrs Van Heerden said, "yet you want to say you never thought about kicking down the door?" Dr Eloff reiterated: "Seen in retrospect, I have more than once told people I would've broken the front door to get the oxygen. But the fact is, I didn't do it. Things did not happen as I thought they would." Mrs van Heerden pointed out to the doctor that both the mother and an off-duty policeman who rendered CPR to the girl in the car, testified that they did not see him giving mouth to mouth resuscitation to the patient. "I cannot comment on that. Many other people saw me," the doctor said. Elna du Toit had taken her daughter Heloïse to Dr Johan Eloff's surgery on January 18, 2003, after suspecting bladder infection. He was not their usual family doctor, and Prof Johan Joubert, a retired head of medical biology at the University of Stellenbosch, who stood in for the doctor, prescribed the antibiotic Keflex and also Mybulen, for pain after consulting with Dr Eloff on the phone. The Keflex was subsequently replaced by pharmacist Dirk du Toit with a generic drug, Ranceph. Mrs M van Heerden for the State, and attorney Vlakkies du Toit, who is representing Heloïse's mother, both questioned why it was necessary for Prof Joubert to consult with Dr Eloff over the phone while he was busy with the patient; why her temperature was never taken with a thermometer after complaints of a high temperature and why no urine tests were done to confirm a suspected bladder infection. They also raised questions about why Prof Joubert had not asked the patient about any allergies or earlier medical history on this first visit to the surgery. The only records were a document filled in by the mother for administrative purposes, which had the word "allergies" scribbled in ink, but no details added, and some brief notes of Prof Joubert pertaining to her symptoms prior to the visit. These documents and the entries made with different pens, were questioned, but both doctors denied any tampering with it to hide possible negligence on their part. Dr Eloff stated that they had enquired about allergies, but the answer had been "negative." He said the professor did not think it necessary to take the girl's temperature, because of his clinical observance that the patient did not present symptoms of a high temperature, and had a sensitivity in her lower abdomen. The laboratory test results would have taken anything from 24 hours and their intention was to provide immediate relief for the pain and discomfort suffered by the patient. He also said tests done on the patient later in the hospital confirmed his diagnosis of infection of the bladder and urinary tracts. Advocate Graham van der Spuy, who is representing both doctors, lodged objections to the "misleading questions of the State", and the line of questioning by Mr Theron. Magistrate S Engelbrecht informed the doctors that they need not answer incriminating questions.
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