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'Dead' accident victim would likely have survived – autopsy report

A damning report by a forensic pathologist has revealed that there was a “good possibility” that Msizi Mkhize could have survived the car accident he was involved in on December 2016 had he received timeous medical attention, and not been refrigerated in a mortuary, says a Daily News report. Dr Segaran Naidoo, an experienced pathologist who works for the UN and the AU on technical expert teams, was commissioned by the Medical Rights Advocacy Network (Meran) to investigate Mkhize’s death.

Mkhize was hit by a car while walking home in KwaMashu. Paramedics declared him dead at the scene and he was taken to the Phoenix mortuary. The next morning when his parents went to identify his body, mortuary staff found Mkhize breathing. In his report dated 26 July, 2018, Naidoo states that the primary medical cause of death would thus be reasonably expressed as “pneumonia associated with head injury”.

“It is my opinion that the terminal event was a respiratory cause on the basis of both the head injury and the pneumonia causing a metabolic acidosis (an excess of acid in the blood that causes the pH to fall below 7.35) as the ultimate mechanism of the death. The state of hypoxia (deprivation of oxygen to the brain) and deep acidosis would have caused compromise of cardiac function and final cardiac arrest,” reads the report.

He obtained the information he used in his investigation from the state pathologist’s post-mortem report, and from a laboratory result for alcohol in Mkhize’s bloodstream.

The Daily News says according to the report, Mkhize had a “deep laceration/injury” to the right parietal (scalp) and “facial injury”, and his pupils were fixed and dilated. No treatment was given by the paramedics at the scene.

After he was discovered alive, he was resuscitated and taken to Mahatma Gandhi Hospital. He was hypothermic. Fractures of the ribs on both sides were noted and no lung contusions were recorded. “The lung sections showed an early but established pneumonia in the early exudative phase, with the beginnings of an acute inflammatory cellular invasion of the alveoli, with prominence of vascular luminal content of polymorpho¬nuclear leukocytes in the alveolar capillaries. He was in the morgue for more than 26 hours.

“In my (Naidoo’s) opinion, the head injury is of a nature that may have been treatable, and from which the patient could have recovered. However, a reliable opinion on this possibility is best obtainable from a neurosurgeon. In my view, the degree of the pneumonia is seen to be one that could easily have developed within 12 to 18 hours of survival after injury where the conditions for the development of the same are optimal. Such conditions commonly involve a state of coma with or without a head injury, alcohol or drug intoxication, aspiration of gastric contents, convulsions, restriction of respiratory excursions, associated injury to the chest or abdomen that restricted adequate ventilation, collection of secretions in the airways, and a conducive environment for the initiation and progression of respiratory infection and which could include a state of prolonged environmental hypothermia such as in the state of refrigeration in a mortuary cold room or fridge,” reads the report.

The Daily News quotes Naidoo as saying: “there may have been a good possibility that the deceased could have survived had he received timeous medical attention, had not been diagnosed as dead at the scene, and had not been placed for the prolonged period within the refrigerator.”

Peter Mkhize, Msizi’s father, said they were consulting a lawyer.

Meran spokesperson Mary de Haas said they had commissioned the report for the Mkhize family. She said the family had a civil claim against the department.

“Meran is concerned about the integrity of the process used to declare someone dead, particularly if there is any possibility that urgent medical attention might save a life. It is possible that this is not the only case in which the pronouncement of death has been made too hastily. We are concerned about the apparent failure of forensic mortuary services to ensure medical confirmation before refrigeration.”

At the time of the incident, the KwaZulu-Natal Health Department had said they were gathering information on the matter. According to the Daily News, department spokesperson Ncumisa Mafunda said officials needed time to study Naidoo’s report.

[link url="https://www.iol.co.za/dailynews/autopsy-released-on-crash-victim-kept-in-morgue-for-26-hours-16320588"]Daily News report[/link]

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