How Mediclinic rescued Wines2Whales rider Hannes Kotze. Mountain biking requires skill. Riders need to be able to pick the best lines while moving at high speeds. Sometimes, even the most talented don't get it right, with potentially devastating results.
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Mountain bike racer Hannes Kotze and his partner, Franso Steyn from Tudor x Van Deijl were leading the Masters section of the 2022 Wines2Whales Shiraz race when Hannes went off the single track at high speed. “While attempting to get back on the track, something I usually do pretty easily, I slipped and fell sideways, landing ribs first on a cut-down tree trunk,” he says – a traumatic injury that sent him to the hospital.

One moment of error
“We were super strong and still leading around the 2km before the second water point,” he continues, recalling clearly what led to the crash. They had begun the stage four minutes ahead of their nearest competitors. After navigating the first 20km of the second stage just fine, they then got onto a fast descent with winding switchbacks. “I had a quick glance up the downhill we were coming down to see who the closest team to us was.” This was exactly when the accident occurred.

The ribs broke, one of them broke in three, and the result of these broken ribs was a haemothorax. “Normally we jump up after the crash to check whether our bikes are fine, but as soon as I did that, I had a shooting pain in my rib cage and could feel something moving inside me.” He couldn’t stand up straight and instantly knew something was seriously wrong. “I lay down on my back, trying to relax, but neither I nor my partner realised how serious my condition was.

What Is a haemothorax?
A haemothorax is a condition where blood starts building up in the space between the lungs and the chest wall. This can lead to trouble breathing and a collapsed lung, among other conditions. It also requires emergency treatment.

The most common cause is an injury that results in a tear in a lung or a blood vessel in the chest. Other causes include tuberculosis, chest cancer, the use of blood thinners, and lung or heart surgery.

Closest competition, biggest ally
When Hannes came off his bike, he was checking behind him to see who the closest team was. This team turned out to be LGE Midas, made up of Igna De Villiers and Dr Paul Theron, a physician at Mediclinic Nelspruit. They were second on the stage and in the Masters category and could have benefited hugely by passing their rivals, but instead, Dr Theron and his partner stopped to see what was wrong.

“Within a minute of assessing my injuries, he told me I had a haemothorax,” says Hannes. Dr Theron also informed him about the risks involved, including the fact that walking would make it worse, and it was best for him to stay in one place and wait. “His honesty, funnily enough, calmed me. He also assured me he would not leave my side.”

I had extraordinary service in the Mediclinic field hospital, where the Mediclinic Events team, led by Dr Darren Green, took over.

“I’m gonna die now”
Dr Theron waited by Hannes’s until the ER24 medical team could get to him. Because of the crash’s location, an ambulance couldn’t get on the trail, so they sent a quad bike. “We were at a spot where even the quad bike could not reach me, but a medic was eventually able to get to me,” Hannes says. He started going into shock, and his partner removed his top to help keep the injured rider warm.

While the ER24 medics were tending to Hannes, his teammate Franso ran a kilometre through the bushes to get the stretcher. The medics administered ketamine to help him cope with the pain and get him on the stretcher. “From there, I can’t remember anything, other than me holding Franso’s hand and telling him I’m gonna die now. He said ‘no, you’re fine’.”

Top-class event medical support team
Hannes says the ride to the ambulance on the quad bike was excruciating. But he had his partner and Dr Theron with him, who, true to his word, stuck with him all the way to the field hospital, where the Mediclinic Events medical team, led by Dr Darren Green, took over.

“I had extraordinary service in the field hospital,” says Hannes, who became a bit of a celebrity, with young nurses bringing out their phones to record the haemothorax. “There was literally a bubble coming out between my ribs as I was breathing.”

Handing over to Mediclinic Vergelegen
“The senior nurse and Dr Green took great care of me at the field hospital.” Besides being grateful to Mediclinic’s Event Medical team, he was even more grateful on arrival at Mediclinic Vergelegen, where he was admitted to the heart and lung ICU under the care of cardiothoracic surgeon Dr Barry Barnard, cardiothoracic anaestheologist Dr Andre Phillips, and physio Jeremy Stockhall.

Hannes was impressed by what he calls “world-class service” from the nursing staff in the ICU and says he’ll always remember the round-the-clock treatment he received there. He went for CT scans, the results of which showed that he had three broken ribs; the one that was broken in three places would require a rib plate procedure. This is when surgeons fix a titanium plate across the length of the damaged rib, instantly setting it and fast-tracking the healing process.the treach

Back on the bike
On 8 November 2022, Hannes went for the surgery on his ribs. Just six weeks later, on 21 December, he got back on his bike for an outdoor ride. In between, he had undergone a gruelling rehabilitation process that began the day after his surgery. “It started with breathing exercises to get the collapsed lung back to normal and oxygen levels up,” he explains.

Hannes was discharged from the hospital on 13 November, went back 10 days later for a check-up, and after three weeks, was able to get back on his indoor trainer and start pedalling to fitness. “The craziest thing of all is that I did the Tankwa Trek in February, just over three months after the crash!”

Riding into the future
Judging by how he and Franso had been feeling before the fateful crash, Hannes believes they would have taken the win in the Wines2Whales Shiraz 2022 Masters category. They returned in 2023 and managed to finish in third place, and “in one piece”, he jokes.

Although he’s sought out the services of a world-class professional coach, Hannes insists he still rides purely for the love of it, and that race results are no longer his main objective. He has a few races in his calendar, including another Tankwa Trek, the Imbuko Big 5, and the Attakwas Extreme. He also intends to test his mettle by entering the Cape Epic. “Race placings are just a result of all the work I put in. My goal is to live a healthy life, using training and riding to cope with everyday life and stresses.”

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