URGENT FORMAL COMPLAINT – WRONGFUL DENIAL OF EMERGENCY ADMISSION AUTHORISATION FOR MINOR CHILD

URGENT FORMAL COMPLAINT – WRONGFUL DENIAL OF EMERGENCY ADMISSION AUTHORISATION FOR MINOR CHILD

Yesterday, 21 November 2025, my two-year-old son presented with a dangerously high fever of 40°C at approximately 14:00. Shortly thereafter, he lost consciousness. I immediately rushed him to a Discovery network hospital for emergency medical attention.

On arrival, he was assessed by a qualified medical practitioner. Blood tests were conducted, an IV line was inserted, and active intervention was required to reduce his temperature. Based on his clinical presentation and test results, the decision was made by the treating doctor to admit him and for the paediatrician to take over treatment.

I was aware that both my son and I are currently on a general waiting period due to a recent change in medical aid and his prior grommet procedure. However, I was explicitly informed that due to his age and Prescribed Minimum Benefit (PMB) protections, any medical emergency requiring hospital intervention would be covered – especially via the emergency department.

Despite this, your Admissions Authorisation Department denied the admission, directly contradicting the professional medical recommendation and the objective clinical evidence presented.

Even more concerning is the fact that the treating doctor personally contacted Discovery’s admissions department on two separate occasions and was informed that the case was believed to be a “fabricated story,” and for that reason no authorisation would be granted.

This allegation is not only false, it is extremely defamatory, *********, and unprofessional.

Your employee—who has never examined my child and was not present at the hospital—made a life-impacting decision in opposition to a licensed medical professional, despite the following objective facts: • My son is 2 years old • He presented with a 40°C fever • He lost consciousness • Blood work confirmed elevated CRP levels (8.8) • IV and emergency intervention were required • A doctor formally decided on admission

This situation was potentially life-threatening. The delay or refusal of proper treatment in a child of this age under these conditions could have resulted in severe injury or death.

I am demanding a full internal investigation into: 1. The identity of the individual(s) responsible for denying authorisation 2. Their qualifications to override a licensed doctor’s decision 3. Their justification for accusing a parent and a doctor of fabricating a medical emergency 4. The breach of PMB and emergency coverage protocols 5. The psychological and medical trauma caused to my child and our family

I also require written clarification on how Discovery is able to disregard a medical emergency assessment for a minor child, and how the accusation of “fabrication” was deemed appropriate under any circumstances.

Make no mistake: This is not a minor error. My son’s life was at risk. And I will be escalating this matter to Council for Medical Schemes, legal representation, and media channels if it is not addressed immediately and with the seriousness it warrants.

I expect an urgent response.