When doctors err, become killers…

How ignorance robs Nigerians of right to probe negligence

By Doosuur Iwambe

Many Nigerians are often quick to accept unfortunate circumstances as acts of the gods.

Thus, the bitter death of a loved one at the hands of medical personnel is swallowed with resignation.

But what if the staff had been negligent or incompetent? What avenues for justice can the families of victims explore? On June 16, 2019, Mr John Abah took his aged mother, Tabitha, to a prominent government hospital in Abuja (name withheld).

The mother, who was battling health challenges such as diabetes, ulcer and mild stroke, was at the facility following a referral from Asokoro District hospital where health workers could no longer handle her situation.

But Tabitha died at the emergency ward after she had been abandoned by nurses. Narrating the ordeal to Daily Times in a telephone interview, Mr Abah said he never knew that would be his mother’s last day on earth.

“Even though my mother was old, I believe she would not have died at the time she did if the doctors and nurses had handled her treatment professionally.

The doctors on duty left my mother unattended for several hours until she suffered a partial stroke which eventually led to her death,” he said.

According to him, a female doctor (name withheld), claimed she could not be admitted due to lack of a bed space.

“The doctor, as well as the nurses, never bothered to find out what was wrong with my mother, despite being told that she was in a critical condition.

“They were looking at us like lepers. At a point, the female doctor collected the referral letter we came with, looked at it and told us to leave the premises as there was no bed space.

“I pleaded with her to attend to my mother, to save her life but she ignored my plea. The security men were not happy with what they saw happening.

They confided in us, saying there are bed spaces for patients. “They also said the health workers were in the habit of being unruly to patients and referring them to the spill area, a private ward where patients are billed heavily.

It was painful as I watched my mother die helplessly before me.

I will never forget the experience,” Abah said. Also, in December of 2012, Ruth went into labour with her first child at a private hospital in the IyanaIba area of Lagos. She was in labour for twenty-two hours.

According to her, when she finally had the baby, she noticed it was in distress. It did not cry. She immediately alerted the doctor.

“I asked the doctor to see my baby because I did not hear her cry. He replied jokingly: “Take a cane and flog her now.”

Ruth was also not lactating, though the hospital had advised breastfeeding exclusively.

The doctor told her that the baby had been given glucose and water. It remained on glucose and water for three days.

“I started complaining to them when, on the third day, she was not making any sound. Yet, the hospital staff said she was fine.”

On the fourth day however, Ruth’s daughter had a seizure.

“The doctor could not tell what was wrong. He referred us to a government hospital,” she explained.

Ruth visited the newly commissioned Mother and Child Hospital in Lagos. There, her daughter was rushed into the emergency department and given an anti-seizure injection.

A brain scan at Yaba Psychiatry showed that the daughter suffered from primary generalised epilepsy. She was placed on a daily medication to lessen the frequency of the seizures.

After consulting with several medical experts, Ruth learned of two likely causes for her child’s condition. “First, by not crying immediately after birth, a part of her brain did not take in oxygen. Second, she also had hypoglycemia (low blood sugar). Her blood sugar level was 15.

It is not supposed to be lower than 40 for a newborn.” Ruth thereafter had to foot the price of the carelessness daily: her daughter needed a drug that cost N2, 050 per bottle, and she had to buy a new bottle every 10 days.

The body responsible for reviewing alleged cases of medical negligence in Nigeria is the Medical Dental Council of Nigeria, MDCN.

When contacted, the spokesperson, E.D. Abdu declined answers to several questions, asking the reporter to instead study the Code of Medical Ethics in Nigeria manual for the answers sought.

According to him, the expected attitude of doctors to patients is contained in the code (2008 Edition) published by the council pursuant to Section 1 (2c) of the Medical and Dental Practitioners’ Act.

But an anonymous source at the agency said people with ‘substantial’ cases of medical negligence could write a petition to the body with proof, following which the council would set up an investigative panel.

The source did not say how many cases had been treated, their outcome, and how long complainants waited to get justice, if at all they did.

Adetunji Nordi, a lecturer of medical law, at the Benue State University, said the problem with attaining judgment for medical negligence in the country has to do with lack of adequate advocacy and education of Nigerians on how to enforce their rights including the systemic and legal challenges of getting timely judgments for such cases.

He explained that time is of essence in making medical decisions, or reporting such issues.

He said judgment on such cases should be delivered “in the space of hours and should not linger for two years or more.”

Also, a Senior Advocate of Nigeria, Uche Okechukwu, blamed the spate of medical negligence in the country on MDCN, ministries of health (federal and states), and health agencies.

He said these bodies are meant to enlighten Nigerians on issues of medical negligence and who to go to when seeking redress for any harm done by medical practitioners.

“The lack of the knowledge of medical standards is one reason why people have not exercised their right in suing for medical negligence.

When you sue for medical negligence, you are entitled to certain damages and there will be measures taken against such hospitals or the medical practitioner, because medical negligence is not restricted to the medical doctors.

Nurses are involved, dentists are involved; but most often, medical negligence is carried out by doctors and private hospitals,” he said.

MDCN should step up to its statutory duty and make public what the basic standard for medical practices is, he explained.

“The people will now be cautious of what to expect and the medical doctors and various medical practitioners will be conscious.

The people who are aware of such standards can easily make complaints to MDCN.” MDCN needs to “stop being quiet. MDCN has, most times, shielded its members. They have kept secret the standard of medical practice that should be in our country. They should publish such rules in such a manner that becomes easily comprehensible by the public.”

Laolu Osanyin, a lawyer who specializes in medical cases, said three factors must be in place before a case to be considered as medical negligence in the eyes of the law.

“The first thing is that there must be a doctor-patient relationship, which you can also call a duty of care.

Then, there must be a breach of that duty. Essentially, the doctor must have fumbled.

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The third thing that must be in place is that harm must occur. The patient must suffer some kind of harm for negligence to occur.”

But how is harm defined? According to Deji Olunlade, a lawyer, harm does not necessarily have to be physical, nor does it have to involve the loss of a body part.

He gives the example of a patient left untreated upon admission because the doctor on duty is not around. Eventually the patient is transferred to another hospital where he is treated.

“It may not lead to death,” said Olunlade, “but the patient has suffered some form of loss even though he was transferred to another hospital and survived.”