Wednesday, 7th June 2023

Menace and consequence of medical negligence in Nigeria 

By Joseph Onyekwere 
21 February 2023   |   1:58 am
There has been growing public concern regarding the ethical behaviours of healthcare professionals. Complaints of poor ethical conduct and rise in litigation against healthcare practitioners is not uncommon.

Medical negligence

There has been growing public concern regarding the ethical behaviours of healthcare professionals. Complaints of poor ethical conduct and rise in litigation against healthcare practitioners is not uncommon. Every profession or calling has ethical code, which are more often than not universally observed, and the medical profession is not an exception.

These professional ethics encompass the personal and corporate standards of behaviour expected of professionals, and what a professional should and should not do. Medical negligence/malpractice is a growing menace in Nigeria. A 2017 survey on medical errors in Nigeria published by Archives of Medicine and Health Sciences showed a prevalence of negligence at 42.8 per cent per 145 medical practitioners. 

According to the report, the three most common errors were error of medication prescription, which was put at 95.2 per cent; error of radio-laboratory investigation ordering at 83.9 per cent and error of physician diagnoses at 69.4 per cent. Other frequently cited studies also placed the number of deaths as high as 250,000 yearly. This makes medical error the third leading cause of death, behind cancer and cardiovascular disease, in Nigeria. 

Penultimate week ago, a Lagos High court sitting at Tafawa Balewa Square sentenced a medical Doctor, Dr. Ejike Ferdinand Orji, to one year imprisonment for causing grievous harm, negligence and endangering the life of a 16-year-old patient. Dr. Orji, who is the Medical Director of Excel Medical Centre Dolphin Estate, was found guilty on four out of the six counts charge brought against him, by the Lagos State government 

Justice Adedayo Akintoye, in her judgement, held that Dr. Orji’s action fell below what is reasonably expected of a medical doctor, adding that the prosecution established the essential ingredients of the offence of breach of duty, care and endangering the life of a 16-year-old patient. The court held: “It’s my opinion that the defendant committed a breach of duty as a medical practitioner, when he willfully refused to remove the Plaster of Paris (POP) cast on the patient left leg despite complaints of severe pains which thereby resulted in a compartment syndrome. 

“Consequently, on counts one and five, the defendant, Dr. Ejike Ferdinand Orji is thereby found not guilty. On count two, three, four and six, I find him guilty and he is accordingly convicted. Therefore, the defendant, Dr. Ejike Ferdinand Orji is hereby convicted and sentenced to one year imprisonment each, on counts two, three, four and six. This is the judgement of the court.”

Court documents revealed that on Thursday July 26, 2018, the victim, Master Somtochukwu Ezi-Ashi (Somi) sustained an injury on the basketball court at the University of Lagos (Unilag) Sports Centre while playing basketball with his mates. He was taken to Excel Children Medical Centre, located at 45B Corporation Drive, Dolphin Estate, Ikoyi Lagos, at about 11:30 am by one Mr. Emmanuel, a security detail attached to the Ezi-Ashis and one Mr. David Joy Makinde, a student of the University of Lagos on the instruction of his mum, Mrs. Ngozi Ezi-Ashi. 

The choice of taking him immediately to Excel was informed by the fact that Dr.(Mrs) Ifeyinwa Grace Orji, who was Somi’s doctor works there. Somi’s mum arrived shortly after he was taken to Excel and saw Dr. Ejike Orji attending to him which was strange to her as Dr. Orji has never attended to him before.  At that point, there was no open wound or blood on Somi’s left foot where he sustained the injury. He only had a slightly swollen left knee. 

On seeing Somi’s injury, Mrs. Ezi-Ashi inquired from Dr. Orji what he intends to do with respect to the swollen knee. He said he needed to get an X-ray done but would have to stabilise Somi’s knee before that. He asked Mrs. Ezi-Ashi to sit in the “waiting room” while  Somi was carried into an inner room in the hospital at the instruction of Dr. Orji.

About 45 minutes later, Mrs. Ezi-Ashi was informed by Dr. Orji that Somi had been sedated and that she could go in and see him. Mrs. Ezi-Ashi found Somi deeply asleep with a synthetic and thermal Plaster cast (Plaster cast) covering his entire left leg from his toes to his upper thigh. Dr. Orji did not obtain Mrs. Ezi-Ashi’s consent, since her son is still a minor, to sedate him. Neither did he tell her that “stabilising” the leg meant Plaster cast. 

It was a shocked Mrs. Ezi-Ashi who asked Dr. Orji if it was wise to put the cast before doing the X-ray and he said yes, insisting that it does not make any difference. A couple of hours later, Somi woke up and complained immediately that the cast was very tight. This was before he was taken to one Broad Places Radiology, located at 15 Babatunde Street, Off Ogunlana Drive, Surulere, Lagos (referred by Dr. Orji) to get an X-ray. Upon return to the hospital with the X-ray results, Somi kept on complaining that the cast was tight but Dr. Orji was not available at the hospital then. A doctor at the hospital gave Somi some antibiotics, pain relievers and castor oil capsules.

Despite the absence of Dr. Orji at the hospital when Somi was brought back from the Radiologists, Mrs. Ezi-Ashi called him to inform him that Somi was going through severe discomfort as a result of the tightness of the cast on his leg. The said Dr. Orji casually dismissed her concerns and informed her over the phone that he has seen the x-ray result and that Somi has sustained a fracture and Plaster cast was the exact treatment needed. Dr. Orji further informed Mrs. Ezi-Ashi that the tightness of the cast will reduce in two days.

Not being satisfied with Dr. Orji’s casual attitude to the extreme discomfort that her son was going through, Mrs. Ezi-Ashi called her brother-in-law who is a medical practitioner in the America for a second opinion and she was informed by her brother-in-law after consultation with his colleagues in orthopaedic practice that Plaster cast was not needed in such circumstance.
To be continued tomorrow