Doctors are humans and they are bound to make mistakes in the cause of carrying out their duties. Though some of such mistakes result from negligence of medical practitioners, a Jos based Chief Medical Director in this report stressed the need to differentiate mistakes from complications.

 

Mrs. Salau had a case of threatened abortion in 2008 which warranted a cervical cerclage to be fixed into her cervix to protect the pregnancy and stop the abortion. However, two weeks before her expected date of delivery (EDD) she returned to the hospital for the cerclage to be removed, but the doctor was in a hurry, he had a function in which he was already late for. Nevertheless, Mrs. Salau was whisked into the theatre and a few minutes into the procedure, the cerclage allegedly cut before it was removed. She asked the doctor if it will affect her labour and eventual delivery, he said no and headed for his function.

 

When she eventually went into labour, Mrs Salau said "the contractions were coming three minutes apart but they said I had not a finger tip of dilation and I was asked to go home. Because I knew what I was feeling, I insisted on staying. The doctor then found out that it was not false labour but he became confused as to why I was not dilating. When I told him about my encounter with the other doctor some weeks back, he called the doctor who insisted that he had removed the cerclage but when they checked, the cerclage had been cut but it hadn't been removed." She explained that "once they removed it, I dilated to two centimetres and after an hour, I went to four cm but that was all, the mouth of the cervix had developed thrombosis and so I was rushed in for surgery. Till today, I cannot dilate more than four cm and because of the doctor's negligence, I had a prolonged labour, my baby took in a lot of fluid and became infected and had neonatal sepsis." As deadly a mistake such as this could be to a patient, it is not likely that doctors may have the courage to come forward or take responsibilities for such mistakes when made. Dr. Eddie Okeke, the Chief Medical Director of Victoria Memorial Hospital in Jos explained that in his over 30 years of practice, he has not met any doctor who has made a mistake and came forward to take responsibility. However, the surgeon was quick to say sometime mistakes of doctors are buried by other doctors due to what he described as "spirit of comradeship." According to him "If a patient had surgery somewhere else and comes to another doctor complaining and the doctor finds out something that shouldn't be there is there, he probably wouldn't tell the relatives of the patient, he may just make sure that the mistake is corrected. So in that case, the other doctor's mistakes are covered. But if you know the doctor, you may also call him personally and tell him that this is what happened so that he can be more careful and it doesn't happen next time."

 

The CMD also said though mistakes are known to be made during treatments or surgical operations, such mistakes are rare. He explained that a clear distinction must be drawn between mistakes and complications stating that complications are more common during surgery. "Complications are problems arising from what the patient is suffering from. For instance, if you did an abdominal operation, it could get infected, that is a complication of the surgery but when you talk about mistakes, the one that easily comes to mind is forgetting something in the abdomen or because of error of labelling parts of the body. May be you were suppose to operate on the left side of the abdomen and because you did not label it properly in the case note or you are not familiar with the patient, you go and operate on the right side which is the wrong side. That is a mistake," he said.

 

While stressing that all mistakes are avoidable as far as the medical practice was concerned, he noted that not all mistakes can easily be rectified especially since a surgeon may not be aware of the mistake. "If you were to forget something in the abdomen during surgery and you are not aware that you have left something and you have closed it, the result is going to come out much later and so there is no way you can rectify it because the mistake has already been made. But if you make a mistake and immediately during the surgery you are able to rectify it, it wouldn't be seen as a mistake because the outcome will be ok," he said.

 

Janet Ibrahim, an accountant recalled how a similar mistake had led to the death of a loved one. Ibrahim explained that "my aunt got infected because a tiny needle was left in her abdomen and by the time it was removed it had rusted and led to an infection." She explained that "she didn't die immediately but she was constantly having abdominal problem even after the needle had been removed until her death three years later." Dr Okeke is of the opinion that mistakes during surgeries usually happen when someone fails to carry out his or her responsibility. According to him "In theatre for instance, when you are operating on a patient, your scrub nurse and the person who hands you instruments is suppose to count every instrument on her table at the beginning and end of the surgery. Those instruments must be counted before the surgeon closes the abdomen. That is the standard rule of surgery so if these things are followed you will find that you will not forget anything in the abdomen but when you don't follow them strictly, then you are bound to run into trouble. Or if parts of the body are not properly labelled in the patient's case note, such mistakes can lead to aggravated mistakes on the patients," he said.

 

Having lost patients in the course of his practice, Dr Okeke said "mistake or no mistake it is difficult on a doctor when a patient dies, it is very painful but you have to tell the relatives. Usually, it is better if you keep briefing the relatives as to the patient's condition, when it's improving or getting worst so that when eventually something happens, it doesn't come as a shock to the relatives. It is also important that the patient becomes more aware that they have a right to know what is wrong with them and what lines of management are being undertaken. It is the responsibility of the doctor to explain and even tell the patient the statistic of the people that have undergone a particular treatment, so that after the briefing the patient can make up his or her mind on whether or not to give you consent."

 

BY LAMI SADIQ,

Dailytrust