By Michael Gwarisa
The High Court has absolved the Avenues Clinic from a US$520,000 medical negligence claim brought by the family of a patient who died after allegedly falling from his hospital bed, ruling that the family failed to provide expert evidence linking the hospital’s conduct to his death.
Justice Dube granted the clinic’s application for absolution from the instance at the close of the plaintiffs’ case, bringing the claim by Sheila Nyadundu and her two children to an end. The three plaintiffs were also ordered to pay the clinic’s legal costs jointly and severally.
The case arose from the death of Francis Nyadundu, who was admitted to Avenues Clinic in March 2024 while receiving treatment for liver cirrhosis.
His family alleged that he fell from his hospital bed, suffered serious head injuries and subsequently died. They accused the clinic and its employees of leaving him unattended despite knowing that he required special care, failing to respond adequately after the fall, delaying notification of his doctor and family, and failing to properly monitor and manage his condition. They also alleged that the cause of his death had been concealed.
The family told the court that Nyadundu had been restless and had attempted to get out of bed before the incident. Nursing records showed that he had been administered lorazepam for restlessness, while bed rails were raised and clutter removed to reduce the risk of a fall.
According to evidence before the court, Nyadundu was later found injured after the fall. His family said they observed wounds to his head and face after his death. A post-mortem examination recorded a head injury and intracranial haemorrhage.
However, Avenues Clinic denied negligence, arguing that Nyadundu had multiple serious underlying conditions and had received care consistent with his treatment plan. The clinic also argued that the family had failed to produce expert medical evidence showing that its staff had breached the accepted standard of care or that any breach had caused his death.
Justice Dube agreed that the family had established, at least prima facie, that the hospital owed Nyadundu a duty of care. The court also found that the nursing records indicated that the risk of a fall was foreseeable because of his restlessness, dizziness and attempts to leave the bed.
But foreseeability alone was not enough.
The court said the plaintiffs needed expert evidence establishing what level of monitoring and fall-prevention measures were medically required, whether the clinic departed from that standard and whether that departure caused Nyadundu’s death.
The court further held that the post-mortem report, on its own, could not establish negligence or causation. While it showed the physical cause of death, it did not establish how the fall occurred, whether the fall caused the fatal injury or whether Nyadundu’s underlying medical conditions contributed to his death.
“Without expert opinion on the standard of care in medical negligence cases, a plaintiff’s case cannot succeed,” the court held.
The ruling does not amount to a finding that the clinic was proven to have provided perfect care. Rather, the court found that the plaintiffs had not crossed the legal threshold required for the case to proceed because their evidence did not establish a prima facie case of negligence and causation.
The court consequently granted Avenues Clinic absolution from the instance and ordered the plaintiffs to pay its costs.
