It's horrible that such a thing happened. D health sector needs a complete overhaul 'cos its a disaster as it is.

There's no point complaining when nothing would be done. We just do not have enough specialists in the first place. If we did, then a medical officer (PMO or not) should not be in the OR doing the job of an obstetrician but unfortunately, this happens all the time. Although in this case, they CLAIM to be have been performing the procedure under specialist supervision but I very much doubt that.

The reality is worse but it's better not to comment further or people will scream here,

As it is, the MDCN needs to ensure that everyone who wants to practice medicine in Nigeria MUST go through residency training to either become a General Medicine Practicioner or some other specialist. A secondary pathway should also be provided for existing medical officers (SMO, PMO, CMO) - the purpose of which would be the opportunity to qualify for specialist certification in fields of their choice. This is in consideration of the fact that some of these physicians have been practicing for 10-15yrs.
Aside this, we need to take specialist re-certification very seriously 'cos its not enough for you to become a
specialist.

The focus shouldn't be on physicians alone but also on nurses and nursing assistants. Nurses need to be re-oriented about the fact that being a nurse isn't just about giving pxt's drugs and changing bedsheets. They need to be integrated into patient managment and every member of the health team needs to understand his role.

There are so many issues that need to be handled ,

professional wrecklessness too bad!

Why is she asking Fashola for Justice? Is he a judge

may i urge the mother to take up a one woman peaceful protest in company of the media i.e channels tv,and head towards the seat of govt in ALAUSA.If the amiable governor ignores or press charges against the accused,then you can expect a free litigation cost from me on behalf of the public and your case being a ref. feel so so sorry for the poor innocant child.

Ujujoan:

Why is she asking Fashola for Justice? Is he a judge

What do you expect from a frustrated woman?

I know for sure, that he who refuses to listen to the cries of the poor and the oppressed, will someday cry out, and not be heard!.

selingel:

What do you expect from a frustrated woman?

I know for sure, that he who refuses to listen to the cries of the poor and the oppressed, will someday cry out, and not be heard!.

Hmm! How I wished those oppressing the common man will read this

a product of the nigerian educational system.

This is really unfortunate.

Hardtalk:

Hmm! How I wished those oppressing the common man will read this

Exactly what I raised the other day. I am not moved by the so-called first class being carried about these days by many, because some of them are not worth it. These guys may have the brains, but the system will never allow the best emerge. That is why someone with third class, will go to UK and do very well.

Who will you blame? Bad educational policy and poor infrastructure, used in teaching these medical students. Please visit all the colleges of medicines in Nigeria, and water will come out of your eyes, in 2010. Half-baked graduates everywhere.

davidif:

a product of the nigerian educational system.

Exactly what I raised the other day. I am not moved by the so-called first class being carried about these days by many, because some of them are not worth it. These guys may have the brains, but the system will never allow the best emerge. That is why someone with third class, will go to UK and do very well.

Who will you blame? Bad educational policy and poor infrastructure, used in teaching these medical students. Please visit all the colleges of medicines in Nigeria, and water will come out of your eyes, in 2010. Half-baked graduates everywhere.

People make mistakes.  If in the name of justice the doctors are locked up, then we are indirectly sentencing other patients who need their care to death.  Nothing can correct the damage that has already happened; since they have owned up to it, let them pay monthly damages for a few decades.

What? This is inhuman. I am ashamed of these guys. Why do this to an innocent baby?.

Seun:

People make mistakes.  If in the name of justice the doctors are locked up, then we are indirectly sentencing other patients who need their care to death.  Nothing can correct the damage that has already happened; since they have owned up to it, let them pay monthly damages for a few decades.

Haba! Mr. Seun, did you really read through? Those guys owned up to this after they were made to know that there was trouble in sight. How many of such cases have they done away with without anyone knowing? It is GOD that wants to expose them. Let them dance to the tune of the new music, else, everyone will commit a crime, and say I am sorry, and that is all.

Didn't read through though.

Seun:

Didn't read through though.

Okay read, and then comment!. Waiting!.

That's a known complication no doubt.

However, in the interest of that baby, they should not have sent the baby home and hand over care to Mother. Knowing what the end result of such complication could be, that baby shouldn't have left hospital for a second even if Mother insisted to take him home! That baby has got rights and every care should be in his interest even if parents object. And you blame mother for taking baby home? Don't they have policies in Nigeria? How do you let such a baby go home? What did you say Mother was gon' use to dress the baby's wound?

There's no way you'll explain this incident/ the possible complications to a mother/family and they will insist on taking the baby home to "dress" him herself. A sick child should not leave hospital even if parents object. As long as that child needs medical attention he should get it. This is absolute nonsense! Why the hell are you a doctor? If I was a judge I'll definitely sentence you to hanging! No two ways.

Secondly, how long do they keep ex-CS patients in hospital? I know minimum is 2-3 days. Are you telling me this woman went home from theatre? This whole story doesn't make sense.
In fact, if that baby was actually rendered incapacitated right from the cut then I don't see how the doctors and nurses and even Mother didn't notice the progress of this baby. Was this noted and just ignored?

The Consultant was present and all this rubbish just got swept under the carpet?

Why did they hide all the details from the parents? Even the test results?

This whole story doesn't just add up. I just can't believe the way patients are managed in Nigeria. I wish I had an answer to all my questions.

I sympathise with the family.

Hardtalk:


Exactly what I raised the other day. I am not moved by the so-called first class being carried about these days by many, because some of them are not worth it. These guys may have the brains, but the system will never allow the best emerge. That is why someone with third class, will go to UK and do very well.

Who will you blame? Bad educational policy and poor infrastructure, used in teaching these medical students. Please visit all the colleges of medicines in Nigeria, and water will come out of your eyes, in 2010. Half-baked graduates everywhere.

That's why i laugh when Nigerians get angry because foreign companies who come to naija hire other foreigners. If i had my own company, i wouldn't hire anybody who studied in naija period.

whaley:

It's horrible that such a thing happened. D health sector needs a complete overhaul 'cos its a disaster as it is.

There's no point complaining when nothing would be done. We just do not have enough specialists in the first place. If we did, then a medical officer (PMO or not) should not be in the OR doing the job of an obstetrician but unfortunately, this happens all the time. Although in this case, they CLAIM to be have been performing the procedure under specialist supervision but I very much doubt that.

I think this doctor was either being reckless or made a genuine mistake that a simple enquiry will unearth. From what I hear C/S is a basic straightfoward surgery that is quite easy. I understand that in some east African countries nurses routinely conduct this surgery (and are cert to do so) esp in rural practice.

This should not be the basis over which Nigerian medical practice should be judged.A mistake is what it is. If the doctor is considered reckless then appropriate sanction should be meted. Also our obstetricians should be held to higher goals rather than dexterity in what is a very basic surgery.

Peak of carelessness, this is how the case will go down the drain at the detriment of the poor woman. God have mercy.

Mob trial does not help.The country is sick.Expecting a health system insulated from this rot is living in fools paradise
People should look at the bigger picture of a failed state rather making a scape goat of haples overworked doctors working in horrendos conditions.

I hate to say it but I consider myself guilty of an offence some pple made earlier on in this thread-not reading the story!

It appeared the baby had a simple scalp laceration that was repaired. The mother failed/neglected to present baby for follow up treatment resulting in ?wound infection, blood poisoning and other complications that resulted in the baby having neurological problems etc.

For all we know blood poisoning could have resulted from improper cord care which is a common problem in our general hospitals but usually does not result in long term complications b/c of the liberal use of antibiotics with some help from cooperative mothers which this woman is clearly not. Even if it is a direct result of the scalp injury the woman is more guilty than the doctor in not making the baby available for continued treatment.

I do sympathize with her though. Inevitably this can be linked to poverty and illitracy a direct consequence of state failure.

I just wonder which would be better- for the parents of the hapless kid to send him to heaven and save him of being bought up incapacitated for life and save themselves the trauma and agony of bringing up a useless slowpoke or let him live and sweat it out through thick and thin for as long as he lives

Pennywise:

I hate to say it but I consider myself guilty of an offence some pple made earlier on in this thread-not reading the story!

It appeared the baby had a simple scalp laceration that was repaired. The mother failed/neglected to present baby for follow up treatment resulting in ?wound infection, blood poisoning and other complications that resulted in the baby having neurological problems etc.

For all we know blood poisoning could have resulted from improper cord care which is a common problem in our general hospitals but usually does not result in long term complications b/c of the liberal use of antibiotics with some help from cooperative mothers which this woman is clearly not. Even if it is a direct result of the scalp injury the woman is more guilty than the doctor in not making the baby available for continued treatment.

I do sympathize with her though. Inevitably this can be linked to poverty and illitracy a direct consequence of state failure.

Why didn't the doctors sit the parents down, and explain all the above and the need for the mother to always bring the baby for follow-up? Why did they have to explain this to Public Defenders, instead of the mother?. Had it been all these processes where duly followed, the situation wouldn't have degenerated to this. They doctors had an interior motive initially, before later admitting to this.

Pennywise:

I hate to say it but I consider myself guilty of an offence some pple made earlier on in this thread-not reading the story!

It appeared the baby had a simple scalp laceration that was repaired. The mother failed/neglected to present baby for follow up treatment resulting in ?wound infection, blood poisoning and other complications that resulted in the baby having neurological problems etc.

For all we know blood poisoning could have resulted from improper cord care which is a common problem in our general hospitals but usually does not result in long term complications b/c of the liberal use of antibiotics with some help from cooperative mothers which this woman is clearly not. Even if it is a direct result of the scalp injury the woman is more guilty than the doctor in not making the baby available for continued treatment.

I do sympathize with her though. Inevitably this can be linked to poverty and illitracy a direct consequence of state failure.

The truth of the matter is that it will be impossible to say that the doctors that managed the case are not culpable.

Medical sector in Naija, just like many other sectors is in shambles, and that reflects the way medicine is practised there compared with better developed countries.

It is very sad indeed that the newborn had to end up with very severe damage. And like you pointed out, the damage is most likely not due to the scalpel cut itself, because the scalpel will not cut through the baby's skull into his brain. That can only happen if they did it intentionally or the doctor was severely intoxicated. The damage was probably due to infection of the wound and severe sepsis.

And they will be culpable for discharging a baby with an infected wound, poor management of the wound, and also trying to conceal these from the mother(if they did). Culpability with regards to the scalpel cut itself (if it is superficial) will be subjective depending on the panel that will review the case.

Obstetrics is a very sensitive specialty and even in advanced countries, they probably have the highest number of malpractice suits. However that does not excuse the very poor outcome in this case.

We need very major changes in the health policies in Naija that will affect, doctors, patients, government, hospital management etc, and until the Government pays more attention to these, we will continue to have these kind of things happening, with high infant mortality/maternal mortality rates.

ziga:

The truth of the matter is that it will be impossible to say that the doctors that managed the case are not culpable.

Medical sector in Naija, just like many other sectors is in shambles, and that reflects the way medicine is practised there compared with better developed countries.

It is very sad indeed that the newborn had to end up with very severe damage. And like you pointed out, the damage is most likely not due to the scalpel cut itself, because the scalpel will not cut through the baby's skull into his brain. That can only happen if they did it intentionally or the doctor was severely intoxicated. The damage was probably due to infection of the wound and severe sepsis.

And they will be culpable for discharging a baby with an infected wound, poor management of the wound, and also trying to conceal these from the mother(if they did). Culpability with regards to the scalpel cut itself (if it is superficial) will be subjective depending on the panel that will review the case.

Obstetrics is a very sensitive specialty and even in advanced countries, they probably have the highest number of malpractice suits. However that does not excuse the very poor outcome in this case.

We need very major changes in the health policies in Naija that will affect, doctors, patients, government, hospital management etc, and until the Government pays more attention to these, we will continue to have these kind of things happening, with high infant mortality/maternal mortality rates.

Sometimes, I think we should keep pride aside, and see how things are done in other developed countries. That way, we would not lack behind.

Interestingly
this is one thing i have been stressing for quite a while, the need for accountability in the health sector.
People need to be made to account for actions/inactions.
That being said, the other problem in nigeria is the sacrifice of research for sensationalism by journalists.
I read a sad and very uninformed story about LUTH on punch homepage a few sundays ago and its quite similar to this and it just shows ignorance about health issues by the correspondents.
See i understand the doctor made a mistake and owned up to it and if found culpable should be punished by the MDCN.
There is no operation without risks even the most minor ones and accidental lacerations are known risks of C-sections especially the emergency type.
The doctors main error i see is in the discharge information which should have been clearly spelt out for the parents, they immediately sutured the laceration didnt they?)
And as a paediatrician, im wondering how a small scalp laceration will cause developmental delay, if indeed it will cause it, it would have gone through several pathways e.g.
laceration--infection--cranial osteomyelitis--meningitis--developmental delay

or laceration--infection--septicemia--meningitis--developmental delay

fact is i could theorize that a child needing emergency CS may have suffered some perinatal asphyxia which may cause the developmental delay.

so i wonder what the woman is claiming, developmental delay from scalp laceration is a long shot(though possible).

i hope the case will be well investigated and pursued to a logical conclusion,let erring people be punished, though something tells me the doctors can only be hooked for not properly handling discharge counselling, but all the same, i guess they'll be much more careful in future(if they still have their licenses).
and i do hope journalists wont be displaying this disregard for research before going to print,its annoying, you hardly see such reporting in the UK.

reindeer:

Interestingly
this is one thing i have been stressing for quite a while, the need for accountability in the health sector.
People need to be made to account for actions/inactions.
That being said, the other problem in nigeria is the sacrifice of research for sensationalism by journalists.
I read a sad and very uninformed story about LUTH on punch homepage a few sundays ago and its quite similar to this and it just shows ignorance about health issues by the correspondents.
See i understand the doctor made a mistake and owned up to it and if found culpable should be punished by the MDCN.
There is no operation without risks even the most minor ones and accidental lacerations are known risks of C-sections especially the emergency type.
The doctors main error i see is in the discharge information which should have been clearly spelt out for the parents, they immediately sutured the laceration didnt they?)
And as a paediatrician, im wondering how a small scalp laceration will cause developmental delay, if indeed it will cause it, it would have gone through several pathways e.g.
laceration--infection--cranial osteomyelitis--meningitis--developmental delay

or laceration--infection--septicemia--meningitis--developmental delay

fact is i could theorize that a child needing emergency CS may have suffered some perinatal asphyxia which may cause the developmental delay.

so i wonder what the woman is claiming, developmental delay from scalp laceration is a long shot(though possible).

i hope the case will be well investigated and pursued to a logical conclusion,let erring people be punished, though something tells me the doctors can only be hooked for not properly handling discharge counselling, but all the same, i guess they'll be much more careful in future(if they still have their licenses).
and i do hope journalists wont be displaying this disregard for research before going to print,its annoying, you hardly see such reporting in the UK.

That is the most probable cause of the brain damage. . . the reason for the CS itself. And the docs may be liable for this or not.

One very bad thing in Nigeria is journalism. They play on people's emotions to be able to get sales. And about this case, they know that they will be able to achieve that by tying the scalp laceration by the doctors to the poor mental development.

And i will repeat, there is no reason for the docs not to have told the patient about the incident as well as report it in their notes.

For Naija journalists, it is very important in life to call a spade a spade, and for what you don't know, you research or ask people who know or you shut up.

Despite all these, the doctors will still have a case to answer, and the only solution will be in proper investigation and punishment, and formulation of policies that will protect patients and health care professionals in future, or else, in a short while, we will have another case on the news.

I'm not defending d docs but I don't share d view of those sayin that d docs deliberately discharged d baby wit infected wound & also tried 2 hide it from d mother. Accordin 2 dr adewale, there was accidental scarpel injury & it was instantly satured by d consultant obestrician. Treatment started wit antibiotic injection, multivitamins & analgesics. Scarpel injury is a complication of C-section worldwide. D mother on d other hand showed d universal human weakness of waitin till things get worse b4 acting & blamin d consequences on others. She must hav known @ d injury even if they didn't tell her when bathing, dressing & breastfeeding d baby. When u buy a good somewhere & it develops fault, u don't take it 2 another place 4 servicing. U take it 2 where u bought it 4 rectification or replacement. D docs @ Apapa knew what happened & are in better position 2 correct it. Rather than go back there, d mother choose 2 waste 3 weeks at other hospitals. Even if her reason 4 going 2 other hospitals is that d docs @ Apapa are incompetent, she should still have gone back there & they would refer her 2 docs they know can handle d situation. The baby was born @ Apapa, d injury occured there & treatment began there. Rather than continue there, d mother opted 2 burn over 3 weeks at other hospitals & now turn around 2 blame Apapa docs for her myopia when things got bad. I repeat again that i'm not defending d docs but i'm 100% sure that even those blaming d docs wouldn't take that kind of rubbish if they were in d docs shoes. I'm typing wit phone so kindly overlook any typing error in my post

I'm not defending d docs but I don't share d view of those sayin that d docs deliberately discharged d baby wit infected wound & also tried 2 hide it from d mother. Accordin 2 dr adewale, there was accidental scarpel injury & it was instantly satured by d consultant obestrician. Treatment started wit antibiotic injection, multivitamins & analgesics. Scarpel injury is a complication of C-section worldwide. D mother on d other hand showed d universal human weakness of waitin till things get worse b4 acting & blamin d consequences on others. She must hav known @ d injury even if they didn't tell her when bathing, dressing & breastfeeding d baby. When u buy a good somewhere & it develops fault, u don't take it 2 another place 4 servicing. U take it 2 where u bought it 4 rectification or replacement. D docs @ Apapa knew what happened & are in better position 2 correct it. Rather than go back there, d mother choose 2 waste 3 weeks at other hospitals. Even if her reason 4 going 2 other hospitals is that d docs @ Apapa are incompetent, she should still have gone back there & they would refer her 2 docs they know can handle d situation. The baby was born @ Apapa, d injury occured there & treatment began there. Rather than continue there, d mother opted 2 burn over 3 weeks at other hospitals & now turn around 2 blame Apapa docs for her myopia when things got bad. I repeat again that i'm not defending d docs but i'm 100% sure that even those blaming d docs wouldn't take that kind of rubbish if they were in d docs shoes. I'm typing wit phone so kindly overlook any typing error in my post

oweniwe:

I'm not defending d docs but I don't share d view of those sayin that d docs deliberately discharged d baby wit infected wound & also tried 2 hide it from d mother. Accordin 2 dr adewale, there was accidental scarpel injury & it was instantly satured by d consultant obestrician. Treatment started wit antibiotic injection, multivitamins & analgesics. Scarpel injury is a complication of C-section worldwide. D mother on d other hand showed d universal human weakness of waitin till things get worse b4 acting & blamin d consequences on others. She must hav known @ d injury even if they didn't tell her when bathing, dressing & breastfeeding d baby. When u buy a good somewhere & it develops fault, u don't take it 2 another place 4 servicing. U take it 2 where u bought it 4 rectification or replacement. D docs @ Apapa knew what happened & are in better position 2 correct it. Rather than go back there, d mother choose 2 waste 3 weeks at other hospitals. Even if her reason 4 going 2 other hospitals is that d docs @ Apapa are incompetent, she should still have gone back there & they would refer her 2 docs they know can handle d situation. The baby was born @ Apapa, d injury occured there & treatment began there. Rather than continue there, d mother opted 2 burn over 3 weeks at other hospitals & now turn around 2 blame Apapa docs for her myopia when things got bad. I repeat again that i'm not defending d docs but i'm 100% sure that even those blaming d docs wouldn't take that kind of rubbish if they were in d docs shoes. I'm typing wit phone so kindly overlook any typing error in my post

Well said, I want you to understand one thing, this is Nigeria.
Meanwhile, okay I accept your fact that the mother knew about the injury.
What recommendations/assurances did the doctors give to the woman, which would have dissuaded her from taking the baby elsewhere, or even attempting self medication? In a case like this, if they had told the woman, we are monitoring what happened to the baby, obviously the matter would not have gotten to this stage. Daily in Nigerian hospitals, we register similar cases, but how many make headlines?
Why did they suddenly discharge the woman, based on this report from the media? Obviously, the woman might have added some spices to make the whole issue to look juicy, but lets look at it from the neutral point of view. The hospital did not manage this situation well at all.

selingel:

Well said, I want you to understand one thing, this is Nigeria.
Meanwhile, okay I accept your fact that the mother knew about the injury.
What recommendations/assurances did the doctors give to the woman, which would have dissuaded her from taking the baby elsewhere, or even attempting self medication? In a case like this, if they had told the woman, we are monitoring what happened to the baby, obviously the matter would not have gotten to this stage. Daily in Nigerian hospitals, we register similar cases, but how many make headlines?
Why did they suddenly discharge the woman, based on this report from the media? Obviously, the woman might have added some spices to make the whole issue to look juicy, but lets look at it from the neutral point of view. The hospital did not manage this situation well at all.

Hmm! Well said.