Stellenbosch Hospital failed to report 'rape' of 15-year-old on time: public protector

A public protector advisory report has found that the Stellenbosch Hospital in 2021 failed to inform parents and police timeously of the alleged rape of a 15-year-old psychiatric patient by a fellow patient.

On the day the alleged incident happened, about the same time, one of the patients broke a window in the ward and escaped through the emergency exit. The two nursing assistants and security ran after the patient, leaving a nurse alone to attend to remaining eight patients.

While the nurse was conducting the rounds and checking whether all patients were present, she discovered that a 15-year-old patient and a 19-year-old male patient were not in their respective rooms.

“She continued checking and found the two patients engaged in an act of coitus in the patients’ toilet in the ward.

“The manner in which they were engaged in the act of coitus made her believe that it was a mutual consensual act.”

She added later that the minor had told her the male patient was her boyfriend.

The doctor on duty in the ward was not immediately informed by the nurse about the act. She recorded the incident in the victim’s file and did not say it was necessary to report the incident to the nursing manager on duty and informed the staff manager about the incident during the handover.

In an incident report from the hospital, it was recorded that the sexual act happened on September 23 in 2021. The female patient’s parents were not immediately informed about the incident nor were the police.

The further findings of the report are that “there was an initial delay of about 24 hours in trying to make contact with the parents and in reporting the incident to the head of the institution.

“This may be due to a failure to recognise the seriousness of the event because of the apparent consensual nature even though the one patient was both psychotic and underage.

“The nurse who witnessed the incident was inexperienced — as a community service nurse — and occupied with another disruptive event in the ward at the time of the incident.

“There was also an initial reluctance by the doctor to report the event to the parents based on hearsay, as the witness of the event had not spoken to the doctor directly. The incident was not reported to the SAPS over the weekend.”

The public protector's office said: “Having considered various legal prescripts and interviewing several persons, conducting an inspection at the hospital, the investigation revealed inter alia that the professional nurse responsible for the adolescent psychiatric unit witnessed the incident, but hospital staff failed to report the matter to the SAPS and instead advised the patient’s mother to report the matter to the SAPS herself.

“Such a failure was short of what was expected of the hospital staff in terms of the relevant legal prescripts.”

The Western Cape department of health has since taken steps to prevent the reoccurrence of such incidents, which include the provision of in-service training to staff on reporting patient safety incidents, posting a security guard at the ward, and a Quality Improvement Programme for Mental Health Care has been developed and implemented. This has shown an immediate improvement in care and compliance with the Mental Health Care Act, it said.

The report stated that disciplinary action, in the form of corrective counselling, was taken against the nurse for failing to report the incident to her manager, and the doctor on duty for not immediately trying to contact the patient’s parents.

It was recommended that within 60 days of receiving the advisory report, the head of department should develop and implement a directive stipulating the timeframes within which an emergency or any eventuality that may befall patients can be reported on time.

The hospital should also ensure that patient files contain sufficient contact information and addresses, including alternative contact details to ensure that immediate family members of patients are easily contactable and provided with accurate information timeously.

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