Doctrine of ‘resipsa loquitur’ in surgical management of head injury in Transkei region, South Africa: Case Report

Background: Poor people accept death as ‘God’s wish’, sing a ritual song and bury their loved ones without pointing a finger at anyone or asking how their loved ones died. Medical errors cause several deaths, but most of the time this goes unnoticed, because many affected by it are poor and illiterate. Objective:To highlight the problem of fatal surgical errors in the management of head injury of patients in the Transkei region of South Africa. Case Histories: The case reports of the autopsies that discussed are intended to highlight the gross surgical negligence of medical professionals. In the first case, burr-holes were made to release intracranial pressure, but a piece of glass, which was the primary cause of increased intracranial pressure, was left in the cranium. In the second case, an inexperienced operating surgeon pushed the drill deep into the cortex of the brain while making burr-holes. The third case report describes a head injury suffered by an alcohol-intoxicated patient. The head injury was inflicted at a police station. This article presents histories, post-mortem findings, causes and mechanisms of death, as well as discusses acts of commission and omission. Conclusion: A high level of fatalities is caused by ‘acts of commission and omission’ in respect of head injury of patients in the Transkei region of South Africa. This matter needs regular auditing through forensic pathology services.