Many man-induced factors, including negligence on the part of medical care-givers, have sent many people to their early graves, reports JULIANA FRANCIS
A medical doctor was watching a football match between Arsenal and Manchester United while a patient was rushed into his office. It was an emergency situation. ‘When the nurses called him, the doctor said he would attend to the patient after the match.
By the time the match was over, the patient was dead. The same doctor signed the patient’s death certificate. The above may sound unreal, but it actually happened. The Director of Programmes, Access to Justice, Leonard Dibia, painted this gory while buttressing his argument that medical negligence has become one of the major causes of untimely death in Nigeria.
According to Dibia, who was one of the facilitators at a workshop organised by the Network on Police Reforms in Nigeria (NOPRIN), the above is replicated almost on a daily basis in government health facilities across the country. The director of programmes presented a paper on “Promoting Awareness and Effective Application of the Lagos State Coroners System Law, 2007.”
He said: “Unlike before 2007, it is heartening to now observe that cases for coroner inquest now compete with regular cause lists in designated magistrate/ coroner courts in Lagos State, with cases for inquest ranging from police killings to medical negligence and domestic violence.
“When the pop star Michael Jackson died in the United States, initial autopsy report cleverly concealed the real cause of his death which was made to appear like a self-inflicted abuse of drugs or an inculpable but abnormal sensitivity to regular dosages of common sleeping pills. “It took an incisive coroner inquest to unravel the real cause of his death which was certified to be a raw case of medical negligence, in respect of which the doctor concerned faced criminal charges.”
Even as Dibia spoke about using the coroner law to arrest and check cases of death caused by medical negligence, with the aim of making medical practitioners accountable for their actions, he went further to explain that under Section 14 of the present coroner law, any aggrieved person who identified himself as “party interested,” could write a “report of death” to the coroner (even in pidgin English), requesting for commencement of inquest. He said: “Such request is called an epistolary procedure.
It involves neither the professionalism of a draftsman nor is it amenable to the technical rules of legal pleadings. It requires neither the authorisation of the attorney-general of the state nor the fiat of the chief judge of the state, nor any preliminary investigation by the police before commencement of inquest.”
According to him, the inquest process is the investigation itself and aims at ensuring a dependable, independent and unbiased process and system of unravelling the true facts and circumstances surrounding the death of a person who the law describes as having died in ‘sudden and unnatural circumstances’.
Explaining how the process of seeking inquest is back by the coroner law system, Dibia said that Section 14 of the law stipulates that: “A report of death shall be made to any of the agencies for the report of death or the office of the coroner and be subject to post-mortem examination where there is reasonable cause to believe that the cause of death was sudden, unexpected….”
Section 15 states that: “The coroner shall hold an inquest whenever he is informed that the death of a deceased person lying within the district was a result of death in a violent, unnatural and suspicious situation…”
Highlighting the ways of combating hidden cases of medical negligence, Dibia said: “The need for an alternative system of inquiry is further underscored by a phenomenon in our society which, though is neglected, has accounted for many preventable deaths in our society, and that is medical negligence. “At the time of presenting this paper, my colleagues in Access to Justice are before the coroner, urging a verdict to be entered against a notable medical facility in Lagos State.
We call it the Malanido inquest. The victims were rushed to hospital within 10 minutes of their being shot by the police. The hospital authorities admitted them properly but, as was alleged by friends of the deceased person, they (the hospital authorities) requested an initial deposit of N1.5 million on a Saturday morning before treatment could be carried out on the dying victims.
“The victims died. The central question which we have submitted to the coroner is to determine whether within the terms of sections 5 and 35 of the Hippocratic Oath and the new legislated Code of Medical Ethics in Nigeria, the conduct of the medical facility should not warrant disciplinary action and payment of exemplary and punitive damages by the hospital. The matter is still ‘subjudice’.
The Michael Jackson case is one striking example. “You may have heard of the Dr Shipman inquiry case in England. Shipman successfully killed hundreds of his patients over a period of 20 years because the circumstances he explained as causing the death of his victims (who were all his patients) were not specifically and mandatorily defined as deserving of inquest. “At the time Shipman’s pleasure for killing his patients was discovered, over 215 persons have gone through the deathhammer of his injection needles.
“Another Shipman may just be lurking around town without anybody knowing. ‘God forbid’ is a common religious cliché in our society. But many things that God forbids occur in our society with unflinching rampancy.
We have to take steps.” Reacting to the issue, the National Coordinator of NOPRIN, Mr Okechukwu Nwanguma, said that clinical negligence could be further defined as the failure on the part of the doctor or treating institution to reach the accepted standard of medicine.
According to him, in Nigeria, many medical practitioners had always got away with deaths or permanent deformities arising from their incompetence or negligence.
This, Nwanguma said, was due to the traditional Nigerian attitude of complacency, reluctance to report and seek truth, justice and accountability, and resignation to fate on account of faith or religious beliefs and notions. He said: “Nigerians do not often take recourse to the coroner system laws in order to have the circumstances of the death of their relatives inquired into, to ascertain whether they died of natural causes or due to negligence.
“There have been several instances of pregnant women losing their lives or the lives of their babies or both after they had gone into the labour room without any prior known medical issues.
“There have also been cases where people in critical situations – people bleeding from gunshot injuries or accident victims – requiring emergency attention had been denied treatment by medical care-givers on account of their requirement of police report or deposit of some money before commencement of treatment.” Nwanguma urged people to begin to report or complain to coroners or demand an inquest into suspicious death of their loved ones.
“If the coroner is not satisfied that the person died from natural causes or the cause of death is unknown, then they must hold an inquest to investigate and establish the cause of death.
“The coroner should hold an inquest where there is reason to believe that negligent medical treatment may have caused the death,” he added. Nwanguma also noted that Nigerians were yet to understand the importance of the coroner system and the need to utilise it.
He said: “Hence, many cases of unnatural death have gone un-inquired into, the truth unravelled and justice not done. The coroner system is basically about finding out the truth about the cause of any unnatural death, ensuring that justice is done and that it does not happen again. It is about preserving human life.”
According to him, the government and civil society need to popularise the coroner system law and sensitise the Nigerians to the system and how it can help them seek and secure truth, justice and accountability in cases of death of their loved ones by medical negligence and other unnatural causes.
He said: “There is also the need to train lawyers to develop expertise on the coroner system law as well, for specialist organisations which will run a legal helpline which victims or concerned citizens can call for detailed advice when there is a question about medical treatment or need for legal services on coroner inquest.”
A medical doctor was watching a football match between Arsenal and Manchester United while a patient was rushed into his office. It was an emergency situation. ‘When the nurses called him, the doctor said he would attend to the patient after the match.
By the time the match was over, the patient was dead. The same doctor signed the patient’s death certificate. The above may sound unreal, but it actually happened. The Director of Programmes, Access to Justice, Leonard Dibia, painted this gory while buttressing his argument that medical negligence has become one of the major causes of untimely death in Nigeria.
According to Dibia, who was one of the facilitators at a workshop organised by the Network on Police Reforms in Nigeria (NOPRIN), the above is replicated almost on a daily basis in government health facilities across the country. The director of programmes presented a paper on “Promoting Awareness and Effective Application of the Lagos State Coroners System Law, 2007.”
He said: “Unlike before 2007, it is heartening to now observe that cases for coroner inquest now compete with regular cause lists in designated magistrate/ coroner courts in Lagos State, with cases for inquest ranging from police killings to medical negligence and domestic violence.
“When the pop star Michael Jackson died in the United States, initial autopsy report cleverly concealed the real cause of his death which was made to appear like a self-inflicted abuse of drugs or an inculpable but abnormal sensitivity to regular dosages of common sleeping pills. “It took an incisive coroner inquest to unravel the real cause of his death which was certified to be a raw case of medical negligence, in respect of which the doctor concerned faced criminal charges.”
Even as Dibia spoke about using the coroner law to arrest and check cases of death caused by medical negligence, with the aim of making medical practitioners accountable for their actions, he went further to explain that under Section 14 of the present coroner law, any aggrieved person who identified himself as “party interested,” could write a “report of death” to the coroner (even in pidgin English), requesting for commencement of inquest. He said: “Such request is called an epistolary procedure.
It involves neither the professionalism of a draftsman nor is it amenable to the technical rules of legal pleadings. It requires neither the authorisation of the attorney-general of the state nor the fiat of the chief judge of the state, nor any preliminary investigation by the police before commencement of inquest.”
According to him, the inquest process is the investigation itself and aims at ensuring a dependable, independent and unbiased process and system of unravelling the true facts and circumstances surrounding the death of a person who the law describes as having died in ‘sudden and unnatural circumstances’.
Explaining how the process of seeking inquest is back by the coroner law system, Dibia said that Section 14 of the law stipulates that: “A report of death shall be made to any of the agencies for the report of death or the office of the coroner and be subject to post-mortem examination where there is reasonable cause to believe that the cause of death was sudden, unexpected….”
Section 15 states that: “The coroner shall hold an inquest whenever he is informed that the death of a deceased person lying within the district was a result of death in a violent, unnatural and suspicious situation…”
Highlighting the ways of combating hidden cases of medical negligence, Dibia said: “The need for an alternative system of inquiry is further underscored by a phenomenon in our society which, though is neglected, has accounted for many preventable deaths in our society, and that is medical negligence. “At the time of presenting this paper, my colleagues in Access to Justice are before the coroner, urging a verdict to be entered against a notable medical facility in Lagos State.
We call it the Malanido inquest. The victims were rushed to hospital within 10 minutes of their being shot by the police. The hospital authorities admitted them properly but, as was alleged by friends of the deceased person, they (the hospital authorities) requested an initial deposit of N1.5 million on a Saturday morning before treatment could be carried out on the dying victims.
“The victims died. The central question which we have submitted to the coroner is to determine whether within the terms of sections 5 and 35 of the Hippocratic Oath and the new legislated Code of Medical Ethics in Nigeria, the conduct of the medical facility should not warrant disciplinary action and payment of exemplary and punitive damages by the hospital. The matter is still ‘subjudice’.
The Michael Jackson case is one striking example. “You may have heard of the Dr Shipman inquiry case in England. Shipman successfully killed hundreds of his patients over a period of 20 years because the circumstances he explained as causing the death of his victims (who were all his patients) were not specifically and mandatorily defined as deserving of inquest. “At the time Shipman’s pleasure for killing his patients was discovered, over 215 persons have gone through the deathhammer of his injection needles.
“Another Shipman may just be lurking around town without anybody knowing. ‘God forbid’ is a common religious cliché in our society. But many things that God forbids occur in our society with unflinching rampancy.
We have to take steps.” Reacting to the issue, the National Coordinator of NOPRIN, Mr Okechukwu Nwanguma, said that clinical negligence could be further defined as the failure on the part of the doctor or treating institution to reach the accepted standard of medicine.
According to him, in Nigeria, many medical practitioners had always got away with deaths or permanent deformities arising from their incompetence or negligence.
This, Nwanguma said, was due to the traditional Nigerian attitude of complacency, reluctance to report and seek truth, justice and accountability, and resignation to fate on account of faith or religious beliefs and notions. He said: “Nigerians do not often take recourse to the coroner system laws in order to have the circumstances of the death of their relatives inquired into, to ascertain whether they died of natural causes or due to negligence.
“There have been several instances of pregnant women losing their lives or the lives of their babies or both after they had gone into the labour room without any prior known medical issues.
“There have also been cases where people in critical situations – people bleeding from gunshot injuries or accident victims – requiring emergency attention had been denied treatment by medical care-givers on account of their requirement of police report or deposit of some money before commencement of treatment.” Nwanguma urged people to begin to report or complain to coroners or demand an inquest into suspicious death of their loved ones.
“If the coroner is not satisfied that the person died from natural causes or the cause of death is unknown, then they must hold an inquest to investigate and establish the cause of death.
“The coroner should hold an inquest where there is reason to believe that negligent medical treatment may have caused the death,” he added. Nwanguma also noted that Nigerians were yet to understand the importance of the coroner system and the need to utilise it.
He said: “Hence, many cases of unnatural death have gone un-inquired into, the truth unravelled and justice not done. The coroner system is basically about finding out the truth about the cause of any unnatural death, ensuring that justice is done and that it does not happen again. It is about preserving human life.”
According to him, the government and civil society need to popularise the coroner system law and sensitise the Nigerians to the system and how it can help them seek and secure truth, justice and accountability in cases of death of their loved ones by medical negligence and other unnatural causes.
He said: “There is also the need to train lawyers to develop expertise on the coroner system law as well, for specialist organisations which will run a legal helpline which victims or concerned citizens can call for detailed advice when there is a question about medical treatment or need for legal services on coroner inquest.”
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