• Saturday, June 22, 2024
businessday logo

BusinessDay

Costly negligence: Story of avoidable deaths, tears in public hospitals

Hospital
Nigerians appear to be getting increasingly wary of the quality of healthcare they access at the health institutions (both public and private) across the country. Even those who have not had any ugly encounter seem to develop goose pimples each time they have any cause to visit a hospital owing to scary stories they have heard about the below-par treatment and general lackadaisical attitude of some health personnel towards their job. It may not be out of place to conclude that some Nigerians who seek medical care outside the country may have been pushed to do so by the gross display of negligence in many hospitals across the country.
In any society where little or no value is attached to human capital, dying or living does not make any meaning, especially to the government and its agencies that care or do nothing to ensure good health for the citizens and, by so doing, preserve their lives.
It is understandable therefore, why in virtually all public health centres or hospitals, negligence are rather the norm than the exception. Doctors, nurses and sundry workers in these centres carry on as though patients are nuisance that have come to invade their privacy or comfort zone.
That a case is an emergency does not stop a nurse on shift from dashing out of her office when her time is up, even when no other nurse is in the office; nor does it stop a doctor from rushing out to attend to his private concerns only to return to the case too late to be needed.
When relatives and friends are told by doctors that death has taken their loved one after spending so much in several instances to keep such a person alive, many have no clue that some of such deaths are directly a result of professional negligence of those saddled with the responsibility of saving lives. Even at that, many people who have a proof that the death of their loved ones were caused by the negligence on the part of doctors and nurses are still hoping for justice.  The worst of it all is the insistence on full payment of medical bills of the dead even when the medical personnel are aware of who is responsible for the death.
These needless deaths occur due to either wrong administration of drugs to patients by health practitioners, delay in responding to patients in critical condition, which is particularly common with government-own hospitals, late arrival on duty of health personnel, unprofessional conducts and general inefficiency. Some Nigerian doctors display attitudes that are short of the level of compassion expected of them by virtue of their calling.
Olabisi Akhile told BDSUNDAY that her road to sorrow due to doctor’s negligence started in March 7, 2012, when she was feeling strong labour pang about 11pm on that fateful day but only to arrive at a private hospital somewhere in Ayobo, a sleepy community in Ipaja, Alimosho Local Government Area, Lagos State, to be told by the doctor who attended to her that she would not be due for delivery until the next three days.
According to her, naively, she went back home still in great pain because she took the doctor’s word since he was a professional and she, having attended antenatal in the same hospital for six months before the unfortunate incident thought the medical personnel was in a better position to know the state of her baby.
“My pain had increased. I knew something was not right. By 3 am, my labour pain became too strong for me to bear. I had to go to another hospital since I was in great pain. But by the time I delivered at this new hospital, the baby was already dead. That was how I lost my first baby,” she said.
A pathetic instance
Lillian Obiageli Essien, another victim of medical negligence, narrates her experience in an interview with BDSUNDAY how one Chief Medical Director and owner of a hospital located at Ilogbo, Ojo Local Governor Area of Lagos State carelessly caused the death of her son, Shawn Essien, who was two years old at the time.
She said: “On the 9th of December 2015, I took my son who was 2 years and 5 months to the hospital for treatment. My child had been restless all night and had woken up weak and with a bit of yellowness in his eyes. We hurriedly left the house very early in the morning and got to the hospital a few minutes past 7am. They inserted a cannula, took his blood and immediately put him on intra-venous (IV) fluid.
“I asked the doctor why the infusion was being given and what drugs were being injected into the iv, since the results of the tests weren’t out yet, and my son wasn’t stooling or vomiting either. He murmured B-complex and walked away. About an hour later, the doctor walked back into the room and I asked him if the test results were out and what the results of the tests were, he said he would be back and walked out again. He kept coming in and going out of the room without telling me what the results were.”
She said these scenarios got her worried and she started to feel something was horribly wrong with her son; hence, the doctor avoided telling her what the results were.  She explained that the next time the doctor came into the room she demanded to know what the test results were and she was told it was acute malaria and that her son’s PCV was 18percent and might be needing blood transfusion.
 “A nurse came in and put in another iv fluid.  I asked her what it was and she said saline. The doctor came in and met the nurse and I talking. He explained that the saline would wash away the yellowness from my son’s eyes. My son became very restless when the second iv fluid got half way and it seemed like he was trying hard to breathe. I asked the three nurses that came into the room if they had a nebulizer but they all didn’t seem to know what a nebulizer was. They said I shouldn’t be scared that it’s the malaria parasite that was making him so restless. They kept assuring me that by the next morning, he would be just fine,” she narrated.
According to her, immediately the second iv finished, the doctor came in and asked the nurse to insert the third, and that by this time, she noticed her son’s belly seemed like it was filled with water and his arms and feet had double their sizes.
“The doctor came in and said I should stop worrying that as long as my son was passing out urine, he was OK. The third iv finished and they put in a fourth. My son seemed to be finding it so hard to breathe. The doctor came in again and I asked him exactly what all the iv fluid was for. My child wasn’t stooling neither was he vomiting. I asked him if all the IV fluid wasn’t diluting my son’s 18 percent blood, since all the fluid is flowing through my son’s veins. He retorted ‘ahn ahn’. ‘Are you a medical personnel’? ‘The drip cannot dilute your son’s blood’.
“He left the room immediately and less than a minute later a nurse came in and said the doctor asked her to take out the iv. At about 10.33pm, the doctor came into the room and I said ‘doctor, please help me. My baby isn’t getting any better and he replied ‘madam, pray to God to help you’. He said he has decided to transfer my son and wrote a referral letter for me to take him to another hospital. My son had started gasping for breath and his eyes seemed to have gone right into its sockets and looking even more yellow”.
She said when she eventually got into the Isolo General Hospital, at past midnight; the doctor that attended to her there was shocked after reading the referral letter and shouted ‘what kind of stupid doctor administered this medication on a child’ and immediately put the son on oxygen.
“My son passed away in my arms after about 2 minutes. Two weeks later I got a call from a certain doctor Vitalis. He said he was the owner and medical director of the hospital where my son was treated and that he was calling to apologise for the incompetence of his staff, which led to my son’s demise. He asked if I could send my address, so that he can come and apologise face to face and pay condolence. He came over a few days later, with a member of his staff called Jerry,” she said.
According to her, Doctor Vitalis then explained to her that on the day she brought her son to his hospital, he had a court case in Ijebu-Ode and left a certain doctor in charge and that this doctor he left had to go for Shiloh 2015 (Winners Chapel Church crusade) and in turn, invited a doctor friend of his, to come and take his place.
According to her, Vitalis explained to her that the doctor who treated her son was not a doctor in his hospital but a friend to the doctor that was meant to be on call, and that with the explanations the nurse who called him knew his staff had messed up; and promised to bring the doctor who attended to her son to come and ‘apologize’ for his mistakes.
 “My husband asked him what the doctor’s name was and he claimed he didn’t know; that when he came back from Ijebu-Ode and heard the entire story of what happened he beat the hell out of the doctor and asked him never to come close to his hospital. He never brought the doctor to apologise.
When asked what her next step was, she said she would like the Medical Association of Nigeria (NMA) to investigate the Doctor Vitalis himself and his hospital, to avoid more lives being lost to either carelessness, negligence or a forged medical license/certificate, and also to avoid any human being passing through the emotional pain and trauma she was currently passing through due to the death of her only son.
How my wife was killed at a teaching hospital
Chike Onugo, a private sector worker living in one of the middle class settlements in Lagos, shared with BDSUNDAY his disheartening experience in one of the public hospitals in Lagos where he took his wife to on referral from a private hospital which lacked the capacity to handle his wife’s case.
“When I arrived at the hospital with my wife, Nkiru, in the company of our church pastor, who drove us to the hospital in his Nissan Sunny car on a Tuesday afternoon, around 4 pm, it was an incomprehensible jolt from a nagging nurse that greeted us,” Onugo recalled.
“Why are you bringing a patient on emergency to the hospital at this time of the day? What have you been doing since morning? Who is going to attend to you now?  I have closed for the day and there is no doctor here,” a visibly arrogant, care-free nurse barked at us, as she committed herself packing her things, readying to get out of her office. And truly, she left.
“My wife who was literally lifeless was still inside the car while I went about knocking on any door on sight, requesting to see a doctor to attend to my dying wife.  From nowhere, a doctor came and without the usual time-wasting procedures, administered some drugs to my wife right inside the car because there was no bed for us in any of the wards.
“Like a miracle, my wife was revived and for the first time in about nine hours, she opened her eyes; started talking and even recognised me and our pastor. But she was very weak and needed rest and sleep on a bed. At last, around 9pm, somebody was discharged and a bed was given to us after the necessary payments. At this point, my pastor took his leave and went home.
“The doctor who attended to us left and from that time to the next morning, no doctor or nurse came to ask us why we were in their hospital.  And my wife who was now sufficiently conscious of her new environment asked me how we got to that hospital.  I told her to hold her peace that it would be a big story for her later. But that story was never told.
“When eventually a doctor came to see us around 9 am, he recommended series of tests which we did. My wife was diagnosed of anaemia and blood deficiency in her system. Her spleen was said to have been infected and needed to be removed through surgery,” Onugo said.
According to him, “Ours was a very young marriage, five years old with only two children who came at distant intervals. The idea of a surgery which we were told might affect the womb did not go down well with us, much as we wanted to save life first.  We communicated our concerns to the doctor who allayed our fears, assuring that they would use chemical methods to take care of the spleen problem.
“Though my wife was relatively healthy, we did not want to leave the hospital because we did not want any stories. I took my annual leave and invested my time and all to ensuring that my wife was alright.
“Two weeks later, another test was conducted, but the result did not give us any relief. The doctor advised us to go for the surgery so that the woman would get on with her life. We agreed and communicated this to our respective families and the church who supported and prayed for us.”
Onugo further said: “Then came the fateful Tuesday, April 12, the third Tuesday of our coming to the hospital. An elated Nkiru woke up earlier than I did and tapped me at the foot of her bed where I always slept. We took our bath, walked to the theatre, sat and waited our turn.  We prayed, chatted and prayed again, time without number. We also joked about her lurid looks now devoid of the charm that defined her supply skin and fine oval face with dimples, pointed nose and fluffy cheeks.  ‘Let them come and remove this thing from my stomach and in a matter of days I will give you back the looks with which I charmed you’, she said, tapping me gently on the cheek.
“Mrs Onugo, please come in”, the doctor beckoned, standing on the theatre door post. Nkiru walked briskly away from where we were sitting and on reaching the door post, turned and waved with a sign of “I will return”. I rushed to the door, grabbed her hand, touched her head and prayed for her.
“Shortly after this, my pastor who along with the entire congregation had held a night vigil for us arrived at the hospital with some brethren. Just a few minutes after they came, the consultant surgeon who headed the team that conducted the surgery came out with a worried look and beckoned on me.
‘We are having challenges with your wife; she is bleeding and so we cannot continue with the operation. We need fresh blood which we don’t have here; you need to go to Island Hospital on Broad Street, Lagos Island, and get us five pints,’ he said, ordering me to be fast about it.
The fresh blood came, but as I found out later from one of the young doctors who was part of the team that carried out the operation, none of the five pints of blood was used because the bleeding did not stop as my wife’s blood did clot and that should have been detected before the operation started.
“Though I caused a stir and created a scene in the hospital when my wife was eventually brought out of the theatre, about six hours later, it did not change anything and that was how my five-year old marriage was terminated by the cruel knife of a care-free and negligent institution that breeds and harbours workers whose attachment to the subject of their calling leaves much to be desired.”
“Several years after, this ugly incident remains ever-green in my mind and gives me goose pimples each time I have cause to talk or even think about it.  It is as disgusting as it is heart-rending that this has continued to happen till today, but nobody calls anybody to order. Indeed, nobody cares!
 I got my life back after six months of wrong treatment
A female Lagos-based journalist recounted her sad experience when the result of a test conducted on her by a teaching hospital was swapped, resulting in six months treatment for tuberculosis she never had.
“From an early age, I have been a regular at the hospital for several reasons; the most sever being asthma, especially during the rainy season. As I grew up, reason for visiting the hospital changed to stomach ulcer with chronic pains. At a point I had to undergo an appendectomy but the pains only got worse. I later went in for another surgery; this time it was a removal of the entire gall bladder, during which I was informed that the appendix was still there as it was not removed. I began to wonder what the surgeon removed a few years back. After this surgery my immune system became very low because of my body weight and the amount of medication I had to consume daily. A few months later, I went for a church programme somewhere along Lagos-Ibadan expressway. The dust was so much; I developed a chest infection because of my low immune system. I returned to the hospital and had some X-rays and test done. The surgeon confirmed that my body could not fight the infection and it advanced into full blown pneumonia. I started taking medication as well as inhaling of nebulizer to fight the illness. At this point I was asked by my family to join them in Port Harcourt, Rivers State, which I did and even went down to the University of Port Harcourt Teaching Hospital (UPTH) to get a second opinion. I was not coughing, but I reacted to some form of smoke, smell, fumes and such.
“On the day of the X-ray, we all sat on a row and went in one after another. The slabs used for the X-ray were brought out and lined up outside the room; and it was picked by the technicians who were supposed to develop the films. At a point it was noticed that the slabs had not been tagged before they were picked up, when the issue was broached with the film developers, they said they knew the order in which the slabs were picked up.
“After a few weeks I went to pick up my result; I received the shock of my life as the test result said I had ‘Assumed Pulmonary Tuberculosis.’ I was short of words, as I was directed to the pharmacy to collect the first dose of my medication. Blood samples were taken for HIV test (which they ran severally), as well as sputum. I took the medication for six months (enduring the stigma of having such an illness) before heading back to Lagos,” she told BDSUNDAY.
According to her, “At the sixth month, I went back to the initial hospital, a private clinic at Dolphin Estate where I had the surgery and previous diagnosis with the X-ray result from UPTH. When I saw the surgeon doctor who ran the hospital the first question he asked was if I was coughing, I answered in the negative. He asked if a particular test was done, I answered in the negative. He then ordered the test done as well as another X-ray. When the results came out, the tuberculosis test was very negative. It was then discovered that the X-ray I was given at UPTH was not mine (it was swapped in error) as the chest infection was on the right side, meanwhile the previous X-rays taken when it was chest infection and later pneumonia, was on the left side of the chest. After six months of wrong diagnosis and treatment, I finally got back my life but at what cost?”
 More sad experiences
Kennedy Irabor, a photographer and owner of KENROCK studios in Ikeja, Lagos State, told BDSUNDAY amid tears his ordeals in the hands of doctors who he said rendered him useless and left him unattended to.
“I was knocked down by a car one morning while I was riding my bicycle. The knee injury I sustained was a minor one and I even drove myself to the hospital later in the day. I was surprised when the doctor told me I was going to undergo a surgery. I agreed not knowing that they were going to use me for experiment,” Irabor began.
“After conducting the first surgery, they told me something went wrong and they needed to conduct another. At the end of it all, I underwent six surgeries and stayed in the hospital for over two years. When the doctors have had their fill, they just abandoned me. They just damaged my entire life; I can no longer work and have to rely on few friends and concerned Nigerians who have taken it upon themselves to help me because my wife deserted me when the problem lingered,” he said sadly.
Vera Maduekwe, a businesswoman in Akwa Ibom State, said she was furious when a month after undergoing surgery she learnt that the doctors forgot cotton wool inside her stomach.
“Last year, I had this excruciating abdominal pain and after a scan was conducted, I was told my appendix was infected and needed to be removed.  More than three weeks after the surgery, I was back in the hospital because I felt something moving inside my stomach. You cannot imagine how shocked I was when after a scan, they told me casually that cotton wool was inside my stomach and they needed to conduct another surgery! After venting my anger on the doctors, they apologized. In the end, another surgery was conducted and the cotton wool removed.
Joy Amadi, a student of University of Port Harcourt said: “I was feeling feverish one Tuesday, so my mother rushed me to the hospital. The test confirmed that I had malaria and medications were administered. The following day, my body began to change and before I knew what was happening, it started swelling up. I went back to the hospital and it was discovered that I was reacting to one of the drugs they prescribed for me- FANSIDER. I could not understand what happened. Was the doctor blind? Because it was boldly written on my hospital file that I react to SULPHUR drugs. For several weeks; I had my body cleaned because I could not take my bath since my body was peeling. I was admitted in the hospital and spent almost a month there before I was discharged.”
Chioma Amuchie said: “My thirteen year old daughter was vomiting during a church programme so I quickly rushed her to a nearby general hospital in Lagos. Thirty minutes after we got there, they were yet to attend to my daughter despite the fact that she was writhing in serious pain occasioned by the abdominal pain. When she eventually saw the doctor, she was given pain-relieving tablets rather than administering medication that could check her incessant vomiting. I was not satisfied with the way she was handled so I rushed her to our family doctor who checked through the tablets and noticed that not even a single tablet which could stop the vomiting was added. A family doctor, who works with a teaching hospital, warned that even if the drugs were given at a teaching hospital, the genuineness could not be guaranteed these days as most hospitals circumvent the right process of sourcing their drugs by contracting the purchase out to persons who are not pharmacists. The doctor advised me to always source my drugs from registered and reliable pharmacies and not depend on “chalks” allegedly being dispensed at many public hospitals.”
Adana Nnabugo, a 200-level student of Abia State Polytechnic, who lost her Dad due to medical negligence, told BDSUNDAY how it all happened.
“My Dad fell into coma and was rushed to the hospital. When we succeeded in getting him to a general hospital, he was not given the urgent attention that his case required at the emergency unit. After a long while, he was moved into a room where we had to wait for a doctor to come and check him up. When a doctor eventually came, he just walked straight to where my dad was, looked at his file and seeing he was diabetic, he just injected him insulin. I politely asked him if he was not going to check what was wrong with my Dad before administering any medication and in response he asked me if I was going to teach him his job. Immediately, he gave my Dad the injection, it went straight to his heart and my dad died. The painful part is that the doctor refused to accept he was wrong. He kept saying that my dad was almost dead on arrival and as such there was little he could do to save his life. Although, I learnt that the doctor was supposed to check my Dad’s blood sugar level to ascertain first before giving him any drug and that insulin was the wrong drug to administer at that time.
Some possible reasons behind the negligence
BDSUNDAY’s checks revealed that some of the acts of negligence are direct consequence of frustration, too much pressure, lack of job satisfaction, among many other factors. It was also discovered that some unhealthy rivalry between medical doctors and nurses also fuel negligence in both public and private hospitals.
Ayo Adebisi, a lecturer with a polytechnic, told BDSUNDAY that he witnessed firsthand a hot quarrel and argument between a doctor and nurse who were on duty on a day he took his sick mother to a public hospital.
“My ageing mother was referred to a public hospital for further treatment. When we got there the nurse on duty appeared too overwhelmed by the number of people waiting to see the doctor. When I called her attention to take my mother’s vitals, she flared up, it was a transferred aggression. And she continued to raise her voice which attracted other nurses and the doctor on duty. The doctor was trying to calm her down when she railed at the young doctor, telling him how he was less-qualified than she is. She said the doctor would not have been able to talk to her if she had pursued her career as a medical doctor. It took a while before she calmed down and you can imagine the level of productively of a frustrated nurse who blames every other person for her limitation in life,” Adebisi narrated.
Other observers point to dilapidated infrastructure in hospitals and the general unfavourable working environment as contributing factors to the rising cases of negligence in hospitals. Yet, some others blame it on a small number of personnel attending to numerous patients.
Adebisi, also said it was possible that the rising cases of abandoned cotton wool, gloves, forceps, etc inside a patient’s womb after operation could be linked to doctors being in a haste to attend to numerous other patients on queue.
“If you go to these hospitals, you will notice that the doctors are over-worked. Some of them perform more number of operations that they should in a day. Every patient wants to be attended to quickly and in the process we hear cases of cotton wool, napkins, gloves, etc being left in the stomach after operation,” he said.
CHUKA UROKO, MABEL DIMMA, NATHANIEL AKHIGBE & CHINWE AGBEZE