We are all aware of the myriads of issues affecting the health sector in Nigeria: Lack of adequate funds, insufficient manpower, inadequate remuneration, epileptic power supply. You can as well add yours, the problems are endless. Honestly, these are incontrovertible facts that every Nigerian will readily accept.
Are the above-listed reasons convincing enough why some of us engage in acts that may constitute medical negligence? The recent reported cases of lack of adequate and prompt care by doctors are worrisome. In as much as some of these reported cases are hyped, we cannot close our eyes to unwholesome practice by some of our colleagues either in the private or government-owned hospitals. This is a wake-up call to every doctor that the era of ‘all-knowing’ physician has gone as our patients are increasingly aware of their rights. I was surprised to see a sponsored campaign on change.org, where Nigerians are signing a petition that legal action should be taken against the nurses and doctors in a particular hospital on account of negligence that resulted in the death of a patient. We are witnessing a period, wherein patients and their legal counsels are demanding a reasonable standard of care amidst the aforementioned challenges. We have to act right in ensuring good care for our patient. We have act to protect ourselves against lawsuit by knowing what constitute medical negligence..
The medical profession is a noble profession because it helps in preserving life. Undoubtedly, life is God-given. As such, a doctor figures in the scheme of God as he stands to carry out His command. When a patient approaches a doctor/hospital, his /her expectations are two-fold: doctors and hospitals are expected to provide medical treatment with all the knowledge and skill at their command and secondly they will not do anything to harm him/her in any manner either because of their negligence, carelessness, or reckless attitude of their staff members.
Generally speaking, negligence is said to have occurred when a person is said to have omitted to do something which a reasonable man would do when he is guided by the factors which ordinarily regulate human conduct or when he does something which a prudent and reasonable man would not do. It can also be defined as the breach of duty of care which leads to damages.
According to the Blacks Law Dictionary, “medical negligence is the failure to provide medical, dental or psychiatric care that is necessary to prevent or to treat serious physical or emotional injury or illness while medical malpractice is a doctor’s failure to exercise the degree of care and skill that a physician or surgeon of the same medical specialty would use under similar circumstances”.
Medical negligence is substandard care that’s been provided by a medical professional to a patient, leading to injury or causing an existing condition to get worse. It can be an act or omission by a medical professional in discharge of his/her duty.
Generally, when a patient is under your care, you owe him/her certain duties which are:
(a) Duty of care in deciding whether to undertake the case.
(b) Duty of care in deciding what treatment to give.
(c) Duty of care in the administration of that treatment.
Duty of care is a legal obligation which is imposed on an individual requiring adherence to a standard of reasonable care while performing any acts that could foreseeably harm others. It may interest you to note that this is the first element that must be established to proceed with an action in negligence.
Any breach of the afore-mentioned duties may give a cause of action for medical negligence and the patient may on that basis recover damages from his doctor.
The Medical and Dental Council of Nigeria has outlined acts or omission that might constitute medical negligence. This can be found in rule 29.4 of the Code of Medical Ethics in Nigeria, 2008. They are as follows:
1. Failure to attend promptly to a patient requiring urgent attention when the practitioner was in a position to do so.
2. Manifesting incompetence in the assessment of a patient
3. Making incorrect diagnosis especially when the clinical features are so glaring that no reasonable skilful practitioner could have failed to notice them
4. Failure to advice or proffering wrong advice to a patient on the risk involved in a particular operation or course of treatment, especially if such an operation or course of treatment is likely to result in serious side effects like deformity or loss of organ, or function.
5. Failure to obtain informed consent of the patient before proceeding on any surgical procedure or course of treatment when such consent was necessary
6. Making a mistake in treatment e.g amputation of the wrong limb, carelessness that result in the termination of a pregnancy, prescribing the wrong drug, or dosage in error for a correctly diagnosed ailment
7. Failure to refer, or transfer a patient in good time, when such a referral or transfer was necessary
8. Failure to do anything that ought reasonably to have been done under any circumstance for the good of a patient
9. Failure to see a patient as often as his medical condition warrants or to make appropriate comments in the case notes of the practitioner’s observations and prescribed treatment during such visits. It also includes failure to communicate with the patient or with his relatives as may be necessary with regards to any developments, progress, or prognosis in patient’s condition.
In order to protect yourself against any lawsuit, take care of the following:
1. Bad Communication: Open and honest communication should be the fundamental principle when interacting with your patient. Patients tend to be more forgiving and understanding of mistakes when they feel their doctors truly care about them and have their best interests at heart. Even though undesired result is not always as a result of poor care or malpractice, you must know that poor communication coupled with negative outcome are impetuses towards litigation. We’ll do ourselves a lot of good to take an online course in the art of effective communication.
2. Failure to get informed consent: Doctors should always ensure their patients have given their consent for any subsequent treatment or procedure.
3. Unsatisfactory training: We should endeavour to update our knowledge in our areas of specialty.
4. Poor follow-up: Occasionally, doctors fail to receive test results, and, in other instances, patients fail to follow through with tests as instructed. Therefore, it’s important that doctors and other medical staff can follow-up on the status of such orders to ensure that no instructions are forgotten or dismissed.
In addition to the aforementioned you must also ensure the following in order minimise the risk of facing lawsuit: Accurate medical records of all the assessment, procedures, counselling; Ensuring patient confidentiality; Offering of honest apology for mistakes; Guard against missed or delayed diagnosis.
In whatever you do always remember this part of the physician’s oath: ‘’ ......I WILL PRACTISE my profession with conscience and dignity; THE HEALTH OF MY PATIENT will be my first consideration; I WILL RESPECT the secrets which are confided in me, even after the patient has died...What Constitutes Medical Negligence BY Abiola Ibrahim
We are all aware of the myriads of issues affecting the health sector in Nigeria: Lack of adequate funds, insufficient manpower, inadequate remuneration, epileptic power supply. You can as well add yours, the problems are endless. Honestly, these are incontrovertible facts that every Nigerian will readily accept.
Are the above-listed reasons convincing enough why some of us engage in acts that may constitute medical negligence? The recent reported cases of lack of adequate and prompt care by doctors are worrisome. In as much as some of these reported cases are hyped, we cannot close our eyes to unwholesome practice by some of our colleagues either in the private or government-owned hospitals. This is a wake-up call to every doctor that the era of ‘all-knowing’ physician has gone as our patients are increasingly aware of their rights. I was surprised to see a sponsored campaign on change.org, where Nigerians are signing a petition that legal action should be taken against the nurses and doctors in a particular hospital on account of negligence that resulted in the death of a patient. We are witnessing a period, wherein patients and their legal counsels are demanding a reasonable standard of care amidst the aforementioned challenges. We have to act right in ensuring good care for our patient. We have act to protect ourselves against lawsuit by knowing what constitute medical negligence..
The medical profession is a noble profession because it helps in preserving life. Undoubtedly, life is God-given. As such, a doctor figures in the scheme of God as he stands to carry out His command. When a patient approaches a doctor/hospital, his /her expectations are two-fold: doctors and hospitals are expected to provide medical treatment with all the knowledge and skill at their command and secondly they will not do anything to harm him/her in any manner either because of their negligence, carelessness, or reckless attitude of their staff members.
Generally speaking, negligence is said to have occurred when a person is said to have omitted to do something which a reasonable man would do when he is guided by the factors which ordinarily regulate human conduct or when he does something which a prudent and reasonable man would not do. It can also be defined as the breach of duty of care which leads to damages.
According to the Blacks Law Dictionary, “medical negligence is the failure to provide medical, dental or psychiatric care that is necessary to prevent or to treat serious physical or emotional injury or illness while medical malpractice is a doctor’s failure to exercise the degree of care and skill that a physician or surgeon of the same medical specialty would use under similar circumstances”.
Medical negligence is substandard care that’s been provided by a medical professional to a patient, leading to injury or causing an existing condition to get worse. It can be an act or omission by a medical professional in discharge of his/her duty.
Generally, when a patient is under your care, you owe him/her certain duties which are:
(a) Duty of care in deciding whether to undertake the case.
(b) Duty of care in deciding what treatment to give.
(c) Duty of care in the administration of that treatment.
Duty of care is a legal obligation which is imposed on an individual requiring adherence to a standard of reasonable care while performing any acts that could foreseeably harm others. It may interest you to note that this is the first element that must be established to proceed with an action in negligence.
Any breach of the afore-mentioned duties may give a cause of action for medical negligence and the patient may on that basis recover damages from his doctor.
The Medical and Dental Council of Nigeria has outlined acts or omission that might constitute medical negligence. This can be found in rule 29.4 of the Code of Medical Ethics in Nigeria, 2008. They are as follows:
1. Failure to attend promptly to a patient requiring urgent attention when the practitioner was in a position to do so.
2. Manifesting incompetence in the assessment of a patient
3. Making incorrect diagnosis especially when the clinical features are so glaring that no reasonable skilful practitioner could have failed to notice them
4. Failure to advice or proffering wrong advice to a patient on the risk involved in a particular operation or course of treatment, especially if such an operation or course of treatment is likely to result in serious side effects like deformity or loss of organ, or function.
5. Failure to obtain informed consent of the patient before proceeding on any surgical procedure or course of treatment when such consent was necessary
6. Making a mistake in treatment e.g amputation of the wrong limb, carelessness that result in the termination of a pregnancy, prescribing the wrong drug, or dosage in error for a correctly diagnosed ailment
7. Failure to refer, or transfer a patient in good time, when such a referral or transfer was necessary
8. Failure to do anything that ought reasonably to have been done under any circumstance for the good of a patient
9. Failure to see a patient as often as his medical condition warrants or to make appropriate comments in the case notes of the practitioner’s observations and prescribed treatment during such visits. It also includes failure to communicate with the patient or with his relatives as may be necessary with regards to any developments, progress, or prognosis in patient’s condition.
In order to protect yourself against any lawsuit, take care of the following:
1. Bad Communication: Open and honest communication should be the fundamental principle when interacting with your patient. Patients tend to be more forgiving and understanding of mistakes when they feel their doctors truly care about them and have their best interests at heart. Even though undesired result is not always as a result of poor care or malpractice, you must know that poor communication coupled with negative outcome are impetuses towards litigation. We’ll do ourselves a lot of good to take an online course in the art of effective communication.
2. Failure to get informed consent: Doctors should always ensure their patients have given their consent for any subsequent treatment or procedure.
3. Unsatisfactory training: We should endeavour to update our knowledge in our areas of specialty.
4. Poor follow-up: Occasionally, doctors fail to receive test results, and, in other instances, patients fail to follow through with tests as instructed. Therefore, it’s important that doctors and other medical staff can follow-up on the status of such orders to ensure that no instructions are forgotten or dismissed.
In addition to the aforementioned you must also ensure the following in order minimise the risk of facing lawsuit: Accurate medical records of all the assessment, procedures, counselling; Ensuring patient confidentiality; Offering of honest apology for mistakes; Guard against missed or delayed diagnosis.
In whatever you do always remember this part of the physician’s oath: ‘’ ......I WILL PRACTISE my profession with conscience and dignity; THE HEALTH OF MY PATIENT will be my first consideration; I WILL RESPECT the secrets which are confided in me, even after the patient has died...
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