Medical negligence and its impact on health outcomes

Mrs. Peju Ugboma walked into the hospital in Lagos, on Thursday, 22nd April 2021. I walked into a Specialist Hospital, Abuja on the same day. Ugboma was scheduled for a myomectomy the next day, and so was I. We were both healthy women, with no underlying conditions, and we had tests to prove it. So how is it that Ugboma is no longer with us? Two words: medical negligence.

When I read the accounts of what transpired in the Lagos Hospital, I felt a myriad emotions all at once; grief, pain, rage, incredulity. I distinctly remember that the predominant emotion was rage, even as I write this, I feel the white hot anger rising from my belly. I’m enraged at the doctors who felt that their training made them superior, and refused to really listen to the concerns of the patient and her family. I’m enraged that a husband and two precious daughters were robbed of their wife and mother. I’m enraged at the system that does not hold medical professionals accountable for incompetence that usually stems from puffed egos. I’m enraged that more families have the same, or similar stories to tell.

Medical negligence ensues when a medical or healthcare professional deviates from the care standards of their profession, and causes injury or fatality to the patient. This can be the result of error in diagnosis, treatment, poor aftercare, or health management, disregarding or not taking appropriate patient history.

In Nigeria, the average citizen is resigned to receiving poor services in the public hospitals they can afford, so they avoid going to the hospital like a plague. They would rather self-medicate, or ask friends or family members who are medical professionals to prescribe medication for their symptoms. This is a whole other problem on its own, but you can’t blame them. Personally, all my encounters with public hospitals have been unpleasant. From rude and impatient nurses, to doctors who refuse to answer my questions about test results because they feel I’m too dumb to know what to do with it (a doctor actually told me, “Even if we tell you the result, what will you do with it?), I too give public hospitals a wide berth.

According to a paper by Bisola Ogundare, “Empirical work by a researcher shows that 61.69 per cent of Nigerian patients feel that medical practitioners in Nigeria are arrogant and careless about their conditions and plights. Also, 33.3 per cent of Nigerian patients indicated that their doctor’s treatment had caused them extra injury beyond the ones, which took them to the hospital. In spite of this large number of victims, the number of cases recorded or filed, as lawsuits are low. The reason for low-level of claims includes a cultural notion of adverse medical events, poverty, illiteracy, limited option of treatment, reluctance to seek redress against the medical practitioner, and most of all ignorance.”

No wonder the system continues to run the way it is; broken! Very few people are able or willing to hold the men and women who swore an oath to take care of them accountable, when they step out of line.

In a 2019 Premium Times article, Ebuka Onyeji writes, “Nigeria’s ratio of doctors to patients is about eight times below the World Health Organisation (WHO)’s recommendation of one doctor to 600 patients. The available ones are overworked and poorly paid and work in facilities, which lack basic equipment that will enable effective service delivery. A Premium Times investigation in 2016 showed cases of alleged medical negligence at the Federal Staff Hospital, FSH, Abuja.

In one of the most severe cases, surgeons in a facility were accused of puncturing the lungs of a 29-year-old staff of the Bank of Agriculture during a minor operation, eventually leading to her death. I can identify with this family, because I lost an aunt several years ago the same way. Different public hospital, different specifics, same negligence, same outcome. More recently, my Dad would have had the same fate, if my mother did not raise hell. Thankfully, we had just purchased insurance and were able to move him to a private hospital.

Private hospitals seem to be the answer for those who can afford it, but that is not always the case. The Lagos hospital is supposed to be one of the best private hospitals in Lagos, but the facts about the tragedy of Peju Ugboma tell a different story. As a matter of fact, several individuals have shared their unpleasant experiences with the hospital on social media. Personally, I’ve had both positive and negative experiences with private hospitals, and my recommendation is this; please do your due diligence and research, research, research.

Medical negligence is not a problem that’s peculiar to Nigeria, but in my opinion, the prevalence of this menace is the symptom of a more chronic disease; complete systemic failure. When doctors in public hospitals have to see up to 120 patients a day, they’re more prone to dismissing your symptoms as mild, so they can move on to the next case. When surgeons have to operate on patients in theatres without the proper equipment, they’re more likely to make mistakes. When hospitals have a culture that put more value on the bottom line than the patients’ wellbeing, you have a breed of doctors who are reluctant to re-evaluate their diagnosis. When these doctors know that they will literally get away with murder, they have no motivation or reason to do better.

What is the way forward? The short answer, fix the broken system. However, we all know that it’s not that simple. In the meantime, how do you protect yourself?

i. Earlier, I mentioned the importance of research when choosing a hospital, especially if you can afford a private hospital. I cannot over-emphasise this. Make sure that the hospital you’ll be entrusting your healthcare and money to, are dedicated to fulfilling their duty of care to you.

ii. You’re smart, and nobody knows your body better than you. Do not allow any doctor, no matter how qualified they are, make you feel that your concerns are not valid. Ask for second, third, fourth…as many opinions as you can.

iii. Ask questions. You’ve probably heard the expression, “No question is stupid.” Apply this principle whenever you have to visit the hospital.

iv. Seek redress. The more negligent doctors are held accountable, the less cases we have. The High Courts and the Medical and Dental Council of Nigeria (MDCN) have the mandate to discipline erring practitioners.

I hope Peju’s family gets justice. I hope we have more doctors like the ones who took care of me. I hope the broken system gets fixed.