There are rising cases of patients losing their lives and body parts to negligence and sometimes inexperience on the part of medical practitioners, but the Medical and Dental Council of Nigeria (MDCN) Tribunal seems to be righting the wrongs, reports MOSES EMORINKEN
It started with an excruciating pain in his groin, but ended with a permanent scission of his kidneys. The pitiable tale of the last days of 25-year-old Isa Hamma is enough to send jitters down the spine of anyone with compassion and empathy.
On that fateful day in July, 2016, Hamma went to Jimeta Clinic and Maternity, Adamawa State, where he met Dr. Yabuku Hassan Koji to help ameliorate the pain he was grappling with.
Koji was barely two years old in the medical profession. Yet, he went ahead to carry out major surgery; he could not even tell the difference between a kidney and a loose internal body mass.
Not only did he fail to diagnose the illness of the patient under his care, he also recommended a surgery even when he suspected a kidney-related issue. After being advised to check the result of an ultrasound to be sure of what an unknown body mass was before commencing the operation, Koji rejected the advice and proceeded with the operation.
Aside that the negligent doctor failed to advise his patient about the risks involved in the surgical procedure, he did not get his consent before placing him under the knife. Moments after the surgery, trouble began. Instead of relief, Isa still felt pains, uneasiness, and was unable to urinate. He was referred to the Federal Medical Centre (FMC) in Yola, Adamawa, for further help and consultation.
It was upon examination of his abdomen at FMC that it was discovered that his kidneys were missing. That was how Hamma became dialysis-dependent for some time before being referred to the Aminu Kano Teaching Hospital, Kano for renal transplant. At last, he died.
The troubling part of the story is that the negligent doctor claimed he did not know he was cutting off Hamma’s kidneys. The patient became a victim of avoidable errors by an inexperienced medical practitioner. That was why the Chairman of the Medical and Dental Council of Nigeria (MDCN) Tribunal, Prof Abba Waziri Hassan, declared him guilty as charged.
Koji was found guilty on a 12-count charge of gross negligence and professional misconduct. His name was struck out of the register of the MDCN, meaning he could not practise medicine anymore. Is that enough closure and justice for the family of the deceased?
Another sorry case is that of Mrs. Rita Uchebuego, a pregnant woman under the management of Dr. Anunobi Chijioke Ralu, a registrar with the Federal Medical Center (FMC) in Asaba, Delta State. She met her untimely end as a result of her doctor’s greed, professional misconduct and negligence.
Trouble started for Mrs Rita Uchebuego when Dr. Ralu did not review her medical condition properly before handing her over to a nurse and doctor still on housemanship. The late Uchebuego was in induced labour at 36 weeks for twin gestation pregnancy induced by hypertension.
Ralu was probed and arraigned on a two-count charge of gross negligence in the management of the medical condition of Mrs. Uchebuego, which, ultimately, led to her death.
He was also arraigned for misconduct in a professional respect when he unethically collected N7,000 as reference fee from her husband, Mr. Ngozi Uchebuego. In the early stage of her pregnancy, Ralu was contacted by the couple for professional help because Rita was sick and experiencing nausea; this was when public hospitals were on strike. The doctor, in turn, referred her to Up-Christ Hospital, a private hospital. After receiving care in the hospital, the couple were no longer satisfied with the services and had to leave after paying about N20,000. They were, however, informed that the doctor who referred them instructed that they pay N27,000. Her husband had to send an additional N7,000 to the doctor.
From the investigation by the MDCN Tribunal, Mrs. Uchebuego might have died from negligence by Ralu, resulting from a reaction to the blood being transfused to her. Few moments after the administration of the blood by a nurse and a doctor on housemanship (without the review and supervision of the doctor on call – Ralu), she began to react adversely to it. She had difficulty breathing with heavy and irregular heartbeats. The blood transfusion was discontinued and the blood returned to the laboratory for screening. However, the negligence of the said doctor became evident when the same blood the deceased reacted to was re-used to transfuse her. She died few moments later after the consultant was called to attend to her.
The tribunal pronounced Ralu guilty of the two-count charge for abdication of responsibility for the care of the patient. He was placed on six months’ suspension from medical practice. Five other doctors, who were fingered in the case, were discharged and acquitted because, according to the tribunal, they carried themselves professionally and did all they could with compassion and empathy. The doctors are – Doctors Okoye Chukwuka Obumnene, Iyiola Akeem Adewale, Adigba Ese Onodjohyovwe, Okoye Nnamdi Pascal, and Oyefara Babatunde, who was the consultant on call and was admonished by the tribunal.
This was the clear case of Dr. Stephen Oludare Alaiyemola of Philadelphia Specialist Hospital, Ebute-Ikorodu, Lagos, who was suspended for six months after being found guilty of collecting N1,858,700 from Mrs. Oyenike Adebajo and her husband as estimated cost of assisted reproductive therapy (ART) and In-Vitro Fertilisation (IVF), knowing that he did not have the expertise and facility to carry out such medical services. The tribunal said although he was not guilty of fee-splitting arrangement to refer the patient to other practitioners, he was adjudged guilty of the other five charges against him.
Also, concerning the same case, the tribunal discharged and acquitted one Dr. Nobert Ifeanyi Ekeh, who was consulted by Dr. Alaiyemola, on the ground that the prosecution did not succeed in proving that the respondent doctor took over the management of Mrs. Oyenike Adebajo, as a patient.
Is the punitive measures meted for negligence enough?
Apart from the above cases, there have been many other cases of negligence from doctors. For instance, in April, there was a groundswell of emotions in the public space when news broke about the heartrending story of a Kebbi State-based medical practitioner, Dr. Jamilu Muhammad, who erroneously diagnosed that the baby in the womb of one Malama Fatima Danjuma, was dead and he needed to carry out a surgery to evacuate the dead baby only to realise that the baby was alive after amputating the baby’s upper limb.
Although he was suspended from engaging in practice as a medical practitioner for six months for gross negligence, incompetence and infamous behaviour, the public seemed not to be satisfied with the degree of punishment given to him.
Speaking to The Nation about the functions of the MDCN, Hassan said the tribunal is not a court that can send people to jail. “We are not a criminal tribunal. We only deal with cases, but we can’t send anyone to prison. How we relate is to affect his or her practice. Any reasonable professional will hate to be named and shamed. When this happens, some of the doctors are remorseful, but it is not enough for us to say – yes, you are remorseful, so you can go, because either you or somebody else will repeat the same mistake,” he said.
As far as he is concerned, the degree of punishment is usually in tandem with the extent of complicity of the said medical practitioner. Once an obvious case of gross misconduct and negligence is established, the tribunal will spare nothing to allow the full extent of the law to take its course, he said.
No requisite experience, no practice
Like the case of Koji, there are many medical practitioners who do not possess the required competence under the supervision of a consultant or in the practice but have begun handling serious medical procedures and operations.
According to Hassan, “Some few years back, about 20 years ago, there was a law that says as a doctor, before you open up an independent practice, you must have at least five years’experience. And it should be acquired from a recognised institution or teaching hospital, tertiary institution or secondary healthcare under a consultant.
“Somehow this disappeared. For example, one of the doctors we struck his name out of the register, has just two years’ experience. He started to do a very major operation, which he didn’t know how to. What we are trying to do is to review the MDCN Act. We are in the process of doing it so that any doctor who does not hold the necessary experience after qualifying, after NYSC, should not practise independently.”
Consequences of delayed constitution MDCN board
The MDCN is the regulatory body of medical and alternative medicine practitioners with mandate to discipline any erring practitioner who falls short of the medical professional ethics.
Beyond this, the Council is also involved in the curriculum for medical school training and the level of practice. Hence the Council must exist in perpetuity. The failure to constitute the MDCN for four years until last year, hampered the regulation of medical practice in the country. This accounts for the prevalence of gross malpractices and misconducts on the part of practitioners. For almost four years, MDCN disciplinary tribunal did not sit because there was no Council in place. Doctors who had cases before the tribunal were forced to practise medicine to the detriment of their patients. For the Chairman of the MDCN, “The council was not on ground for a long time since it was dissolved in 2015, and was only reconstituted last year. So, we inherited a lot of cases. We had to investigate properly so that we are fair to both the doctors and their victims and their relatives.
“One of the things that the government has now done and a point that has already been made by the Nigerian Medical Association (NMA) is that the Medical and Dental Council should not be dissolved and then stay for a long time. It is only the Chairman that is appointed by the President. All the other members are statutory members; every state of the federation is represented, including the FCT. The Medical and Dental Council is not a political board but a professional one. We need to make sure that the board is always reconstituted so that cases don’t stay long without being investigated and tried. Once this is being done, the public will be satisfied that something is being done.”