By Ike Augustine, Esq.
The death of a loved one is one of the most painful experiences anyone can endure. It becomes even more devastating when there are legitimate questions as to whether the death could have been prevented through greater care, diligence and professional responsibility.
I therefore heartily sympathise with my dear brother and friend, Justice U. John, over the tragic death of his wife, reportedly arising from human error. No family should have to endure the pain of losing a loved one in circumstances where serious questions concerning preventability, professional conduct and the standard of care remain unanswered.
His experience has also compelled me to reflect on my own family’s encounter with the Nigerian healthcare system—a traumatic and life-threatening experience which, by the grace of God, did not end in the loss of my wife.
A Personal Experience That Should Concern Us All
My wife’s ordeal began on 28 March 2025, when she attended her antenatal appointment at the then Federal Medical Centre, Owerri, now Federal University Teaching Hospital, Owerri. She was booked for an emergency Caesarean Section because of pre-eclampsia.
We had encountered a similar situation during the birth of our first child in 2022. On that occasion, my wife had initially been booked for a Caesarean Section and preparations were made accordingly. However, the medical team succeeded in stabilising her blood pressure. She was subsequently induced and, by God’s grace, delivered safely through spontaneous vaginal delivery.
Because of that previous experience, we remained hopeful that her blood pressure could once again be stabilised.
Unfortunately, the situation was different this time. Her blood pressure continued to rise at an alarming rate, leaving us with no reasonable option other than to proceed with the Caesarean Section in the early hours of 29 March 2025.
Two pints of blood had already been made available at about 1:00 a.m. in anticipation of the procedure.
The doctor on duty who eventually performed the surgery reportedly expressed reluctance because his duty period was coming to an end. From our family’s perspective, the circumstances surrounding the procedure caused us considerable concern.
Following the surgery, my wife’s blood count dropped significantly, suggesting substantial blood loss. Yet, despite the blood that had been made available before the operation, she was not transfused at that point.
After several days, her blood count improved somewhat, and we were eventually discharged.
We thought the ordeal was over.
It was not.
When the Complication Became Life-Threatening
Some days after her discharge, my wife developed serious complications. Following further medical examinations, she was diagnosed with fibrinous ascites suggestive of haemoperitoneum and peritonitis.
Her condition became so serious that an urgent major surgical procedure was considered necessary.
I was required to sign a high-risk consent form. I was informed, in substance, that the procedure carried significant risks, including the possibility of death and the removal of her womb, among other serious consequences.
At that moment, I wept inwardly.
But I prayed.
I prayed fervently that God would spare my wife.
By God’s grace and mercy, she survived.
I remain profoundly grateful.
However, the experience left me with questions that extend beyond my family. They are questions about the state of healthcare delivery in Nigeria, professional accountability, patients’ rights and the protection available to victims of suspected medical negligence.
Medical Negligence Is Not Merely a Medical Issue
Medical negligence should not automatically be assumed whenever a patient suffers an adverse outcome.
At the same time, neither should every adverse medical outcome be dismissed as an unavoidable complication.
Medicine is not an exact science. Doctors, nurses and other healthcare professionals often work under difficult circumstances and must make decisions in situations involving uncertainty, urgency and significant risk. Complications can occur even where appropriate professional care has been provided.
The important question, therefore, is not simply whether a patient suffered an adverse outcome.
The critical questions are: Was the applicable standard of care met? Was there a departure from that standard? And did such departure cause or materially contribute to the injury or death?
Where a healthcare professional or institution fails to exercise the degree of care, skill and diligence reasonably expected of a competent professional, and that failure causes injury, disability or death, the circumstances deserve serious and independent investigation.
The public must be able to distinguish between an unavoidable medical complication and an avoidable injury resulting from negligence, incompetence, recklessness or failure to comply with appropriate professional standards.
That distinction is critical.
Allegations of medical negligence should therefore neither be ignored nor determined by public sentiment. They should be subjected to appropriate professional, administrative and judicial processes, with fairness to both the patient and the healthcare professional involved.
The Vulnerability of Patients
A patient entering a hospital is ordinarily in a vulnerable position.
The patient may not understand the medical terminology being used, may not know what medication is being administered and may not fully understand the risks associated with a procedure. In many circumstances, the patient is simply unable to determine whether a particular treatment has been properly administered.
This creates a relationship of enormous trust between healthcare professionals and their patients.
That trust must not be abused.
Patients are entitled to expect competent, timely and responsible medical care. They are entitled to appropriate information concerning their condition and available treatment options. They are entitled to dignity, proper attention and appropriate documentation of their treatment.
Where something goes wrong, patients and their families should be able to ask questions and seek answers.
The Problem of Accountability
One of the major challenges confronting our healthcare system is the difficulty victims may encounter when attempting to obtain accountability.
Families who lose loved ones in hospitals are often overwhelmed by grief. Many do not know what went wrong. Some may struggle to obtain medical records or independent medical opinions.
Others cannot afford legal representation or the cost of obtaining expert medical evidence.
Some victims simply accept the outcome as “God’s will”, even where there may be legitimate questions concerning the standard of care provided.
Faith and accountability are not mutually exclusive.
We can thank God for what cannot be changed while still demanding accountability for what could have been prevented.
Accountability should not be viewed as an attack on healthcare professionals. Rather, it should be understood as an essential component of improving healthcare delivery and protecting future patients.
Protecting Victims of Suspected Medical Negligence
Victims of suspected medical negligence require meaningful institutional and legal support.
First, there must be effective and accessible mechanisms for investigating complaints against healthcare professionals and healthcare institutions.
Regulatory bodies should not wait until allegations become matters of public controversy before taking appropriate action. Relevant professional regulatory and disciplinary institutions—including the Medical and Dental Practitioners Disciplinary Committee, the Nursing and Midwifery Council of Nigeria and appropriate hospital management authorities—must effectively perform their statutory and professional responsibilities.
Where professional misconduct or negligence is established after due process, appropriate disciplinary measures should follow.
Secondly, patients and their authorised representatives should have meaningful access to relevant medical records and information concerning their treatment, subject to applicable legal and professional requirements.
A patient cannot effectively investigate or challenge suspected negligent treatment where the evidence necessary to understand what happened is inaccessible.
Thirdly, victims should have access to affordable legal assistance.
Many victims of medical negligence are ordinary Nigerians who lack the financial capacity to pursue complex litigation. There is therefore a compelling case for greater involvement by the legal profession, civil society organisations, human-rights groups and public-interest litigation initiatives in assisting deserving victims.
Hospitals Must Develop a Culture of Transparency
Hospitals should not automatically become defensive whenever a patient or family raises a complaint.
A serious complaint should trigger an objective and professional investigation.
Where an adverse event occurs, the institution should ask:
- What happened?
- Why did it happen?
- Who was responsible?
- Could the injury or death have been prevented?
- Were established protocols followed?
- Did systemic weaknesses contribute to the outcome?
- What measures can prevent a recurrence?
A culture of concealment is dangerous.
A culture of accountability saves lives.
Every serious adverse medical event should provide an opportunity to improve institutional systems, staff training, emergency-response procedures, documentation and patient safety.
The Welfare of Health Workers Matters Too
Demanding accountability does not mean ignoring the difficult conditions under which many Nigerian healthcare professionals work.
Doctors, nurses and other healthcare workers deserve decent remuneration, adequate staffing, functional equipment, safe working environments and continuous professional development.
An exhausted doctor working in an understaffed hospital without essential equipment may also be operating within a system that contributes to medical errors.
Accountability must therefore operate at both individual and institutional levels.
Where negligence results from an individual’s failure to exercise reasonable professional care, the individual should be held accountable in accordance with the law.
Where systemic failures contributed to the harm, the institution and relevant authorities must equally answer legitimate questions.
We should not create a system in which individual healthcare workers become convenient scapegoats for institutional failures.
Victims Must Know Their Rights
There is an urgent need for massive public sensitisation concerning patients’ rights.
Many Nigerians do not know that they can ask questions about the treatment they receive in a hospital. They may not understand the importance of obtaining relevant medical records, preserving receipts and other documents, documenting symptoms and treatment, seeking appropriate independent medical opinions and consulting lawyers where serious injury or death occurs.
Patients should be educated about their rights.
Families should know that when a loved one dies or suffers serious injury in circumstances suggesting possible negligence, they do not necessarily have to remain silent.
They should be able to seek an explanation.
They should be able to request an investigation.
They should be able to approach the appropriate professional regulatory body.
And, where appropriate, they should be able to pursue civil, professional or other remedies available under Nigerian law.
We Must Move Beyond Compensation
The conversation about medical negligence should not be limited to monetary compensation.
Compensation may assist a victim or family in dealing with the financial consequences of an injury or death, but it cannot restore a life that has been lost.
The greater objective should be prevention.
If a patient dies because an emergency was not attended to promptly, the system must ask why.
If a patient suffers complications because essential medical equipment was unavailable, the system must ask why.
If a patient suffers injury because a professional failed to exercise reasonable care, the system must ask why.
And when the answer is established, corrective action must follow.
Accountability Also Protects Doctors
Interestingly, effective accountability can also protect responsible healthcare professionals.
A transparent system makes it easier to distinguish genuine medical negligence from unavoidable complications, unreasonable expectations or allegations unsupported by evidence.
Healthcare professionals should therefore not fear legitimate complaint mechanisms.
A properly constituted and independent investigation can vindicate a professional who acted appropriately just as it can expose one who failed in his or her professional duty.
The ultimate beneficiary is the patient and, by extension, the entire healthcare system.
A Call for Reform
Nigeria urgently needs a stronger patient-safety and medical-accountability culture.
Among other measures, there should be:
- Accessible and independent complaint mechanisms in hospitals and healthcare institutions.
- Prompt investigation of serious allegations of medical negligence.
- Effective enforcement of professional standards by relevant regulatory and disciplinary bodies.
- Improved access to medical records for patients and their authorised representatives, subject to applicable law.
- Greater public awareness of patients’ rights and available remedies.
- Legal assistance for indigent victims of serious medical negligence.
- Improved hospital infrastructure, staffing and emergency-response systems.
- Mandatory institutional review of serious adverse medical events to identify failures and prevent recurrence.
- Stronger collaboration among lawyers, medical professionals, regulators and civil society organisations in promoting patient safety.
- Appropriate sanctions where negligence or professional misconduct is established, while ensuring that every accused professional receives fair hearing and due process.
Conclusion: Patients Deserve Care, Victims Deserve Justice
My wife’s survival was, for my family, a miracle for which I will forever remain grateful.
But gratitude should not silence legitimate questions.
My experience has reinforced my belief that we must build a healthcare system in which patients are not merely recipients of treatment but are recognised as human beings whose dignity, safety and rights deserve protection.
We must support our doctors and nurses.
We must demand better welfare for health workers.
But we must equally demand professional responsibility.
We must appreciate the difficult work healthcare professionals perform while insisting that avoidable negligence should never become normalised.
When something goes wrong, victims should not be abandoned.
When an allegation is made, it should be investigated.
When wrongdoing is established, appropriate sanctions should follow.
And when systemic weaknesses are discovered, they must be corrected.
The death of Justice U. John’s wife and my own family’s traumatic experience are painful reminders that behind every medical negligence case is a human being—a mother, father, wife, husband, child or loved one.
The fight against medical negligence is therefore not a fight against doctors.
It is a fight for safer healthcare, professional integrity, accountability and the protection of human life.
As a society, we must never become so accustomed to preventable tragedies that we begin to regard them as ordinary.
Patients deserve care.
Victims deserve justice.
Healthcare professionals deserve support.
And the system owes everyone accountability.
Ike Augustine, Esq.
Legal Practitioner & Human Rights Advocate
