Category: Ethics and Law

Categories : Cardiovascular Disease Ethics and LawTags :

Cardiologist “Gags” Carte Blanche

On By ModernMedia

By Tania Broughton

Photo by Bill Oxford on Unsplash

A Durban-based cardiologist has secured a “gagging order” against Carte Blanche, stopping it from broadcasting a programme in which patients accuse him of medical malpractice for inserting stents unnecessarily.

Dr Ntando Peaceman Duze was given multiple opportunities for more than a week to respond to the allegations raised by his patients, which were corroborated by independent experts. But instead of responding, he launched an urgent application in the Kwazulu-Natal High Court in Pietermaritzburg on Friday.

He gave Carte Blanche only one day’s notice of the application.

Carte Blanche opposed it, arguing that Duze wanted to “bury these allegations for as long as possible if not indefinitely”, and that he was seeking an “unlawful prior restraint on freedom of speech and media”.

But Acting Judge Mpumelelo Sibisi granted an interim interdict, stopping the broadcast scheduled for Sunday 8 June.

Judge Sibisi said Duze needed to be given an opportunity to file a replying affidavit and that Carte Blanche had put a “gun to his head” to answer the questions posed to him. The judge said it would be appropriate to interdict the broadcast until the matter could be properly ventilated.

He set the return date for 13 June. But unless the matter is given a special allocation, it may not be argued and finalised on that day.

Cardiologists accused of defamation

Duze, who runs his practice from Life Westville Hospital, initially cited two other cardiologists in his application, seeking orders that they must desist from making “slanderous, insulting and defamatory remarks” about him.

He put this down to professional jealousy because their patients had moved over to his practice.

He alleged that the two cardiologists had instigated complaints laid by about seven of his patients against him with the Health Professionals Council of South Africa (HPCSA). He claimed that such was the professional jealousy, that he had been a victim of “witchcraft”, with chicken bones and red [Hindu] strings being left in the operating theatre.

He said the cardiologists had told his patients that “I had opened up their blood vessels” [an apparent reference to stent surgery], when it was unnecessary to do so.

Duze said the complaints to the HPCSA were “baseless”.

The cardiologists opposed the application.

Then on Friday, Duze’s legal team withdrew the claim against the cardiologists, and tendered to pay their legal costs. The lawyers gave no explanation for this. But it came in the wake of Carte Blanche, in its affidavit, saying they had not interviewed the cardiologists. Instead they had interviewed Duze’s aggrieved patients on camera and done follow-up investigations, including obtaining independent medical corroboration based on the patients’ medical records.

Gag order

Duze, in his application, said at any given time he had an average of 50 patients at the hospital, all with heart conditions. He had never before been reported to the HPCSA and, if the allegations against him continued and were made public on Carte Blanche, it would severely harm his reputation, “and may even lead to my financial demise”.

“Carte Blanche launched their own investigation and wants to broadcast a programme about this on Sunday 8 June, which I want to prevent, because it will be filled with untruths and defamation,” he said.

He said Carte Blanche had approached him for comment, and asked 14 specific questions, which he was not prepared to answer because the issue was “sub judice”.

“Once the [HPCSA] has completed its investigation, I will no doubt be willing to be interviewed and explain everything, because I will no doubt be cleared of these false allegations,” he said.

In her opposing affidavit, Carte Blanche producer Mart-Marie Faure said the application was an “abuse of process”.

“It is unsustainable on the facts and law and constitutes an impermissible attempt to obtain a pre-publication interdict in circumstances where no case has been made out for one and such an extreme order is not justified,” she said.

“The complaints, which form the subject matter of the inset entitled ‘Dr Stent’, were initiated by his patients, who had all, they allege, been subjected to unnecessary surgical procedures.

“Independent medical professionals who have been interviewed or consulted all confirm that the applicant [Duze] undertook unnecessary surgery that has had adverse consequences for his patients.

“This has nothing to do with jealous colleagues. The complaints are driven by his patients who allege serious medical malpractice with the most grave medical consequences.”

Faure said she had engaged with Duze and his attorneys for nine days in an attempt to secure answers to her questions “to no avail”.

“Carte Blanche was contacted by patients who claimed they were operated on unnecessarily. They consulted with other medical professionals who have said the insertion of stents was unnecessary. And in fact had caused heart disease when none was previously present.

“They will be required to take blood thinning and other medication for the rest of their lives.

“The HPCSA confirmed it received five complaints against the applicant.

“Life Healthcare has confirmed that it received information regarding allegations against the applicant from the HPCSA and has initiated an investigation.”

Faure said the complaints were not sub judice and that the explanation the doctor would advance to justify his conduct in that investigation would no doubt be the same he would give on camera or in a written response.

“If media houses were required to await the finalisation of proceedings before any professional or regulatory body, the public would be deprived of timely, relevant information on matters of pressing concern,” she said.

“This is antithetical to the very purpose of a free press.

“The patients’ accounts are based on their personal experiences and have been corroborated by independent experts. In every such story the person in respect of whom the investigation is conducted is unhappy. The remedy is to tell their side of the story, which the applicant has been repeatedly offered – not to gag the media.”

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Read the original article.

Categories : Ethics and LawTags :

Webinar: Navigating the New HPCSA Booklet 19: The Ethics of Billing | 2 CPD Points

On By ModernMedia

The healthcare sector is most effective when all stakeholders behave professionally and uphold ethical principles. Unethical practices are evident when stakeholders violate moral principles, ethical practices and organisational standards resulting in reduced productivity, decreased patient outcomes, increased patient risk and cost, fraud, and wastage.

Ethical practice is however linked to cultural values, context and workplace norms. As such, what may be viewed as unethical in one situation could be viewed as ethical practice in another. Unethical behaviour may therefore be unintentional and hence the importance of having clear guidelines on how to act in specific situations.

During this recorded webinar, healthcare providers will review the newly released HPCSA Booklet 19: Guidelines for Health Practitioners on Matters Relating to Ethical Billing Practices where the pertinent South African laws and basic principles around ethical billing practices are laid out. The live audience had an opportunity to engage with faculty who offered a clinical (Dr Simon Strachan, paediatrician in private practice and CEO of South African Private Practitioners Forum), legal (Deniro Pillay, Norton Rose Fulbright Admitted Attorney in the medical law and malpractice litigation sector), HPCSA (Mr Mpho Mbodi, HPCSA Head of Professional Practice division), medical malpractice insurance (Dr Hlombe Makuluma, EthiQal Medicolegal Advisor) perspective through short lectures, interactive case studies, a series of multiple choices questions (MCQs) and Q&A sessions.  

Healthcare professionals who watch this full webinar are entitled to claim 2 ethics CPD points. Instructions on how to claim points are covered in the webinar recording.

Watch the webinar at this link:  https://ethiqal.co.za/webinars/

Categories : Ethics and LawTags :

Protecting People, Preserving Trust: Why Risk Management is Critical in SA Healthcare

On By ModernMedia
Photo by cottonbro studio

What happens when trust – the cornerstone of healthcare – is broken? In South Africa, the answer is increasingly found in litigation. As medical malpractice claims soar and public confidence in health systems teeters, the call for urgent reform is unmistakable. At the centre of this complex issue lies a simple truth: Risk is inevitable but unmanaged risk is unforgivable.

Leandren Naidoo, Manager of Business Risk Solutions at OLEA South Africa, says, “Medical malpractice is more than a legal matter, it’s a profound rupture in the sacred relationship between healthcare providers and patients. At its core, it is about harm – physical, psychological and often, emotional. But it is also about dignity. Neuroscientific studies show that psychological injury registers in the brain in much the same way as physical harm. Yet, while a physical injury may receive swift attention, a bruised sense of dignity can linger and fester indefinitely.

Leandren Naidoo, Manager of Business Risk Solutions, OLEA South Africa.

“The perceived violation of dignity can fuel resentment, prolong trauma and, ultimately, drive patients to seek justice in courtrooms rather than consulting rooms.”

What is driving the rise in malpractice claims?

Across the globe, medical malpractice claims are on the rise.  In South Africa in 2023 a parliamentary report revealed that medico-legal claims, against the state, exceeded R78 billion, nearly tripling over the past decade. In high-risk disciplines like obstetrics, claims have risen by over 25% annually.

He says, “several forces are converging to create this perfect storm. Greater public awareness of patient rights, aggressive legal marketing and the adoption of ‘no win, no fee’ legal models have all made it easier to pursue claims.”

So, what does medical malpractice incorporate?

Errors and omissions, care related injuries, misdiagnosis, incorrect dispensing or prescription of medication, unnecessary surgery or treatment and medical equipment related injuries.

Court or conversation: What works best for resolving claims?

Naidoo says, “despite perceptions of rampant litigation, most malpractice cases never reach court. An estimated 95% of claims are resolved before trial, often on the proverbial courthouse steps. The reasons are manifold. Overloaded dockets, lengthy trial timelines (often five to seven years) and soaring legal costs.

“But there’s a deeper problem, courtrooms aren’t designed to resolve emotional trauma. Patients often seek validation more than victory,” he says, “They want to be heard, not just compensated.”

Why is risk management more urgent than ever?

In an environment where claims are increasing by 3 to 4% annually and legal defence costs are rising by 6 to 8%, risk management is no longer optional, it’s essential. It’s the only true defence healthcare providers have against both reputational damage and financial ruin.

What does effective risk management look like in practice?

  1. Patient safety protocols: Clear procedures to minimise errors, from surgical checklists to medication audits.
  2. Staff training: Empowering healthcare professionals with up-to-date clinical and legal knowledge.
  3. Record-keeping: Robust documentation that supports clinical decisions and protects against unfounded claims.
  4. Communication strategies: Cultivating a culture of transparency, apology and early intervention.
  5. Insurance alignment: Ensuring cover matches exposure, taking into account both damages and escalating legal fees.

Practitioners and medical institutions need to assess their limit of indemnity carefully. “An obstetrician can pay up to R1.7 million annually in premiums. This isn’t just a cost, it’s a risk exposure that needs to be planned for.”

What are the highest-risk disciplines and the cost of getting it wrong?

While all medical professionals face some risk, certain specialties are far more vulnerable:

  • Obstetrics: Cerebral palsy claims can reach R48 million
  • Neurosurgery: Brain and spinal complications
  • Orthopaedics: Post-surgical disabilities
  • Emergency medicine: Delays or misdiagnosis

Average claim amounts range between R300 000 and R12 million. High-end cases, particularly involving children, can exceed R40 million. This is because claims, involving minors, extend the period of prescription until three years after they reach 18, significantly increasing potential compensation.

Can the right insurance really make a difference?

“Absolutely,” says Naidoo. “Medical malpractice indemnity insurance provides cover for the following: Arbitration costs, court judgement and awards made against the insure, expert legal fees and support, court costs, settlement costs and attorney’s (and mediation) fees.”

Insurance is not merely a financial product, it’s a strategic partnership. A good insurer doesn’t just pay claims, they help prevent them. At OLEA South Africa, for instance, brokers conduct detailed situational audits of healthcare institutions to assess operational risks.

“As brokers we advise which insurer will be the most effective for that particular institution or medical practitioner. It’s about education, not just insurance,” Naidoo explains. “We want to develop a system and environment where malpractice is unlikely. But, if it does happen, the tools must be available to resolve it constructively.”

Is the media making things worse?

Yes and no.  On the one hand, media coverage of high-profile cases has increased accountability. On the other, it has inflated public expectations. Patients increasingly equate any adverse outcome with negligence, leading to an uptick in opportunistic claims.

Moreover, the rise of “ambulance chasing” has introduced a dangerous incentive structure. In 2024 alone, the SIU flagged over 2 800 suspicious malpractice cases, many driven by legal marketing, rather than genuine harm.

This places additional pressure on doctors, who may resort to defensive medicine, ordering unnecessary tests, referrals or procedures. Not to improve care but to avoid liability.

Most importantly, healthcare institutions must view risk management not simply as a compliance exercise but as a moral imperative.

And final words from OLEA South Africa

  • We value our healthcare practitioners immensely. To our doctors and nurses, you carry the weight of life and death every day. But you shouldn’t carry it alone. Equip yourselves with the tools, training and protection you need to do your job with confidence
  • To insurers and brokers: Be more than policy providers. Be educators, allies and defenders of dignity
  • To patients: Know your rights but also recognise your responsibilities. Healthcare is a partnership, not a transaction
  • And to policymakers: Prioritise patient safety, not just with funding but with forward-thinking reforms that streamline resolution, reduce conflict and restore trust

Because, at the heart of it all is one shared goal. Protecting people. And there’s no greater purpose in healthcare than that.

Categories : Ethics and Law IT in HealthcareTags :

The Evolution of AI in Patient Consent is a Data-Driven Future

On By ModernMedia

Henry Adams, Country Manager, InterSystems South Africa

One area undergoing significant evolution in the healthcare industry is the process of obtaining patient consent. It is a topic that is highly controversial but absolutely necessary and one that must evolve if we are to bring patient care into the 21st century.

Traditionally, patient consent has involved detailed discussions between healthcare providers and patients, ensuring that individuals are fully informed before agreeing to medical procedures or participation in research. However, as artificial intelligence (AI) becomes more prevalent, the mechanisms and ethics surrounding patient consent are being re-examined.

The current state of patient consent

Informed consent is a cornerstone of ethical medical practice, granting patients autonomy over their healthcare decisions. This process typically requires clear communication about the nature of the procedure, potential risks and benefits, and any alternative options.

In the context of AI, particularly with the use of big data and machine learning algorithms, the consent process becomes more complex. Patients must understand not only how their data will be used but also the implications of AI-driven analyses, which may not be entirely transparent.

The rise of dynamic consent models

To address these complexities, the concept of dynamic consent has emerged. Dynamic consent utilises digital platforms to facilitate ongoing, interactive communication between patients and healthcare providers.

This approach allows patients to modify their consent preferences in real-time, reflecting changes in their health status or personal views. Such models aim to enhance patient engagement and trust, providing a more nuanced and flexible framework for consent in the digital age.

AI has the potential to revolutionise the consent process by personalising and simplifying information delivery. Intelligent systems can tailor consent documents to individual patients, highlighting the most pertinent information and using language that aligns with the patient’s comprehension level. In addition, AI-powered chatbots can engage in real-time dialogues, answering patient questions and clarifying uncertainties, enhancing understanding and facilitating informed decision-making.

Data privacy, ethical and security considerations

The integration of AI into patient consent processes necessitates an increased attention to data privacy and security. As AI systems require access to vast amounts of personal health data, robust additional safeguards must be in place to protect against unauthorized access and breaches. Ensuring that AI algorithms operate transparently and that patients are aware of how their data is being used is critical to maintaining trust in the healthcare system, and AI in particular.

While AI can augment the consent process, the ethical implications of its use must be carefully considered. The potential for AI to inadvertently introduce biases or operate without full transparency poses challenges to informed consent. Therefore, human oversight remains indispensable.

Healthcare professionals must work alongside AI systems, the “human in the loop”, to ensure that the technology serves as a tool to enhance, rather than replace, the human touch in patient interactions.

The next 5-10 years

Over the next decade, AI will become increasingly integrated into patient consent processes. Experts predict advancements in natural language processing and machine learning will lead to more sophisticated and user-friendly consent platforms. However, the centrality of human judgment in medical decision-making is unlikely to diminish. AI can provide valuable support, but the nuanced understanding and empathy of healthcare professionals will remain vital.

So, as we take all of this into account, the evolution of AI in patient consent processes offers promising avenues for enhancing patient autonomy and streamlining healthcare operations. By leveraging AI responsibly, healthcare institutions can create more personalised, efficient, and secure consent experiences.

Nonetheless, it is imperative to balance technological innovation with ethical considerations, ensuring that human judgment continues to play a pivotal role in medical decision-making. As we navigate this new world, a collaborative approach that integrates AI capabilities with human expertise will be essential in shaping the future of patient consent. And for healthcare in South Africa, this is going to have to start with education.

Categories : Ethics and LawTags :

Déjà Vu: Moss v Road Accident Fund

On By ModernMedia
Photo by Tingey Injury Law Firm on Unsplash

By Raynold Tlhavani, Partner & Micaela Pather, Senior Associate from Webber Wentzel

The recent judgment in Moss v Road Accident Fund,1 handed down by the Western Cape High Court, has reignited debate regarding the Road Accident Fund’s (RAF’s) liability to compensate accident victims for past medical expenses already covered by their medical aid.

If this sounds familiar, that’s because it is. Recently, the same court in Rahldeyah Esack v the Road Accident Fund1 dealt with the same legal question raised in Moss: can a claimant’s right to compensation under the RAF Act 56 of 1996 be diminished by third-party payments? The court in Moss followed the earlier ruling in Esack, which held that the RAF is liable for a claimant’s past hospital and medical expenses, even if these were covered by a medical scheme.

The facts in Moss were that, in September 2017, the 77-year-old plaintiff sustained bodily injuries when he was struck by a vehicle while cycling. He claimed ZAR 34 286.59 in past medical expenses, of which ZAR 4 173.80 had been paid out of pocket, while the balance had been settled by his medical aid. The RAF opposed the claim, relying on its internal directives from 2022 and 2023, which instructed staff to reject past medical expense claims where the expenses had already been paid by a medical scheme. These directives were not formally introduced before the court. The defence was described as ill-conceived and procedurally inappropriate. Although the court declined to rule substantively on the legal issues raised by the RAF’s directives, it noted that the directive touches on complex areas of law, including common and statutory law, champerty, subrogation, and medical scheme law, which it would not address in context of this judgment.

The court also remarked on the RAF’s litigation practices, observing that the fund had drastically reduced its reliance on external counsel and instead “overburdened” a handful of attorneys at the State Attorney’s office.

It noted with concern that counsel from previously disadvantaged backgrounds, who had historically relied on RAF work, were no longer being briefed, undermining transformation imperatives. It further highlighted the impact on practitioners who, through no fault of their own, were forced to juggle multiple RAF matters in a single day.

Ultimately, the court’s decision in Moss mirrored that in Esack, granting the plaintiff a full award for past medical expenses, regardless of third-party payments. It remains to be seen whether this approach in the Western Cape Division, at odds with a Full Bench decision of the Gauteng Division, will gain traction in other divisions.

  1. [2025] JOL 68686 (WCC). ↩︎
  2. [2025] ZAWCHC 27. ↩︎

Categories : Ethics and Law UrogenitalTags :

Court Rules that UTI Drug Trade Names are Too Similar

On By ModernMedia
Photo by Bill Oxford on Unsplash

A court case over the trade names of two urinary tract infection (UTI) drugs has been settled. The court ordered that Cipla Medpro be restrained from using the trade name Furizome as it is too similar to Adcock Ingram’s UTI drug Urizone, leading to potential confusion by consumers. In his ruling, Justice James Lekhuleni of the High Court, Western Cape Division, who stated that despite safeguards against confusion in prescribing, ultimately “doctors are human”, so miscommunications could occur – and that the agency of patients cannot be ignored.

The trademark infringement case was brought by three applicants: Adcock Ingram Limited, Adcock Ingram Healthcare (Pty) LTD, and Italian company Zambon S.P.A. Zambon is the owner of the name Urizone, which is used under licence. Urizone had been launched in South Africa in 1993. The applicants stated that more than 3 million sachets had been sold between 2011 and 2023, with R5 million in advertising spent to promote the drug between 2018 and 2022 alone.

The applicants brought the case that Cipla Medpro’s Furizome, with the active ingredient fosfomycin, was too similar to their own product, Urizone, which contained the same ingredient in 3g sachets, and thus could confuse consumers. They alleged that Cipla Medpro sought to capitalise on the reputation earned by Urizone.

The applicants made the case that, despite Urizone being made available as a generic, none of the pharmaceutical companies producing it chose to use the name. When Furizome was launched, Adcock Ingram sent a letter of demand to Cipla to stop using the name due to its . Cipla, through its attorneys, rebutted the claim, saying that the two are sufficiently distinct to avoid confusion, with the “F” alluding to the fosfomycin ingredient. Cipla contended that it had already submitted the name through SAHPRA, and

Cipla also contended that the consumer – the patient – would not be misled during the prescribing and purchase of a schedule 4 medication as they would be informed by the pharmacist of the two different drugs.

In considering the judgment, the court noted that a test as to whether trademarks are be similar can be mode on a phonetic basis, or if they conceptually or visually similar. A trademark’s essential function is to indicate the origin of the goods in connection with which it is used. The “N” and “M” where seen as visually and phonetically similar, and “furi” was similar phonetically to “uri“. This could cause confusion and miscommunication even between doctors as to what drug they had prescribed a patient.

While Justice Lekhuleni acknowledged the safeguards of prescribing schedule 4 medications, he pointed out that the general public had become much more knowledgeable about prescription drugs in the past two decades. On this, he wrote “…the reality is that patients are involved in the process of deciding which medicines they will use, and that creates the risk of confusion. This situation in turn creates a responsibility upon pharmaceutical companies to make sure that they adopt trade marks that are not confusingly similar.”

Categories : Cancer Ethics and LawTags :

Court Orders Gauteng Health Department to Treat Cancer Patients

On By ModernMedia

Judge rules failure to deal with backlog of patients needing radiation treatment is unconstitutional

By Liezl Human

Photo by Bill Oxford on Unsplash

The Gauteng Department of Health is appealing against a judgment by the Johannesburg High Court ordering it to provide radiation oncology treatment to a backlog of nearly 3000 cancer patients at Charlotte Maxeke Hospital and Steve Biko Hospital.

In April last year, activists from SECTION27, Cancer Alliance and the Treatment Action Campaign (TAC) joined cancer patients to march to the department’s provincial office, demanding that millions of rands set aside for radiation treatment be used.

The matter was then taken to court by the Cancer Alliance, represented by SECTION27, after years of attempts to engage with the department about radiation services. They said in a statement they wanted the court to compel the department to provide treatment to the backlog of cancer patients still waiting.

Some patients have been on the list for nearly three years, while others have died while waiting, according to the judgment by Acting Judge Stephen van Nieuwenhuizen. He noted that “irreparable harm” has occurred and continues to occur in the absence of treatment.

He said the backlog, of mostly Charlotte Maxeke patients, had grown due to a lack of radiation equipment at the hospital and a shortage of staff. This was in spite of an allocation of R784-million over three years, specifically ring-fenced for radiology oncology services. The allocation was also meant to help clear the backlog of patients.

Delays in finalising a tender for these services meant that R250-million was returned to National Treasury at the end of the fiscal year, he said.

The judge found that the provincial department had infringed on the rights of these cancer patients in that a high standard of professional ethics had not been maintained. “Efficient and effective use of resources were not promoted. Services were not provided impartially, fairly, equitably and without bias.”

Judge van Nieuwenhuizen said the provincial health department had done “nothing meaningful” since the money was allocated in March 2023 to actually provide radiation oncology treatment to the cancer patients. “On the other hand, the health and general well-being of cancer patients has significantly deteriorated. There is a clear, imminent and ongoing irreparable harm that cancer patients who are on the backlog list are suffering.”

The judge ruled that the department’s failure to provide radiation services to cancer patients on the backlog list was unconstitutional and unlawful.

He added that the provincial health officials “have conducted themselves as a law unto themselves” and ordered that measures be put in place to ensure officials are “held to account for their constitutionally imposed obligation to provide healthcare services … to cancer patients who are on the backlog list”.

He also ordered that the list of cancer patients still awaiting radiation treatment must be updated within 45 days and that a progress report and long-term plan must be submitted to the court within three months.

Salomé Meyer, director of the Cancer Alliance, told GroundUp the ruling would allow the court to get accurate information on the circumstances of each patient still waiting for treatment.

She said the judgment “confirms that civil society has a role to play to hold the government responsible for what it is supposed to do”.

In a statement on 2 April, the department confirmed that it had filed an application for leave to appeal against the ruling. The department said “there are several substantive grounds of appeal, which if left unchallenged will be greatly prejudicial to the patients undergoing radiation oncology services at the hospitals” and might set an “undesirable” precedent.

Republished from Groundup under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Read the original article.

Categories : Ethics and Law Injury & Trauma NeurologyTags :

New AI Tool for TBI Investigations in Forensics and Law Enforcement

On By ModernMedia
Photo by Tom Jur on Unsplash

A study led by University of Oxford researchers has developed an advanced physics-based AI-driven tool to aid traumatic brain injury (TBI) investigations in forensics and law enforcement. The findings have been published in Communications Engineering.

TBI is a critical public health issue, with severe and long-term neurological consequences. In forensic investigations, determining whether an impact could have caused a reported injury is crucial for legal proceedings, yet there is currently no standardised, quantifiable approach to do this. The new study demonstrates how machine learning tools informed by mechanistic simulations could provide evidence-based injury predictions. This would help police and forensic teams accurately predict TBI outcomes based on documented assault scenarios.

The study’s AI framework, trained on real, anonymised police reports and forensic data, achieved remarkable prediction accuracy for TBI-related injuries:

  • 94% accuracy for skull fractures
  • 79% accuracy for loss of consciousness
  • 79% accuracy for intracranial haemorrhage

In each case, the model showed high specificity and high sensitivity (a low rate of false positive and false negative results).

This research represents a significant step forward in forensic biomechanics. By leveraging AI and physics-based simulations, we can provide law enforcement with an unprecedented tool to assess TBIs objectively.

The framework uses a general computational mechanistic model of the head and neck, designed to simulate how different types of impacts—such as punches, slaps, or strikes against a flat surface—affect various regions. This provides a basic prediction of whether an impact is likely to cause tissue deformation or stress. However, it does not predict on its own any risk of injury. This is done by an upper AI layer which incorporates this information with any additional relevant metadata, such as the victim’s age and height, before providing a prediction for a given injury.

Lead researcher Antoine Jérusalem, Professor of Mechanical Engineering in the Department of Engineering Science, University of Oxford

The researchers trained the overall framework on 53 anonymised real police reports of assault cases. Each report included information about a range of factors which could affect the blow’s severity (e.g., age, sex, body build of the victim/offender). This resulted in a model capable of integrating mechanical biophysical data with forensic details to predict the likelihood of different injuries occurring.

When the researchers assessed which factors had the most influence on the predictive value for each type of injury, the results were remarkably consistent with medical findings. For instance, when predicting the likelihood of skull fracture, the most important factor was the highest amount of stress experienced by the scalp and skull during an impact. Similarly, the strongest predictor of loss of consciousness was the stress metrics for the brainstem.

Understanding brain injuries using innovative technology to support a police investigation, previously reliant on limited information, will greatly enhance the interpretation required from a medical perspective to support prosecutions.

Ms Sonya Baylis, Senior Manager at the National Crime Agency

The research team insists that the model is not intended to replace the involvement of human forensic and clinical experts in investigating assault cases. Rather, the intention is to provide an objective estimate of the probability that a documented assault was the true cause of a reported injury. The model could also be used as a tool to identify high-risk situations, improve risk assessments, and develop preventive strategies to reduce the occurrence and severity of head injuries.

Lead researcher Antoine Jérusalem, Professor of Mechanical Engineering in the Department of Engineering Science at the University of Oxford said: ‘Our framework will never be able to identify without doubt the culprit who caused an injury. All it can do is tell you whether the information provided to it is correlated with a certain outcome. Since the quality of the output depends on the quality of the information fed into the model, having detailed witness statements is still crucial.’

Dr Michael Jones, Researcher at Cardiff University, and Forensics Consultant, said: ‘An “Achilles heel” of forensic medicine is the assessment of whether a witnessed or inferred mechanism of injury, often the force, matches the observed injuries. With the application of machine learning, each additional case contributes to the overall understanding of the association between the mechanism of cause, primary injury, pathophysiology and outcome.’

The study ‘A mechanics-informed machine learning framework for traumatic brain injury prediction in police and forensic investigations’ has been published in Communications Engineering. It was conducted by an interdisciplinary team of engineers, forensic specialists, and medical professionals from the University of Oxford, Thames Valley Police, the National Crime Agency, Cardiff University, Lurtis Ltd., the John Radcliffe Hospital and other partner institutions.

Source: University of Oxford

Categories : Ethics and Law HospitalsTags :

HASA Launches NHI Legal Challenge

On By ModernMedia
Photo by Bill Oxford on Unsplash

The Hospital Association of South Africa (HASA) remains unequivocally committed to working with all stakeholders to build a healthcare system that sustainably benefits all citizens of South Africa and urges all involved parties to engage in a solution-oriented approach.

HASA believes the National Health Insurance is neither sustainable nor affordable and that dialogue and collaboration between all stakeholders is critical to finding and developing solutions to achieve universal health coverage. 

HASA has thus far deferred filing a legal challenge to the NHI Act as it firmly believes that sustainable and affordable solutions, to achieve universal health coverage for all South Africans, are within reach. However, the government’s lack of response to several constructive and practical proposals, including those of Business Unity South Africa (BUSA), and the Minister of Health’s recent public statements concerning the NHI, including regarding the imminent publication of NHI regulations, have necessitated that HASA move forward with its legal challenge to the NHI legislation. 

Even though HASA has decided to proceed with legal action, it remains hopeful that the Presidency will respond positively to the constructive proposals that have been made. 

HASA remains open to engaging with the Government on the way forward in parallel to the legal process. Reiterating the time-critical nature of the matter, Melanie Da Costa, Chairperson of HASA, today said, “We remain firmly committed to participating constructively while the legal process unfolds. As an organisation, we have always preferred to resolve matters through dialogue, and we believe that effective healthcare solutions are urgently needed and achievable through a reasonable and collaborative approach.” 

Categories : Ethics and Law Respiratory DiseasesTags :

Activists Furious after Competition Commission Drops Probe into Pharma Company

On By ModernMedia

Life-saving drugs still not available to many cystic fibrosis patients

Photo by Robina Weermeijer on Unsplash

By Tania Broughton

Health campaigners have slammed a decision by the Competition Commission to end its investigation into Vertex Pharmaceuticals’ monopoly on life-saving medicines for people living with cystic fibrosis.

“We are concerned that the Commission has fallen victim to Vertex’s well-known and aggressive PR and legal strategy, designed to safeguard its global patent monopoly at all costs,” said a statement by nine organisations: the South African Cystic Fibrosis Association, Right to Breathe Campaign, Health Justice Initiative, Vertex Save Us, Just Treatment, SECTION27, Treatment Action Campaign, People’s Health Movement and Cancer Alliance.

The Commission, in a statement released on 11 December, said it had initiated the probe against Vertex based on allegations that it was engaging in exclusionary practices and excessive pricing in the provision of Kalydeco, Orkambi, Symdeko and Trikafta – medicines used to treat cystic fibrosis.

“Following the Commission’s investigation and various engagements with Vertex, Vertex gave formal undertakings to the Commission to continue to make Trikafta available in South Africa through Section 21 of the Medicines and Related Substances Act, which enables the sale of unregistered drugs within South Africa,” it said.

This undertaking, it said, had resulted in a “non referral” of all allegations against the company.

It said that Trikafta had broadly replaced the use of the other medicines. Previously patients with cystic fibrosis had to import it. To reduce the financial burden, Vertex had from April this year begun supplying it through a local distributor.

“This makes Trikafta available locally at prices that enable cystic fibrosis patients to access treatment. Separately, financial assistance is available through a patient assistance programme managed by a non-government organisation, and eligible cystic fibrosis patients who belong to certain medical schemes get Trikafta at no cost as they also receive some financial assistance from their medical aid schemes.”

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But health campaigners are not happy They say for the vast majority of cystic fibrosis patients (about 63%), nothing has changed.

“The real victims of this decision by the Commission are the most vulnerable South African children and young people who rely on the public health sector, who are not rich, and who have little or no medical scheme cover,” they said.

“These patients do not currently, and will not get access to this medication because of Vertex’s patents and secretive, limited access and excessive pricing strategies.”

Alarmingly, they said, the medicine remains unregistered in South Africa, forcing patients to either import it or rely on the “administratively burdensome” section 21 approval process.

“This is not a sustainable way to address a chronic treatment need,” they said.

The so-called patient assistance programme did not promote equity, was far from transparent, nor sustainable and the price was undisclosed.

They said they were seeking an urgent meeting with the Commission

“We cannot allow the manipulation of South Africa’s laws, regulations and health system to go unchecked in the name of one drug company’s self-interested monopoly greed.”

Vertex replies

Approached for comment, Vetex said more than 180 cystic fibrosis patients were accessing the medicine through the Section 21 pathway “which represents about 50% of the eligible population”.

“We took this pathway because we strongly believe that this is the fastest and most efficient route to sustainable access in South Africa, given that it does not require a regulatory filing, which can take many years.”

The company said even with regulatory approval, most novel, high value medicines were not included on the Prescribed Minimum Benefits list.

“There is therefore no obligation for funders [private and public health insurances] to reimburse the costs of these medicines, which effectively make them inaccessible to most patients. In our opinion, a license application would not speed up the process for broad access to our cystic fibrosis medicines.”

It said its triple combination therapy was currently funded by eleven healthcare providers, who cover most cystic fibrosis patients in the private sector in the country.

“We are continuing discussions with other health insurers and are in parallel exploring potential sustainable access opportunities in the public sector, which has been historically challenging for rare disease medicines in South Africa.”

It said “exact pricing” and details of its partnerships remained confidential.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

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