Organ harvesting or negligence? Boy’s intestine vanishes after surgeries at LASUTH, private hospital
There is a shocking and disturbing occurrence between LASUTH and a private hospital, Obitoks, in which a patient’s small intestine disappeared without trace. The two hospitals have denied knowledge of what happened. While LASUTH claimed the patient’s intestine was mutilated and removed from the private hospital, Obitoks insisted that the boy’s organ was intact as at the time of the referral. The question now is: Who removed the small intestine and for what purpose? Is this a case of organ harvesting which is a crime against humanity and violation of fundamental human rights of an individual? This is the crux of this investigative story by New Telegraph’s Isioma Madike.
It is strange; novel. The story is grim and difficult to confirm. However, it is hard to imagine the trauma and anguish of the mother of the patient and her family when doctors broke the sad news to them that their child’s small intestine had vanished into thin air without trace, leaving a shell. The family is baffled, knowing not who to accuse of this scandalous incident. The small intestine disappeared under the watch of medical doctors, and no one could explain what happened, sounds like a tale from moonlight.
Adebola Akin-Bright (12) is today a shadow of himself. He was taken first to Obitoks Hospital, Oke Odo, in Lagos, on March 6. He had been to another private hospital, according to Dr. Abay- omi Baiyewo, a family physician and MD of Obitoks, who handled his case. The unnamed private hospital had treated Adebola for typhoid and malaria, Baiyewo told New Telegraph. He said: “When I saw him, I discovered that he had a distended abdomen on the right side.
I diagnosed the case of a ruptured appendicitis that had to be operated on March 7. I invited a senior colleague, a paediatric surgeon from the Lagos State University Teaching Hospital (LASUTH), Ikeja, and we took him to the theatre where we discovered to our amazement that the appendicitis had ruptured and had gummed the small intestines to the rectum.
“At that moment, to remove the appendix would have been disastrous because you have to cut all the organs, and we tried to relieve the boy of the pain, and drain the pus from the abdomen. We reasoned that once it ceased to form, the ruptured intestine would heal by itself.” Baiyewo said the boy was referred to LASUTH on June 17, at the insistence of his mother, Deborah Akin-Bright.
In the referral, the doctor said, as expected, he explained what he did to the boy so as to guide his professional colleagues at LASUTH, who he anticipated would speed up action as Adebola’s case, required urgent attention. “A member of Adebola’s family was invited into the theatre to witness what we did; we did this because we had nothing to hide,” said Baiyewo.
“Unfortunately, the doctors at LASUTH as I gathered did not operate on him immediately until the portion of the abdomen, which we stitched after our surgery forcefully opened with faecal matter gushing out, according to the mother. “Perhaps, it was this occurrence that forced the LASUTH doctors to quickly operate on him. But what they did or how they did it, I do not know since I was not in the surgery theatre with them,” he added.
However, LASUTH’s CMD, Prof. Adetokunbo O. Fabam- wo, who spoke for his hospital told New Telegraph that the patient had been operated elsewhere and they had mu- tilated him, removing all his intestines. “We did what was supposed to be a corrective surgery. I have a detailed report from my surgeon. The injury was there and an attempt to repair it was done here. He had been mutilated before he got here.
So, what we did here was an attempt to correct that.” Fabamwo added: “It’s only the doctors in the private hospital where the patient was first treated that will tell us what they did and what actually happened to the patient’s small intestine. Again that speaks to the quality of services being provided in some of our private hospitals. “We need to keep an eye on what some of them are doing.
Let me say it clearly that the boy had been mutilated in the private hospital and we tried to correct that and we have records. A lot of the intestine was removed and a lot of damage was done. It was not done here, a correction was done here.”
Adebola’s mother speaks:
I need an explanation for my son’s intestine disappearance; he must not die Incidentally, the boy’s distraught mother isn’t interested in the doc- tors’ conflicting stories. She has no doubt that her son’s organ was removed from his body, even as she demands explanation on what happened. It’s not just possible, she said, for her son’s small intestine to suddenly disappear without the doctors explaining what actually happened.
“I’m not a medical doctor but I know that his small intestine was intact up to the point we took him to the hospital. For the doctors to tell me that his intestine suddenly vanished drives me crazy; I’m going mad; nothing must happen to my son,” she cried. “They told me the only way out is a possible transplant in India; I know that the cost will be enormous. How do I finance that? Where do I get such money?
The Nigerian Medical Association (NMA) and the Lagos State government should please come to my aid and unravel this mystery. “I’m also using this medium to appeal to both the government and well-meaning Nigerians to assist me as I cannot afford his trip abroad for transplant. I have sold all that I have to make sure he lives. I have nothing more to sell,” Deborah begs. She explained that her son had a stomach upset sometime in March and was vomiting.
It was in the middle of the night and he started vomiting and having diarrhea so the mother treated him for that for a few days. After that, she discovered that Adebola wasn’t getting better, and he was clutching his stomach. This necessitated an abdominal scan test, which revealed a ruptured appendicitis. This discovery made her to rush Adebola to Obitoks, a private hospital at 2, Gideon Adeniran Street, off Old Otta Road, Oke-Odo, Lagos, for proper examination and treatment.
She recounted: “He was admitted on March 6, and operated upon on March 7, for ruptured appendicitis. The doctor told us it had burst for a period of two weeks and some of his intestines were cracked and they had to wash it, and then it would be back to normal. During the first operation, one of my family members was in the theatre room with them all through, to witness everything that happened.
“After three months, Adebola came back from school complaining of stomach pains again, and we went back to the same hospital. He spent additional two weeks at the hospital and was discharged on March 20. At the hospital, he complained of abdominal pain, and the doctor said that since it is the upper abdomen it is most likely to be ulcer. He prescribed some drugs, which we bought immediately, used it and he was relieved of the pain.
“Only for him to wake up early on that fateful Sunday morning that same week and complained of pain again and was vomiting. So, we called the doctor and he got him admitted and he kept treating the ulcer for an upward of three days. At that time he was vomiting a greenish substance, which they said is bile. At the same time, we noticed a kind of growth that one can feel when touched at his upper abdomen.
When we touched that portion, he felt pain and his stomach became bloated. “By this time, he was no longer passing out faeces but vomiting frequently. If he takes in water he would vomit a greenish substance, so the doctor decided that it was beyond ulcer and instructed us to do another abdominal scan and that revealed an intestinal disruption. That was on June 6. “The doctor demanded a deposit of between N400,000 and N500,000 before he could commence the second surgery.
He explained that he was inviting two consultant paediatric surgeons to help with the case because he might not be able to handle it alone. And that was when the trauma started. She added: “On the third day there was a tube that was inserted into Adebola’s abdomen to monitor any log. There was an NG2 placed on his mouth down to his stomach to control the bile. On that same day, the leak from the surgery started. It didn’t come on the first and second day. But on the third day it was heavy.
“We asked the doctor and he said we should just watch. The leak was coming out like light brownish co- lour/yellowish and he was draining heavily. After the seventh day the leak stopped and we thought it had finished only to discover that the tube that passed through the mouth had been disconnected from the abdomen. “Unfortunately, the leak was now going into the abdomen. When the doctor discovered that, he removed the lid and that was when that thing started coming out from the abdomen.
That was on March 15. The leak was coming out and the doctor was not giving us any tangible explanation and the boy was not farting, which he told us was necessary at the time. “When one of my family members visited, she noticed that the boy had emaciated as he had not been eating. The doctor at this point was threatening that if we fail to pay the N220,000 balance he would stop his treatment though he had forfeited his professional fee of N50,000 out of compassion.
“And because we could not readily pay the balance, the doctor asked us to be buying things he would ad- minister to the boy; the fluids, and other items because the boy couldn’t eat solid foods. He also promised to bring a professor from LASUTH, though the prof. was not part of those that did the first and second surgeries. “He said that the prof. was coming to review the situation but at that time we had made our decision to be referred to LASUTH since that was where the professor was coming from.”
Deborah said that her son was admitted into the surgical emergency at LASUTH because there was no bed space at the paediatric ward. That was where the paediatric doctor, identified only as Dr. Oguntimilehin, met them. He was placed on fluids initially and in the process of getting to know what was wrong with him, they saw the drain coming out in his fistula. The doctors couldn’t operate on him immediately because the boy, according to them, had to be stable first.
So, they asked the mother to be patient and do all they asked her to do; get the drugs they asked her to buy while the doctors concentrate on their investigations. After one week, Adebola defecated and the doctors were happy; even as they called it a good sign, the leak was still coming out. They even said because of that, surgery may no longer be necessary. Later the incision started closing up and the leak stopped. They were buying at least N25,000 drugs daily so that everything would be fine.
The doctors conducted a test on him and the second or third day they did an abdominal scan that revealed everything was fine. The kidney and visualised bowel, for instance, looked fine. There was an X-ray too. “We did all these and nobody saw that there was no small intestine in his body. They only told us that they needed to balance electro- lyte and if the blood was not enough we would buy more. He had taken seven pints of blood thus far.
At a time we had to buy albumin and that one cost N66,000 just for him to build up for surgery as the expected improvement didn’t materialise. “They called in a professor to review the case, it was then they discovered the leak was still there and they said that since it’s coming out from the incision side they would have to open it up a bit because, to them, it is better outside than inside. “They opened it up and I think they touched a tissue so they sewed it back but that didn’t help.
After two days, that place that they tried to open started expanding and more tissues were coming out. I asked them what that meant and they said it’s the tissue that covered the intestine. “It was like that until it finally burst when they were dressing it. There’s a video. At the time we thought he would go for surgery but because the potassium dropped to 2.5 and the lev- el was supposed to be 3.5, they said he was not fit for surgery and that we had to boost him up again on potassium.
However, it was the burst that quickened the emergent surgery.” Deborah added: “The surgery lasted for three to four hours. The lead surgeon, a consultant, Dr. Omolara Williams, called me and said that what they saw was only large intestines when they opened him up. She said the only thing they saw of the small intestine was a small Duodenum. “She explained that the intestine is divided into three: Duodenum, Ileum and Jejunum.
And they had to anastomose (join) the large intestine to the Duodenum, which is an unusual thing to do as they cannot guarantee that the boy will survive or not. She said that after three days if it doesn’t break, that means it might hold. “The surgeon said the small intestine was cut off and they didn’t know why and how it happened since they were not part of the first and second surgeries.
I asked about the tpn (fluid) that is given to those that cannot feed orally, she said she can’t speak on anything until the anastomosis holds because if it breaks, that’s the end. Immediately, darkness enveloped me; I was just looking at the surgeon and my sister was crying. “We were told they saw 10-12 cm Duodenum and yet the small intestine is meant to be 20-22 feet. They said they didn’t see it.
I asked the consultant what was happening and she repeated the same thing and I asked her why they didn’t call us when they discovered that. She said they were trying to sort it out. I felt they should have called us in and explained what they saw to us. But they didn’t do that. “Afterwards she called me to show me what they did and I asked if that was the beginning of the procedure and she said no and asked if I was insinuating that they cut off the boy’s intestine.
I said I don’t know because I don’t know what to say. “She said they were 15 that were in the theatre during the surgery and that if they did something like that one of them would have told me. She showed me the picture where, according to her, they had sorted it and they saw only the large intestine, the colon and Duodenum and stuff like that. “She also showed me the video when they were talking. She didn’t give it to me.
People were reacting in the background. The anesthesiologist was there, there were five surgeons there and the nurses. And I said this is baffling and immediately called Dr. Baiyewo because I got to know him through a friend. The man said it is crazy because if there was no small intestine there he wouldn’t have referred the boy to LASUTH and he would have insisted on finishing the job if he had done something wrong.
“That is where we are. My son has been on tpn since that day, and it costs N54,000 every day. That’s how he is feeding. He takes it in the morning and at night. Somebody should please explain to me what happened to my son’s small intestine.”
LASUTH CMD reacts
Professor Fabamwo in his reaction reiterated what he told New Telegraph earlier that the boy had been operated elsewhere and they had mutilated him. He maintained that the private hospital had removed all his intestines. “We did what was supposed to be a corrective surgery. I have a detailed report from the surgeon. The injury was there and an attempt to repair it was done here. The news that we removed the intestine is incorrect. He had been mutilated at one private hospital; so what we did here was an attempt to correct that.
“Again that speaks to the quality of services being provided in some of our private hospitals. We need to keep an eye on what some of them are doing. Let me say it clearly that the boy had been mutilated in the private hospital and we tried to correct that and we have records. A lot of the intestine was removed and a lot of damage was done. It was not done here, a correction was done here.”
He added: “He was brought here and stayed for three or four days before we ventured into anything, corrective surgery was carried out and the report was sent to me yesterday (Tuesday), August 9. I have given a directive that our findings should be communicated to the referral hospital. “We are not supposed to be judgmental; we are not inviting the doctor of the private hospital for an interview because it’s not my business to do that. If the parents wish to pick up a case with him, that will be their concern.
I’m not supposed to instigate them and we will let them know what we found out. “You said he was here for about 23 days before his surgery, well, I don’t know. All I know is that not all cases that come are immediately suitable to be operated upon. Sometimes you need to build the patient up; give blood, correct infection and do all things. I was just reading the report yesterday (Tuesday), August 9. I also believe all that was explained to the parent’s mother.”
Obitoks’ MD: Our story
Dr. Baiyewo of Obitoks Hospital said once the appendix is ruptured, it forms a bag of pus and mesh together with faecal matter as time goes. “That is what happened and we tried to get the pus out and we put a tube in. It’s natural healing that would take care of the rest and after six months you can remove it. That’s why it has to be removed at the base. He got well and went back to school only to come back on June 4, with severe abdominal pain in the upper abdomen and he was vomiting.
We placed him on intravenous fluids thinking it was something minor. “When the vomiting persisted we dis- covered that he was having it in bouts; one minute he would be fine and the next he would be vomiting. We also discovered that he had swelling of the upper abdomen and there was obstruction. I told the mother that there is an obstruction and we had to open it up to free the obstruction because of the former rupture.
“We went in, I invited an anesthesiologist and another colleague and we went in and discovered that the boy had multiple obstructions in the intestines. “The appendix area was already sep- arating itself and it’s accessible this time because we had stemmed the appendix at the base. While going in there was this rupture in the intestine that had been there. I called the patient’s mother to come and see what was going on, she came and saw it and was praying that everything would be alright.
I told the mother we would have to close the hole and I showed her the blackish thing. “There was also this bind and how it came about we don’t know. We discovered that the part that was pressed by the upper abdomen was already blackish and that was the upper part of the small intestine and we needed to cut four inches of the blackish part. We joined it together in two layers and everything was looking good.
“On the fifth day, instead of the faecal matter continuing to come out, it stopped and he was discharging greenish matter, that’s the bile. The mother alerted me that he had stopped passing faecal matter and he was passing bile through the mouth. We stopped him from eating and we put a tube into his stomach. “I told the mother that the boy had to be reopened because there is drainage of the bile and that means there is an obstruction that is not letting it get to the intestine or there was a perforation.
That was the two things we suspected and the only thing we could do was to go in and see. We reasoned that to open it and see it remains the best. “We arranged for him to be opened. I invited other surgeons and one from LASUTH and an anaesthesiologist that would gas the boy but to my surprise, as I was waiting for the experts to come, by 3pm the patient’s mother came and told me they wanted the boy referred to LASUTH.
I told her she has spent so much money here so why not complete the procedure here and then let the boy go home but she insisted it was her final decision. “And I had to let her take the child because she has the right to the child. Baiyewo added: “I referred him to LASUTH and I stated in the referral note what I had done in the case. We were waiting for their findings. The next day I called and I was told they hadn’t done the examination.
I called her again and asked what was happening and she said that he had low potassium and that they were trying to beef it up. “When they eventually did their sur- gery, they went inside and came out with a video of the last part of the surgery. The beginning of the video was not shown to the mother. By this time as I was told part of the Duodenum was gone while the Ile- um was gone completely.
“They took it off; they said there was nothing like a small intestine there again. The woman was with me when we were doing our own surgery; she saw the small hole and how we closed it and everything we did. I’ve never heard it before in medicine that somebody will be without his intestine and a small boy like that for that matter.
“Like I said earlier, what we did was mentioned and properly explained in our referral note. Let me snap it to you through WhatsApp for you to see.” The doctor eventually sent the handwritten referral note via WhatsApp as he promised.
A surgeon who does not want to be mentioned, said from the picture painted about the case, the issue could be a case of professional negligence. “Yes, I can tell you there’s nothing like organ harvesting here; what happened is pure professional negligence.
Somebody has done what is not right and that can’t be explained. It’s unfortunate it happened. What needs to be done now is a possible transplant but again the boy has to be stable first,” he added.
Lagos State Ministry of Health
An official at the Public Affairs department of the ministry, who identified himself simply as Segun, responded to New Telegraph’s inquiry on behalf of the Director, Public Affairs. He told our reporter that since the LASUTH CMD has spoken, there won’t be a need for their reaction anymore.
Get the latest news delivered straight to your inbox every day of the week. Stay informed with the Guardian’s leading coverage of Nigerian and world news, business, technology and sports.