In what appears to be another case of medical negligence in the Nigerian health system, the Onua family is currently seeking justice over alleged negligence, extortion, and intent to invade justice, by one of the largest Neurosurgical hospitals in Enugu State, Nigeria, Memfys Hospital, in handling the treatment of their late father, Mr Samson Onua. Sunday Ehigiator and Esther Oluku report
The story of Mr Samson Onua, a patient of Memphis Hospital, Enugu, was brought to the knowledge of THISDAY by the family after having been under the care of the hospital for over two months.
Unfortunately, in the course of filing this report, news arrived that Mr Samson Onua has passed on from complications arising from his sores.
Family’s account
According to Mr Onua’s son, Mr Rodwell Onua, Mr Onua was referred to Memfys Hospital after he sustained a spinal injury from a fall he had while trying to use the restroom in February. He was being managed at a particular hospital until he was referred to Memfys Hospital for further care.
At Memfys Hospital, the family was advised that Mr Onua would have to undergo spinal surgery to correct the spinal injury which had paralysed him from his waist downwards.
The family agreed and made the necessary payments for the surgery but afterwards, the situation worsened. Rodwell who explained the problem following the surgery said; “During the surgery, I think there was a complication. For a person who didn’t have any major health challenges, his lungs stopped functioning well. They said he would have to undergo a tracheostomy. After the tracheostomy surgery, he was placed on a ventilator.
“The situation was financially draining. The hospital just kept giving us bills. We were not seeing any improvement and he was in the Intensive Care Unit after his surgery.
“I had to open a GoFundMe account to raise funds. We managed to bring him out of the ICU and just soon after, he was rushed back to the Intensive Care Unit(ICU) again. When they eventually brought him out from the ICU we saw this mighty bed sore.
“This is a huge hospital but the level of neglect for a person under their care is shocking. Because, how is it possible that the hospital representatives did not know or see the sore if they have been taking care of him?”
Mr Rodwell said the family had tried to get an explanation for the deterioration of their father’s health from the hospital to no avail. Hence, his sister, Ms Blessing Onua, reported the matter to the police.
Alleged extortion
Also speaking with THISDAY, Blessing Onua, a daughter of the deceased, said, “I took the case to the Police. The police redirected me to a lawyer because of the magnitude of the case and the reputation of the hospital. When I contacted the lawyer, he wrote a petition to the hospital.
“The Police station which is an Area Command advised me to refer the case to the Commissioner of Police, Enugu state which the lawyer also wrote.”
According to Ms Blessing Onua, bed sores or pressure ulcers were part of her fears when her father was being kept in the ICU for a prolonged period and she got reassurance that with optimal care from the medical team at Memfys hospital, it would not occur.
The family only got to find out after her cousin who was stationed at the hospital to look after her father revealed that he had spotted a large sore on their father when the medical team was screening him for a bed bath.
She stated that upon the family’s discovery of the situation, the Medical Director had promised to take a percentage responsibility for the financial cost of treating the bedsore but upon meeting the account team to get the rebate promised by the Chief Medical Director (CMD), she was asked to get a signed authorisation from the CMD.
Upon going back to get the rebate authorisation, the CMD reneged on his promise saying that he would not be able to grant a rebate anymore.
Alleged attempt to invade responsibility
According to Blessing, the hospital sent her a report discharging Mr. Onua. When she went to confirm the discharge report, she was invited to the office of the CMD.
She said: “That evening, I received a medical report stating that my Dad had been discharged. On seeing that, I was anxious to know what they meant. I was told that the owner of Memfys Hospital wanted to talk with me. So I went. He started telling me some things that I’d never heard of.
“When we arrived at the hospital initially, we had a biopsy to check if he had a prostate and the result was negative.
“But to my greatest surprise, the doctor said there were traces of cancer in my Dad’s prostate. Again he said my dad had some kind of stroke. They were just bringing up a lot of things. So we asked them what the way forward was.
“They said that since we requested treatment of the bedsore in a petition we had sent for negligence through a lawyer, they have agreed to do the plastic surgery. I told them aside from doing the plastic surgery, my dad is still not in good health. His condition has deteriorated after the surgeries.”
THISDAY’s effort
When THISDAY called Memfys hospital to confirm their side of the story, the Front Desk officer on two occasions, promised to send the number of the Head of Communications to our correspondent, but never did. Upon calling again to re-request the number, the hospital stopped taking THISDAY’s call.
THISDAY however was able to get the contact and contacted the doctor who was said to have taken care of Mr. Onua in the ICU of Memfys Hospital, Prof. Ndubuisi. However, he declined to comment.
Response of the Chief Medical Director, Memfys Hospital, Enugu
Meanwhile in an audio conversation with a member of the Onua family, which THISDAY was privy to, the Chief Medical Director, Memfys Hospital, Prof. Samuel Ohaegbulam, explained to the family that contrary to the thought of the family that Mr. Onua just had a headache, medical assessment done proved that Mr. Onua had other underlying health problems.
He said: “The story we got from the family when he arrived here was that they thought he had a headache but when we extradited the assessment, what we saw on assessment was that he didn’t just have a headache. Even if he had a headache, he had additional problems in the head.
“He had a disastrous spinal cord injury. There are other problems. We’ve done all the tests to find out if we can put a finger on them but we have not succeeded. What else do you want us to do?
“We are not magicians. The only area where we want to investigate is to see if the prostate is related to that. We saw some changes in the brain stem which is critical to the brain.
“In the course of the series of tests, we discovered he was anaemic, some indicators were very high pointing to cancer of the prostate so we had to verify to make sure where we stand because we can’t do a major surgery with all those problems.
“It took us almost a week to reach a point on it. The prostate, we couldn’t dismiss but since there was no sprain on the prostate, we could relieve the pressure of the spinal cord.
“We can’t convince you for what we have done and we can’t take the blame for everything that has happened. We have done our best but our team may not have yielded the expected result. It is beyond us. What is the cause of the deterioration? We don’t know. Many other factors may have added to the problem.”
Responding to the allegation of extortion posed by the Onua family, Memfys CMD stated that contrary to the assumption of the Onua family that adequate care was not given to the patient resulting in the bedsore, the amount paid was only for intensive care and the standard was the same everywhere in the world.
According to him, “The Intensive Care treatment is not drugs, Google it. You requested to leave and we obliged. If you want to stay, we accept. That is the condition of that process. The condition is that if you continue to care, he is now a new patient. Even if you don’t have the cash to pay, you have to tell us how it would be paid. That’s all.
“We cannot give a guarantee as doctors but you are forcing us to do that. Was it an infection? Was it growth? We couldn’t confirm that. The MRI could not say what it was. What is causing the anaemia, we couldn’t see any open bleeding so usually what causes that is something more serious and he came with anaemia.
“What is the cause for the deterioration, we don’t know. Many other factors may have added to the problem.”
Shades of secrecy around the patient’s care
Although Memphis Hospital holds that the stage of the pressure ulcer was stage 3, images captured from Blessing’s camera and analysed by a nurse close to the family showed a depth that may have reached the bone lesions of the patient indicating that the sores may have reached stage 4.
Blessing told THISDAY that the hospital had barred her from seeing the wounds or capturing images of them. She also revealed that a doctor (name withheld) whom she approached to know the current state of the wound advised her to go very early in the morning but on each occasion, they never allowed her to see the wound after her initial capture.
Expert analysis
With the images (rated 18) of the sore captured by the family and made available to THISDAY, we went ahead to seek expert analysis of the case with consideration to the issues raised by the Onua family, a medical doctor with commendable years of practice who pleaded animosity explained that “Usually, bedsores or pressure ulcers are a complication that happens for bedridden patients.
“They are turned occasionally. In my facility, every two hours but that does not mean that the patient may still not have the pressure ulcers.
“The patient is bedridden; he is on ventilation and has assisted ventilation so there is something in the throat that affects the turning of the patient so you can’t turn the patient to the left or to the right all the time because of the attachment.
“Pressure ulcer is a very unfavourable complication that happens with bedridden patients and with the patient in the Intensive Care Unit attached to a ventilator, it happens but before it got to grade 4, they should have called the plastic surgeon to review it.”
Speaking on the ethics of concealing the information on the state of the patient until the family found out, she said: “That is wrong. They should have told the relatives of the patient when they came in for review even over the phone. There may be other things too, such as a patient’s nutritional status.
“I’m not happy that they concealed this wound until it got to stage 4 because from what I can see in this picture, it has already gotten to stage 4. It didn’t just jump to stage 4. I can’t really say what they did for the patient whether there was appropriate wound care to prevent the spread of the wound, but I will advise the family to call in a lawyer, only then can the truth be unravelled.”
Concerns over cases of medical negligence in Nigeria
In recent times, there have been growing concerns over several cases of medical negligence in Nigeria ranging from failure of medical practitioners to promptly attend to patients in emergencies, lack of proper attention to patients’ complaints during care, to making wrong diagnoses, which often, leads to the demise of the patient.
Medical negligence refers to the failure of healthcare providers to fulfil their professional obligations, breaching the duty of care and not exercising a reasonable degree of skill The Medical and Dental Council of Nigeria (MDCN), under the powers conferred on it by the Medical and Dental Practitioners Act 20042 issued a Code of Medical Ethics in Nigeria 2008 (“the Code”).
The Code, which codifies the rules of professional conduct for medical practitioners, also regulates the conduct/activities of medical practitioners in Nigeria.
For instance, the Code states that all medical practitioners and dental surgeons owe a duty of care to their patients in every professional relationship, however, medical negligence recorded in Nigeria often relates to a lack of proper care of the patient.
To curb this, it is very instructive to mention that medical practitioners, like any other professional, are not immune from criminal prosecution for reckless or negligent conduct in Nigeria. They can be prosecuted for obvious misconduct committed while carrying out their professional duties.
This is as seen in the case between The Lagos State Government V. Dr. Ejike Ferdinand Orji (Unreported Decision in Suit LD/8963C/2019).
On 20th January 2023, Honourable Justice A.A Akintoye sitting at the High Court of Lagos State (the Trial Court) delivered judgment in respect of a criminal charge of medical negligence preferred against one Dr Ejike Ferdinand Orji (the Defendant).
The Trial Court, in its well-reasoned judgment, found the Defendant liable for recklessness and negligence in the provision of medical care and services that unfortunately led to the deformity of the left limb/leg of his patient, one Master Somi Ezi-ashi (Somi or the Patient).
In the context of the decision of the Trial Court, more Nigerians need to know that they have a right to life and dignity.
As enshrined in Section 34 of the Constitution of the Federal Republic of Nigeria (CFRN), 1999, provides that every individual is entitled to respect for the dignity of his person, and accordingly, Section 34(a) states that “no person shall be subject to torture or inhuman or degrading treatment…”
Similarly, section 33(1) of the constitution provides that “every person has a right to life, and no one shall be deprived intentionally of his life, save in execution of the sentence of a court in respect of a criminal offence of which he has been found guilty in Nigeria.”
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