Melomed Hospital (Mitchell’s Plain) vs. Cape Argus

SUMMARY

The headline to the story in dispute read, headlined ‘Bladder infection’ actually labour – Teen gives birth after alleged misdiagnosis at private hospital (published on 24 May 2013).

This ruling by Press Ombud Johan Retief was based on the Press Code that was in effect before 30 September 2022.

 

The story was about a pregnant teenager who had gone for medical care at Melomed Mitchells Plain hospital’s emergency unit and who had been misdiagnosed as having been ill with a bladder infection. The patient was then sent to another hospital, where she soon afterwards gave birth.

Melomed complained that the:

•  journalist had failed to record the following facts that it had provided the journalist with, and in this process erroneously/misleadingly/unfairly:
  • portrayed the hospital as a private hospital group;
  • reported that the family had been aware that Micaela was pregnant;
  • stated that another doctor had told the teenager later that day that she was 32 weeks pregnant;
  • failed to consider that its doctor’s diagnosis was backed up by that of a second (private) doctor; and
• headline was misleading.

It added that the reportage was a “deliberate if not negligent attack on the hospital”.

Retief dismissed the complaint, mainly because:

• the omission to state that Melomed was not solely responsible was not material enough;
• the journalist was justified to report the second doctor’s diagnosis, as well as the view of the patient’s father on this matter;
• what another doctor had said or had done after the patient left Melomed was not the issue and did not distract in any way the father’s right to criticise this hospital for the treatment that his daughter got at the time;
• the article sufficiently covered Melomed’s response; and
• headline accurately reflected the contents of the story.

 

THE RULING ITSELF

This ruling is based on the written submissions of Mr Mohamed Ashfaque Ahmed, legal counsel for Melomed Hospital Holdings (Pty) Ltd, and the Cape Argus newspaper.

COMPLAINT

Melomed complains about a story in the Cape Argus headlined ‘Bladder infection’ actually labour – Teen gives birth after alleged misdiagnosis at private hospital, published on 24 May 2013.

The hospital complains that the:

•  journalist failed to record the following facts provided by the hospital and in this process erroneously/misleadingly/unfairly:
  • portrayed Melomed as a private hospital group;
  • reported that the family had been aware that Micaela was pregnant;
  • stated that another doctor had told the teenager later that day that she was 32 weeks pregnant;
  • failed to consider that its doctor’s diagnosis was backed up by that of a second (private) doctor; and
• headline was misleading.

It adds that the above-mentioned boiled down to a “deliberate if not negligent attack on the hospital”.

ANALYSIS

The story, written by Sipokazi Fokazi, said that a pregnant teenager who went for medical care at Melomed Mitchells Plain hospital’s emergency unit was misdiagnosed as having been ill with a bladder infection. The patient, Micaela October, was reportedly given antibiotics before she was sent home. Fokazi wrote that Micaela had consulted another doctor that same day. She was then sent to another hospital, where she gave birth a few hours later to a boy weighing 1.9 kg.

Failing to record

I shall first consider each of the specific complaints, after which I shall take a broader look at the hospital’s communication with the newspaper (to ascertain if its reporting was fair or not).

Portraying Melomed as a private hospital group

The story said that Micaela’s father (“October”) believed that “the private hospital group was negligent in not picking up that his daughter was in labour”. (emphasis added)

Melomed complains that this was “in total conflict” with its email response to the newspaper that indicated that doctors at the emergency units of all Melomed Hospitals practiced “independently” from the hospital group. The issue of (possible) negligence by the hospital is intrinsically linked with the above.

Cape Argus replies that:

• the statement that the hospital subcontracted its emergency units to “private” doctors was irrelevant, as October had approached Melomed Hospital and at all times dealt with its administration; and
• it is a question of complex legal analysis to determine whether the hospital or its subcontractor was responsible for the latter’s actions.

Please note that it is not my task to determine who should take responsibility for what happens at Melomed’s emergency units. Fact of the matter is that the newspaper did not state it as fact that the hospital itself was solely responsible – it merely quoted October’s opinion to this effect. Given the fact that his daughter went to Melomed Hospital (and that she gave birth later that day at another medical institution), it was reasonable for him to have blamed the hospital for being negligent (if indeed he believed that it had been the case).

This is not to say that October was correct in his assessment. From a journalistic perspective he was entitled to his opinion, and likewise the newspaper was justified in reporting his views.

So, the question remains: Should Fokazi have reported that Melomed said that the doctors at the emergency unit acted independently from the hospital group?

Yes, if the story stated as fact that Melomed was solely responsible – which it did not do. While I agree that that would have been the ideal, I also do not believe that the omission of this statement was material enough in order for me to find against the newspaper.

Family aware that Micaela was pregnant

Fokazi wrote: “The family were (sic) aware that Micaela was pregnant, but did not know when she was due.”

Ahmed says that the hospital informed Fokazi that Micaela had told the doctor (Dor Morar) that her father did not know that she was pregnant, and requested that the doctor not disclose this information to him. He argues that, because Micaela was over 12, the hospital was obliged to comply with her instruction. He complains that the journalist (again) failed to report this fact.

Cape Argus replies that October told the reporter that he had been aware of the fact that his daughter was pregnant and, in fact, earlier even ordered that a scan be booked to ascertain the term of her pregnancy). “Regardless of what his daughter may have said to the doctor, the statement is factual, unless October lied about how the scan was booked.”

The newspaper adds that the knowledge of Micaela’s pregnancy by the family was not defamatory and did not reflect on Melomed at all. This is why Fokazi did not include the private discussion between the teenager and her doctor in the story, “which was already long and had to be cut in the editing process”.

I am not in any position to find for or against either party on this issue, as I simply do not have any ground to do so. However, I do note that the story did not say that Micaela’s father knew that she was pregnant – it merely stated that her “family” was aware of that. The story did not say her “whole” family.

I also agree with Cape Argus that this matter could not have caused Melomed any unnecessary harm.

32 weeks pregnant

After quoting October as saying that the (first) doctor (Morar) treated Micaela for a bladder infection and was sent home (but her abdominal pains continued), Fokazi wrote: “Later that same day, she went to a private doctor for an ultrasound, and was told she was 32 weeks pregnant.” The journalist also reported that Melomed had informed her that at the time of the examination there were no signs that Micaela had been in labour.

Ahmed refers this office to Melomed’s email to Fokazi which stated that Micaela had told the doctor in her mother’s presence that her last menstruation had been on January 2 that year. “This information led Dr. Morar to believe that the patient was only 17 weeks pregnant at the time,” the email continued.

He argues that the doctor’s diagnosis and treatment was based on this information – which was clearly false. “This was conveyed to the journalist in our e-mail to her (Fokazi), but she again failed…to include our comments in this regard, instead pursuing a negative and scandalous angle in her report which leans toward holding our Melomed hospital responsible for the alleged ‘misdiagnosis’.”

The hospital states: “The fact that the information provided was false had a significant impact on the thinking of the attending doctor, and thus had an effect on the diagnosis and advice given by the doctor. Failure to clarify this creates the impression that the attending doctor failed in his/her duty and was negligent.”

Cape Argus replies that the sentences in dispute were direct quotes from October and adds that, when read as a whole the story in fact quoted the hospital. The newspaper also points to the statement as recorded in the story that Melomed had said that it had treated Micaela “in accordance with history given”.

I note that the story reported the second doctor’s diagnosis, as well as October’s views on this matter. Surely it was justified to do so.

It would have been better if the story explained what it meant by “in accordance with history given”. However, I also believe that the omission of the information that Micaela allegedly gave Morar about the date of her last menstruation (17 weeks) was materially covered by this phrase.

Not considering some ‘verification’

Ahmed quotes two sentences in the story that “suggested” that Morar’s diagnosis was reasonable as it was seemingly backed up by that of a second doctor, who also did not pick up that Micaela was due to give birth – a probability that he says the journalist should have considered, but failed to do.

He refers in this regard to statements in the story that:

• the second doctor made a booking for her for antenatal care – which (according to Melomed) pointed to the fact that this practitioner also did not believe that Micaela was in immediate danger; and
• it was this antenatal unit (and not the second doctor) that told her that she was due to give birth.

Ahmed adds that he fails to see how Fokazi could have seen fit to report that Melomed was “solely negligent” in this regard.

Cape Argus argues that the second doctor’s diagnosis was irrelevant as it was not part of the story. The newspaper says that, had Melomed examined Micaela more thoroughly instead of relying on her memory about her last menstrual cycle, the hospital would also have been able to determine that she was 32 weeks pregnant and probably in labour.

“In all respects, the portion of the article…is factually correct.”

Again, I find the publication’s argument convincing. What another doctor said or did (or did not say or do) after Micaela left Melomed is not the issue and does not distract in any way October’s right to criticize this hospital for the treatment that his daughter got at the time.

Also, it is not fair to state that Fokazi reported that Melomed was “solely” responsible – she certainly did not state that as fact.

A broader look at Melomed’s communication

I am now asking the question whether the story sufficiently and fairly reflected Melomed’s responses to Fokazi’s questions.

Cape Argues believes that it did, and adds that the reasonable reader:

• was provided with sufficient information to distil from the story the two contradictory views and to understand that it was October’s unhappiness with Melomed’s treatment that led him to complain to the hospital’s management and, when it declined to accept responsibility, to go to the press; and
• would have weighed Melomed’s response against the fact that Michael gave birth later that day “and that, regardless of what she disclosed to the Melomed doctor, was probably in labour when she consulted Melomed”.

After carefully studying the hospital’s email correspondence to Fokazi, and comparing it to what the story reported, I am convinced that the article sufficiently covered Melomed’s response and that as did not omit any piece of material information.

Headline misleading

Ahmed complains that the headline contradicted the hospital’s response to the journalist (stating that it had disputed that October was in active labour) and states that Fokazi was negligent in this regard.

Cape Argus says that it was a fact that the urinary tract infection diagnosed was actually early labour pains. “Whether or not the patient was misdiagnosed because of her disclosures to the doctor does not change the facts. The (main) headline is therefore indeed accurate and…is neither defamatory, nor does it reflect on the patient.”

The newspaper adds that sub-headline was also factually correct, as October indeed had alleged that Melomed was negligent – the story did not state as fact that the hospital had been negligent, but merely that this was October’s opinion.

The acting editor also explains that Fokazi was not responsible for the headline, which was “based on the editorial interpretation of the content of the article by the editorial staff”.

I believe that the headlines accurately reflected the contents of the story (as required by the Press Code). After having found that there was nothing materially wrong with the story, it follows that the headlines themselves were journalistically sound.

Deliberate attack

Melomed complains that the above-mentioned boiled down to a “deliberate if not negligent attack on the hospital”.

The newspaper denies this allegation.

Given all of the above I cannot reasonably concur with this part of the complaint.

FINDING

The complaint is dismissed in its entirety.

APPEAL

Our Complaints Procedures lay down that within seven working days of receipt of this decision, either party may apply for leave to appeal to the Chairperson of the SA Press Adjudication Panel, Judge Bernard Ngoepe, fully setting out the grounds of appeal. He can be contacted at [email protected].

Johan Retief

Press Ombudsman