Winnie Madikizela-Mandela on Wednesday denied claims that she approved the publication of a controversial book describing former president Nelson Mandela's final years.

Madela's ex-wife said she'd merely signed the first copy of Mandela’s Last Years as a courtesy to its author, Lieutenant General Vejay Ramlakan.

“He brought me the first copy and he said: ‘Mama can you sign the first copy?’ I am asked for my autograph often, and my autograph has never become an endorsement of anything.”

Publisher Penguin Random House South Africa on Monday said it had withdrawn the title from publication out of respect for Mandela’s family.

Madikizela-Mandela said only Ramlakan could explain who gave him permission to write the book.

She was married to Mandela between 1958 and 1996.

Graça Machel

On Friday, Mandela's widow Graça Machel condemned the book "in the strongest terms". She said its publication was a breach of doctor-patient confidentiality.

"I am taking legal advice on whether to institute legal proceedings against the author and its publisher," Machel said.

Ramlakan headed Mandela's medical team until his death in December 2013. In extracts of the book released to News24, Ramlakan wrote about Mandela's admission to Mediclinic Heart Hospital in a serious condition on June 8, 2013.

"On the previous night, we surmised, a sudden ulcer bleed and concomitant lung infection had probably caused an aspiration from blood that was being regurgitated," he wrote.

Ramlakan retired from the South African National Defence Force (SANDF) in 2015.

The Defence Department on Saturday said the book did not represent the views of the department or the SA Military Health Service.

"The views and patient doctor engagements expressed in the book have not been sanctioned by the senior cadre of the department and the SANDF respectively," spokesperson Siphiwe Dlamini told News24.