Following his death, Mkhize asked the ombud to investigate Lethole's stay at the hospital, one of the designated hospitals for managing Covid-19 cases.
The report found that Lethole died of overwhelming SARS-CoV-2-induced Acute Respiratory Distress Syndrome, with multisystem dysfunction compounded by poor and negligent medical care.
It also found that Lethole was not offered food during his stay in hospital for a total of 100 hours and 54 minutes.
The ombud found that it was only on June 26 at 9.55am - 69 hours and 19 minutes after Lethole had been admitted at the hospital on June 23 at 12.36pm - that two medical practitioners could assess his condition.
These practitioners were on call when Lethole was admitted.
Outcome 'could have been different'
The report said Lethole's death was preventable and avoidable.
The ombud also relied on Dr Portia Ngwata, head of internal medicine at the hospital, who provided an independent analysis and review of Lethole’s clinical records after the release of the health ombud’s preliminary report in December to affected parties.