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News | Medico-legal Affairs
Patient Confidentiality Prevails in Supreme Court Ruling on Research Ethics
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Keywords: medico-legal affairs, patient confidentiality, medical ethics, research ethics, Department of Health
Published: 13 January 2025
A recent judgment by the Supreme Court of Appeal (SCA) marks a victory for medical researchers and affirms the Court’s commitment to upholding a patient’s right to confidentiality.
On 30 December 2024, the SCA dismissed an appeal by the Gauteng Health MEC, which sought to compel Stellenbosch University researcher Dr Regan Solomons to provide documentation and recordings related to medico-legal cases cited in a 2020 article he co-authored.
The study in question was published in the American Journal of Perinatology in December 2020. The researchers reviewed 10 medico-legal cases involving neonatal encephalopathy and cerebral palsy survivors, focusing on basal ganglia-thalamic (BGT) injuries caused by intrapartum hypoxic-ischemic (HI) events that occurred without a clear obstetric "sentinel event" (e.g., uterine rupture or placental abruption).
Dr Solomons and his co-authors found that cardiotocography (CTG) admission data was reassuring—indicating no immediate concern during labour—in six cases and suspicious, with potential signs of foetal distress in four cases. Their findings suggested that prolonged non-reassuring foetal status during labour could result in BGT pattern HI injury even in the absence of a sentinel event, highlighting the complexities of perinatal injuries. You can access that study here
As the corresponding author, Dr Solomons was subpoenaed on 21 May 2021 by the Gauteng Health MEC, demanding patient names, case numbers, raw data, expert reports, medical records, and MRI scans referenced in the study. The MEC argued that the data was needed to defend a R29 million medical negligence claim against the Department of Health.
Medical negligence claims in Gauteng have risen dramatically in the last five years, with payouts increasing by 36% in the past year alone—from R512 million in 2022 to R696 million for 2023–2024—largely driven by obstetric cases. More on this story
Dr Solomons resisted the subpoena, citing patient confidentiality and research ethics. Supported by Stellenbosch University’s legal team, he argued that he was legally bound to protect patient information and was not in possession of the requested documents.
He offered to provide the de-identified data to the MEC on a ‘without prejudice’ basis, but the MEC chose to escalate the matter to the Gauteng High Court.
High Court Ruling
In his affidavit in support of his case, Dr Solomons reiterated that he neither controlled nor possessed the documents requested by the MEC. The High Court sided with him, ruling that the subpoena was overly broad, vague, and futile, as Solomons lacked the documents in question. The court upheld his defence under Section 36 of the Superior Courts Act. The case was dismissed the MEC was ordered to cover legal costs.
Appeal and SCA Judgment
The MEC, however, chose to appeal the High Court decision, taking the matter to the SCA, arguing that Solomons should be compelled to disclose the whereabouts of the documents.
The Court, with a unanimous bench, determined that no live dispute existed, as Solomons had consistently stated he did not possess the materials.
In his judgement, Justice Mabindla-Boqwana criticised the High Court for entertaining the matter in the first place despite the absence of a valid cause of action.
The SCA struck the case off the roll, stating that the original application was purely academic. The MEC was again ordered to pay costs.
Lessons Learnt
The ruling reaffirms the principles of patient confidentiality and research ethics. However, the judgement also highlights the legal protections not only researchers, but all practitioners must uphold when handling sensitive data.
Access the Judgement
MEC for Health, Gauteng v Dr Regan Solomons (1089/2023) [2024] ZASCA 184 (30 December 2024) (PDF)
Access the Clinical Study in Question
Smith, J., Solomons, R., Vollmer, L., Langenegger, E. J., Lotz, J. W., Andronikou, S., Anthony, J., & van Toorn, R. (2022). Intrapartum Basal Ganglia-Thalamic Pattern Injury and Radiologically Termed "Acute Profound Hypoxic-Ischemic Brain Injury" Are Not Synonymous. American journal of perinatology, 39(10), 1124–1131. https://doi.org/10.1055/s-0040-1721692
For more stories like this
16 September 2024 | Medico-legal claims against South Africa's Department of Health: What we know so far
This story was compiled from various resources, including:
30 December 2025 | Court Judgement | MEC for Health, Gauteng v Dr Regan Solomons (1089/2023) [2024] ZASCA 184 (30 December 2024) (PDF)
3 January 2025 | Conviction | Gauteng Health MEC's bid to compel top researcher to disclose confidential patient data fails
8 Oct 2024 | BusinessLive | Medical negligence payouts in Gauteng soar 36%
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