SPECIAL REPORT: How patients lose lives, body parts due to alleged medical negligence at Nigerian hospitals

National Hospital
National Hospital, Abuja

When Kingsley Kalu left home on October 18, 2017, it was with the hope of returning safely as it had been on other days. He never knew he would be crippled by a stray bullet released by a police officer. He never thought he would end up at the hospital battling to save his life.

The unfortunate incident occurred at about 8:30 p.m. around Exclusive Stores in Wuse 2 when Mr. Kalu went in company of his newly wedded wife and brother-in-law went out.

A trigger-happy policeman, during an argument with a colleague, ended up shooting a wrong person – Mr. Kalu.

The bullet pierced through his left leg, crippling him instantly.

He was rushed to Maitama General Hospital by his wife and brother-in-law who were present at the scene of the incident.

At the hospital, the doctors on duty successfully stopped the bleeding but Mr. Kalu could not move his left toes. The doctor noticing that he (Kalu) couldn’t feel any sensation, said he needed to be transferred to a specialist hospital.

The following day, Mr. Kalu was at the Trauma Centre of National hospital, Abuja where he was not attended to promptly and due to the negligence of the medical practitioners, he eventually lost the use of his left leg permanently.

Eight days later, Mr. Kalu’s leg was amputated.

While narrating his ordeal to PREMIUM TIMES, he said he lost his leg due to the careless attitude of the medical practitioners at the Trauma Centre of the National Hospital.

“I saw the consultant the following morning and he tried his best to stop the bleeding which they successfully did. It was in the process that he noted that I was not feeling any sensation in my left toes and could not move it,” Mr. Kalu who is now recuperating from the incident said.

“Immediately he noted that, he told me that he was not comfortable keeping me at Maitama explaining, that it was a nerve problem which they cannot handle and as such would transfer me to the Trauma Centre in National hospital because they have specialist who would be able to handle my case.”

Mr. Kalu reportedly arrived at the National Hospital around 10 p.m. with the expectation of being treated and discharged soon. The doctor at the General Hospital had told him that there was no cause for alarm as there was no bullet lodged in his leg.

The physician had explained that since he was not feeling any sensation or could not move his toe, with physiotherapy, and proper medical attention from a nerve specialist, he would be able to use it as, ”his leg was still warm.”

Mr. Kalu lamented that if he had known that the outcome of going to National Hospital would lead to losing his leg, he would have asked to be referred to a private hospital.

With tears, he explained his ordeal further.

“If I had an inclination of what of the attitude of the doctors at that hospital, I would have opted for the services of private hospitals which would have been more expensive but intensive and might have saved my limb.

“I still believe the way the medical practitioners handled my case did more damage than good. I was not attended to until the following day in spite of my referral note saying my case was urgent.

“I was referred to that hospital so that my limb would be salvaged, yet I ended up losing it due to the negligence and nonchalant attitude of the doctors who are trained to have empathy on people but instead treat their patients as if they are gods in charge of their fate and with no conscience,” he lamented.

He told PREMIUM TIMES that after a long wait at the National Hospital, the doctor who took charge of his case after going through the referral note and examining him again, said he needed urgent surgery and an iron would be fixed in his leg.

“My wife was linked with the iron vendor and we made purchase at the cost of N50,000 same day. Unfortunately, the surgery was postponed. On getting to the ward where they were to prepare me for theatre, I was told my PCV (percentage of red blood cells circulating) was low and (I) would need blood transfusion.”

He explained that arrangement was promptly made for blood transfusion and he was given four pints. He said the doctor came back to inform him that the iron previously purchased might not do an effective job, especially if he wants to be able to bend his knee.

Mr. Kalu said though he was angry at the new suggestion, he went ahead and purchased the new recommended iron which cost another N80,000.

According to him, he was taken for surgery seven days after his admission to the hospital.

“I thought I had seen the worse but the bad news flowed after the surgery as the doctors told me my leg had to go because it had been infected.

“I was so angry. I had been at the mercy of these doctors for seven days without receiving any special medical care for the leg except them dressing it and using me for teaching experiment for their students. To compound the matter, they had also opened my leg up and fixed an iron which was not even looking like the one I bought only for them to be telling me again that my leg has to go.”

He explained that at this point, he was already traumatised and wanted to leave the hospital which made him start seeking for second opinion outside the hospital.

“I was already depressed by then. The consultant just said it with no feelings and told me I had 48 hours to make up my mind and walked away. I had to ask why he even fixed the iron on my leg in the first place when he realised the leg was still going to be amputated.”

Later, Mr. Kalu realised from second (medical) opinion that that nothing could be done any longer and the limb really had to be amputated.

“I had to forcefully discharge myself because I no longer trusted them with my life. I got the leg amputated at a private hospital,” he said, explaining that the police said they were still investigating the shooting.

OTHER CASES OF ALLEGED NEGLIGENCE

Mr. Kalu’s experience captures the reality of alleged medical negligence patients suffer in Nigerian public hospitals.

Another victim, who pleaded anonymity because of he is also an official in the health sector and fears for his job, explained how delay in medical decisions, ignorance and non-availability of consultants made him lose four fingers on his right hand.

According to him, he was involved in a car accident which claimed the lives of 10 people.

He said he was referred to National Hospital, Abuja, due to the wounds he sustained in his right hand.

Unfortunately, instead of getting a solution to his case, it got even worse. He reportedly had to get a referral to a private hospital in Osun State because his hand was already decaying and nothing was being done about it by the medical personnel.

“There is a need to declare a state of emergency on Nigeria health system. I lost four fingers which ordinarily I shouldn’t have because I was referred to National Hospital.

“That hospital is expected to have a national trauma centre which by default should have first class equipment and staff to handle all trauma cases in the country, unfortunately the reverse is the case. It is surprising that a place like National Hospital could not demonstrate appreciable and high professional competence in attending to trauma patients,” he lamented.

Lamenting his treatment at the hospital, he said he was forced to seek help elsewhere after staying there for three weeks.

”It is pathetic. I was paying for bed space, buying drugs and my wound was not attended to. Being a laboratory scientist, I understood some of the treatment I should be giving, but it was not forthcoming. I was eventually forced after putting a lot of pressure on National Hospital, to seek help elsewhere.”

He said he gathered from experts’ opinion that the surgery which was eventually carried out on his hand, three weeks after the incident, should have been done within 48 hours.

He said while at the National Hospital, he had been taken to the theatre twice but nothing was done to save his fingers except, ”removal of wound debris.”

He also lamented the lax attitude of consultants who were rarely seen at the hospital saying their presence might save a lot of lives.

“The consultants are another story entirely, you rarely see them, and we are left at the mercy of resident doctors, house officers, nurses and ward assistants. The fact that you are a consultant means more time, more dedication to work, but what you see is that all of their focus is on their private facilities and how to get patients to their private facilities.

”Some of the doctors suggest private facilities to patients and you ask them, if you are the best hands here, why should you be suggesting private facility to patients?”

He also claimed that most of the medical personnel at the hospital exhibited hostile attitude toward patients.

He explained that these workers issue ‘outrageous bills’ including investigations not done and go to the extent of going to wards to harass them (patients) to pay.

Asked why he did not pursue a legal action, he said he had to bow to pressure and pleas from, ”various people in the sector.”

“Taking legal action or not has nothing to do with their attitude. There is a regulatory body or authorities in charge of the facilities and I am sure they are aware of the happenings in the system. How many successfully prosecuted cases have you heard of?” he said.

NOT SO ‘LUCKY’

Debbie, (surname withheld based on family instruction) was another victim of alleged medical negligence, who unlike Messrs. Kalu and Olumide is however not lucky to be alive to tell her story.

Debbie died few weeks after complications from a Caesarean Section, CS done on her at Asokoro General Hospital, Abuja, four years ago.

According to her brother, Jude Akarah, Debbie was rushed to the hospital during labour. She was in labour for two days before a CS was done.

Mr. Akarah said the problem started three days after she was discharged from the hospital.

“The CS was successful, we had both the mother and child. Unfortunately, three days after getting home, we realised that her stomach was swelling and where she had been stitched was open. We had to rush her back to the hospital.”

He said on getting back to the hospital, they were told she would be re-stitched and it was at this point that they realised that the doctors had forgotten some gauze inside her when they had done the CS.

“This led to infection and complications, which we started battling. Unfortunately, she died.”

According to Mr. Akarah, the victim’s husband had alleged that he suspected that the doctor who had operated his wife during the CS had been drunk because the doctor had been reeking of alcohol that day.

Mr. Akarah said they had initially contemplated a legal action against the hospital. However, they did not follow it through because of the emotional torture the case would give the victim’s mother.

“We thought of the effect a legal battle would have on our mother who till date is yet to get over her death. We thought it would be unfair to keep reminding her of what she would not want to remember and believed the best way to handle it is to let (go),” he added.

A FORTUNATE ONE?

Amos Dunamis, though also a victim of alleged medical negligence, is luckier than the others as he was able to quickly make a decision which perhaps saved his arm from being amputated.

He claims the decision he took after the first ‘failed medical intervention’ at the hospital has given him the privilege to continue using his arm.

Mr. Dunamis, while recounting his experience at the National Hospital, told PREMIUM TIMES that he has come to realise that, ”Nigerian hospitals do not necessary have the sole solution to people’s problem, instead they even end up compounding the issue.”

Mr. Dunamis was admitted at the National Hospital in July 2017 after a motor accident where he sustained facial injuries and a fracture in the left arm.

According to him, he was promptly attended to by the medical personnel on ground who cleaned up his wounds because he was bleeding profusely on the face and also took down his data.

It was after that day, he added, that his ordeal started with the medical personnel who did not attend to him until the ninth day when they gave him to options for his broken arm: a surgery in which they would put iron or casting using POP.

“Though I did lots of x-rays on the first day I got to the hospital, it was the second day that they bandaged my arm because the bone broke in two places. They stitched my head then transferred me to one of the male wards.

“I had to keep waiting for the doctors to come attend to me and I was in terrible pains because the bone was not set. Though the nurses were attending to me and giving me drugs, nothing was said or done about the broken arm until eight days after getting to the ward,” he said.

Mr. Dunamis said he opted for POP, based on a previous advice from a medical friend who had seen the film during his visit.

“I think that iron is their business because it was after they saw the X-rays that they suggested surgery and gave me the phone numbers of the people selling the metal that would be inserted into my hand. Out of curiosity, I made an inquiry from the metal dealer and was told that the stipulated metal for the arm would cost N60, 000 and the surgery will cost N150, 000.”

He said the POP was done on the tenth day, and when he went back for check-up five weeks later, they realised they would have to either re-do the POP or as suggested carry out surgery to insert iron because the bone was not set.

Mr. Dunamis said the X-ray result showed that the bone was not in the right position and as such they would have to remove the previous one, rest the bone and fix another POP or do surgery.

He said hearing that, he made up his mind on an alternative. He started making enquiry for available local bone setters, and subsequently stopped going to the hospital.

”If I had I known it would be like this, I would have left the hospital, maximum four days and this hand would have been better than this. I would have been working. I have not been working for the past three months,” he said.

Regulatory body ‘responds’

The body responsible for reviewing alleged cases of medical negligence in Nigeria is the Medical Dental Council of Nigeria, MDCN. When PREMIUM TIMES’ tried to get an official reaction from the spokesperson of the council, ED Abdu, on the alleged cases of medical negligence, this reporter was asked to study the “Code of Medical Ethics in Nigeria” manual for the answers sought.

According to a terse response to a PREMUM TIMES enquiry from the regulatory body, the official position of the council on the approved 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. That section basically tells aggrieved persons to report alleged medical negligence to the council.

No further response was provided on specific questions of how many such complaints have been made, how many have been investigated and concluded and so on.

A source at the agency, however, told PREMIUM TIMES that people with ‘substantial’ cases of medical negligence can write a petition to the body with proof of such and they (council) would set up a panel to investigate.

The source could not, however, say how many of such cases have so far been treated, the outcome of such cases and how long complainants had to wait to get justice if indeed they did.

A previous case of medical negligence that led to the death of a woman, reported by PREMIUM TIMES in 2016, is yet to be concluded by the MDCN.

LAWYERS SPEAK

Ife Bamidele, a lecturer of medical law, College of Law, Afe Babalola University, said the problem with attaining judgement 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 judgements for such cases.

Mr. Bamidele 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.”

“Even as at now, because there is no council at MDCN appointed by the president, that means all the cases we have at the Medical, Dental Practitioners Disciplinary Tribunal, MDPT are hanging for up to two years so it means that a bad doctor can sit and continue to do the things that he did that made him eligible to appear at the tribunal for two years consistently and nothing is happening.”

He however said that this should not deter people from seeking redress for wrongs from medical negligence, ”as it is their right.”

Mr. Bamidele said people need to be aware of their rights as patients as this will enable them to be able to take up actions either at the professional level by going to report at MDCN or perhaps institute an action at the law court.

“We have to continue educating people, then the medical professionals have to accept that negligence is part of the profession so they should accept that there will be bad eggs and do a little more ‘publicity’ with discipline,” he said.

Frank Tietie, Executive Director, Citizen Advocacy for Social and Economic Rights, CASER, laid the blame of continual medical negligence in the country on the door step of MDCN, the ministry of health, both federal and states health agencies and other health related agencies.

He said these 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 the medical standard 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 that MDCN should step up to its statutory duty and make public what the basic standard for medical practices are.

”The people will now be cautious of what to expect and the medical doctors and various medical practitioners will now be conscious of that and that becomes a bridge. The people who are now aware of such standards can easily make complaints to MDCN.”

He said the public needs to have access and knowledge of what standards they need and MDCN also needs to step up to its duty by making the public aware of its activities, ”and stop being quiet.”

“MDCN has shielded most times, their 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.

“We can also put the blame on the various ministries of health that is the federal ministry of health and the various state governments which has also failed to educate the public as to what is the basic standard of medical practice.

“Let MDCN and the various ministries of health and health agencies wake up to their responsibilities to let the people know what the basic medical standards are and what to expect whenever they approach the health facilities. When that is done, the medical health providers will know that the people are aware of what to expect.”


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