A pathologist who conducted postmortems on patients who died during the Life Esidimeni marathon project said negligence was a factor as some patients died from bedsores.
The pathologist said some patients were put in non-governmental organisations (NGOs) that were not well- equipped to look after them.
Dr Musa Makhoba was giving expert evidence at the Life Esidimeni Inquest on Thursday. The inquest, held at the Pretoria high court, aims to determine if anyone can be held criminally liable for the deaths of 144 mental health patients who were moved to ill-equipped NGOs in 2016.
He said Frans Decker died from complications resulting from bedsores. “After completing the autopsy, I concluded that the cause of death was decubitus ulcers [bedsores]”
Makhoba said bedsores are formed when a patient is not moved frequently when they are bedridden. “This is not good for the body, this area results in injury and infection,” he said.
Decker's bedsores had infiltrated into his muscle and potentially his bones. He also had signs of pitting oedema, which is fluid in the limbs, this means the patient had a serious chronic illness.
“Bedsores of that degree are severe and need continuous management including surgical, medical and ICU management. My view is that Tshepong was not an ideal centre where this type of patient can be handled,” said Makhoba.
Joseph Gumede was a patient who died from complications resulting from coronary artery disease. Makhoba said Gumede also had signs of a diabetic kidney, which showed he was not having his glucose tested regularly and did not get treatment from Anchor House NGO, the home he was placed in.
“In my view, the overall clinical management was inadequate. There was a lack of proper clinical note taking and this compromised the patient,” he said.
Another patient, Timothy Nxumalo, died after getting a severe septic burn on his arm and had signs of being chronically ill. “The cause of death was burns complicated by cellulitis and broncho pneumonia... when I looked at the right forearm I saw what looked like a burn wound that was infected,” said Makhoba.
He told the court that the main wound was 8cm by 3cm, but that there were also other wounds on Nxumalo's body.
Makhoba said another patient, Kenneth Sithole, died from aspiration pneumonia and sepsis. He explained that aspiration pneumonia is caused by food or foreign matter going into the lungs, this sometimes happens when someone is having a seizure. “The sepsis was found in the kidneys and the lungs,” he said.
The inquest continues.