A Nigerian Immigration officer, Aliu Lawal, is at loggerheads with some doctors at the University College Hospital, Ibadan, Oyo State, over the alleged shoddy treatment of his fractured left leg.
But the hospital absolved the doctors who attended to Lawal of any wrongdoing, claiming that the poor outcome was due to the patient’s non-compliance with the treatment protocol.
Sunday PUNCH learnt that Lawal was involved in a car accident in Lokoja, Kogi State, on July 10, 2017 and was first attended to at the Federal Medical Centre, Lokoja, before he was transferred to the UCH two days later.
At the UCH, he was scheduled to be attended to by a consultant surgeon, one Dr Ifesanya, for the correction of “femur and tibia fractures” he sustained during the crash.
The officer said he didn’t meet with the consultant and instead, a team of resident doctors operated on him and allegedly improperly placed an implant on his femur which failed even before he was discharged from the hospital.
He said the alleged poor treatment worsened his condition and had since caused him harrowing pains.
In a letter to the chairman, Medical Advisory Committee of the UCH, dated September 24, 2020, Lawal, through a rights group, Veteran Organisation for Human Rights, detailed how he was treated at the hospital.
The letter was titled, “A passionate appeal for immediate attention and redress to the honourable minister of health, the honourable speaker of the Federal House of Representatives, the CMD, UCH, the chairman, Medical Advisory Committee, UCH, the chairman Servicom, UCH, on a case of serious threat to life, inhuman treatment, masochism, clavicle damage and improper placement of an implant on the femur fracture of Mr Lawal Aliu Abolaji, leading to angulations of the left femur and persistent excruciating pain perpetrated by Dr Okunlola and others, of the Orthopedic Unit of the UCH.”
The petition stated that in the absence of Ifesanya, the femur implant was carried out without the consultant’s supervision, noting that Lawal sustained a clavicular fracture in the process.
It read, “This mistake led to angulations and shortening of the leg by 2-3 centimeters. Subsequently, all the doctors he has been meeting kept posting him and giving him flimsy excuses, as a result of this grave and life-threatening mistake, he was bedridden for more than a year. Fortunately, Mr Lawal came across a female doctor in October 2018 who told him the surgery has to be performed again.”
Lawal was said to have been referred to one Dr Oladiran, who promised to repair the damaged clavicle and booked him for a surgery in April 2019. As a result of an alleged delay on the part of doctors, the surgery was cancelled and postponed till May that year.
Oladiran reportedly insisted that Lawal should write an undertaking that he (Lawal) chose to undergo clavicle operation before another femur surgery.
“On the day of the clavicle surgery, a woman among the officials of the theatre, who felt Lawal has been dehumanised and maltreated asked him about the time the accident occurred and he told her 2017.
“She asked further why the operation wasn’t done before now. He replied that the doctors kept telling him that they didn’t do clavicle surgery in UCH, giving an impression that it could be done elsewhere,” the letter added.
Two months after the clavicle surgery, Lawal reportedly met Oladiran for the femur correction but the latter allegedly declined, claiming that the femur would become shorter.
The doctor was said to have referred Lawal to another consultant, one Dr Okunola, who, upon examining the x-rays, reportedly remarked that K-nail implant ought to have been used for the femur and insisted that it would be operated in order to straighten the bent bone.
The petition further read in part, “Dr Okunola insisted on a method that ordinarily should be used for a 4cm shortening. When Mr Lawal noticed it was a double standard decision, he met one doctor to help him plead with Dr Okunola but he refused. He himself pleaded with him before he eventually paid the sum of N200,000 to the account given to him.
“The surgery however made the femur to remain bent as the method used for 4cm shortness was used for Lawal’s 2.5-3 cm shortness. At the physiotherapy unit, UCH, One Mrs. Orogbemi took the measurement to 2.7cm and it was documented. Another measurement was taken at High Rise Orthopedic, was 3cm.
“After the surgery (on November 4, 2019), when Mr Lawal sighted the x-ray, he was shocked because instead of correcting angulations at the fracture site, Dr Okunola fractured another place on the femur bone. Up till now, Mr Lawal is still living in excruciating pain for more than three years now which has become a life-threatening situation.”
The human rights group led by Sikirullahi Abayomi, urged the medical advisory committee to investigate the matter thoroughly and ensure that justice prevailed.
But the UCH, in its response dated October 13, 2020 and signed by one Niyi Ajayi for the Director of Administration and Chief Medical Director, said it could not establish any treatment errors after conducting an extensive enquiry.
The hospital said in the course of Lawal’s treatment, the primary consultant, Ifesanya, went on a study leave; hence Oladiran, the next consultant in the unit, took over the treatment.
It claimed that Lawal was admitted to the facility with diagnosis of multiple injuries which included c-spine injury, blunt chest injury, mandibular fracture, clavicular fracture and fractures of left femur and right tibia and was co-managed by Orthopaedics and Trauma, Cardiothoracic, Neurosurgical and Oral and Maxillofacial surgical teams.
It further said Lawal was operated upon by an orthopaedics and trauma team on July 17, 2017 by competent senior registrars under the supervision of their respective consultants, describing it as the standard practice “as the procedure is within the competency of the operating surgeons.”
The hospital stated, “The implant failed shortly after surgery because the patient failed to adhere to treatment protocol of not bearing weight on the fracture fixation and this led to angulation of the fracture, improper union and shortening of the limb. The clavicular fracture was not operated on initially as it is managed mostly non-operatively in UCH, Ibadan and this is because evidence based practice revealed that there is no significant difference in functional outcome between clavicular fracture managed with and without surgery.
“Mr Lawal’s symptomatic non-united fracture of clavicle was operated only after a duly signed informed consent by him as there are attendant complication risks of non-union and other surgical and anaesthetic complications. After the fixation of the clavicular fracture on May 24, 2019, Mr Lawal demanded re-operation on the femur as the fracture was not fully united and there was associated deformity and shortening.
“Further operation with conventional treatment with either plate and screws or intramedullary nail will lead to further shortening of the limb and there is also the possibility of non-union of the fracture.”
The hospital said Lawal was consequently referred to Okunola for an alternative fracture fixation with circular external fixators that would best address the challenges of non-union, deformity and shortening of the limb simultaneously through a surgery.
It claimed that Lawal, being a paramilitary officer opted for the procedure to have his lower limb equalised, adding that the details of the surgery were explained to him.
“This includes the steps involved in the surgery, the estimated cost of surgery, the duration of treatment (between seven and nine months) during which he would have the external fixator on, the fact that the circular external fixator to be used had to be sourced from outside the hospital because it is not available within.
“He has to be highly motivated and cooperative throughout the course of treatment. Following the detailed counselling, Mr Lawal consented to have the surgery done for his benefit and promised to cooperate with the managing team,” the hospital’s response further read.
After the operation, the UCH said Lawal was trained in daily adjustments of the external fixator to gradually correct the deformity, achieve fracture union and leg equalisation and was discharged home “to ambulate on partial weight bearing with crutches to aid treatment.”
It said, “However, throughout the time he was on an external fixator, he did not comply with the treatment protocol. He did not follow daily adjustments of the external fixator strictly and did not ambulate with crutches regularly. He moved about in a wheelchair most of the time and complained of unbearable pain despite adequate analgesic, persuasion and encouragement.
“He mounted a lot of pressure for the removal of the circular external fixator before the appropriate time despite a lot of persuasion and entreaty. Though the length of the limb was equal to the other side, the fracture and the new bone had not fully consolidated when the external fixator was removed at his request.”
The hospital claimed that due to the premature removal of the external fixator that supported the limb, the new bone responsible for the leg length equalisation collapsed under Lawal’s weight, leading to further deformity of the whole femur and associated shortening.
It added, “Despite the failure of treatment because of poor compliance to treatment protocol, another option of care was discussed with the patient with the use of free intramedullary nails donated by an international organisation for indigent patients to achieve deformity correction and improve the leg length inequality.
“In view of the findings made during the investigation, the management therefore believes that appropriate surgical procedures and adequate care was given to Mr Lawal since he became a patient of the hospital in July 2017 and there was no procedure carried out on him that resulted in a threat to his life.”
However, Lawal, who also wrote to the Medical and Dental Practitioners, faulted the UCH’s findings, saying that he was not invited during the investigation.
Responding to his complaint, the Secretary of the Investigative Panel of the Medical and Dental Practitioners, Dr E.D Abdu, furnished Lawal with responses of Okunola and Oladiran, dated July 14, 2021 and promised that “further communication would be conveyed to you in due course.”
Oladiran, in a letter he deposed to and addressed to the panel, said he couldn’t reply to Lawal’s complaint because he was unable to access the patient’s record and documents in the custody of the hospital due to the ongoing strike by the Nigerian Union of Allied Health Professionals of the hospital at the time.
He added, “The medical records and other related matters of the complainant are germane to my defence and as soon as the association calls off its industrial action, I will prepare my reply to the complainant’s petition and forward the same to your panel accordingly.”
Okunola also gave the same reason and promised to respond to the request of the investigating panel as soon as the NUAHP called off its strike.
When our correspondent contacted Abdu on Thursday on the phone to know if the doctors had eventually sent in their responses to the panel, he said, “We don’t talk to the press on investigations. So the person (complainant) should call and we will tell them whatever they want to know.”
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