Some patients have limited understanding of medicine, so it is difficult, if not impossible, for a doctor to confirm that a patient has given adequately informed consent.
File photo: Surgeons at work
It is almost self-evident that adherence to the doctrine of informed consent requires a doctor to disclose enough about the risks and benefits of proposed treatments that the patient becomes sufficiently informed to participate in shared decision making.
What happened on September 26, 2014 will remain in the memory of the parents of a three month-old girl, Wunmi, who was said to have died about 20 minutes after taking two injections at a hospital (names withheld) located in Masaka, Nasarawa State, on the prescription of a doctor for cough and catarrh.
The baby girl allegedly died on the way home after the injections were administered on her by the hospital’s matron.
The parent blamed the death on the injections. Yinka, mother of Wunmi, said she took the baby to the hospital for cough and catarrh which persisted after she had given the child Paracetamol and Vitamin C.
The hospital, when contacted by Sunday Vanguard on the incident, declined to comment. The mother, a teacher, said the cough and catarrh started mildly on Tuesday, September 23, 2014 and ran through Thursday, September 25 even after the drugs she had given her.
So she took permission from her place of work to take the baby to hospital on Friday, September 26 where she gave birth to her for medical attention.
On getting to the hospital, she approached the matron to inform her that the baby was sick but had no money to pay for the treatment immediately with a promise to pay afterwards.
The matron directed her to speak with the doctor about the credit treatment which she did. The doctor accepted her plea, having delivered her of the same baby on June 29, 2014. The mother of the baby explained to the doctor that she had administered Paracetamol and Vitamin C on the child for the cough and catarrh.
The doctor examined the baby, made some prescriptions and also wrote the amount for the treatment on the same paper as N2, 500. The mother then went back to the matron for the drugs. Meanwhile, the matron picked up the baby’s file, totalled the bill on the same prescription paper in the file, N3, 500 (N1,000 for hospital card + N2,500 for treatment), and, after administering the two injections, the matron marked the injections as given on the same prescription paper. The mother then put the baby on her back afterwards and left the hospital to deliver a message to someone on her way home.
She said when she got to where she was to deliver the message; she removed the baby from her back only to find that she was dead. She raised the alarm that attracted people who grabbed the baby from the mother and took her to a hospital nearby where a doctor confirmed the baby was dead on arrival.
The death of the child shook the mother throughout that Friday so much so that she didn’t remember to call the doctor who prescribed the injections administered on Wunmi to inform him about the turn of events. After the baby was buried on Saturday, the mother, however, visited the hospital to speak with the doctor to know the injections administered on the baby.
The following conversation between Wumi’s mother and the doctor ensued:
Mother: What kind of injections did you give to my baby?
Doctor: She got PCM and chloroquine injections which you can see in her file; and they are for two days.
Mother: This is not the paper you wrote on when I came yesterday morning. Where is the one that the bill was written on and the matron marked on? This is not the paper in the baby’s file yesterday.
Doctor: This paper is just a summary, it is a rough work. We need to see the rough work before the summary. The rough one maybe is the one that had the calculations and balance, but this one is just a summary. I can’t lie to you, she is accusing me wrongly.
Mother: This is not the paper you wrote on yesterday.
Doctor: When someone says that, it means that I am lying.
Mother: The injections were for two days; yesterday and today. Didn’t you write my balance inside the paper yesterday?
At this point, the mother of the dead child insisted that the doctor invite the matron to his office so she could throw some questions on what he wrote on the missing paper.
Mother: What happened to the paper you wrote on yesterday?
Matron: It was inside the folder
Mother: How much did you write there and how much was my balance?
Matron: The treatment is N2, 500 and the family card is N1, 000.
Mother: Did you not total the amount l owe the hospital?
Matron: Yes. I summed it up
Mother: Did you not mark all you gave to my baby in the paper yesterday?
Matron: I gave your baby what the doctor said I should give her yesterday
Mother: That is not what I asked you, you have not answered my question.
The doctor cuts in: What we gave to your baby was what we wrote
Mother: I am not asking you doctor.
Matron: The ones prescribed for your baby, are the ones given to her
Doctor cuts in again: We are both civilian, if you punch me I will punch you and we will both start fighting which is not mature; we have to resolve this issue amicably.
Mother: I won’t fight you because my baby has died and you people changed the file and are trying to deny it. The matron admitted that she totalled everything in the paper but what you are showing us now does not have the total and marked injections. Instead of you to apologise and admit you were wrong, you are lying.
Doctor: Why should I apologise, did I kill your baby?
Mother: If you didn’t kill my baby, why did you change the paper?
Mother: My baby had only cough and catarrh. You gave her injections and she died.
Doctor: If you want to make case with me, go ahead and make case. I am a qualified doctor and registered in Nigeria to practise medicine. You can’t come and talk to me anyhow. I know that you lost your baby but that is not a good reason for you to talk to me anyhow. Go and do whatever you want to do, what rubbish are you talking about?
Mother: Doctor, are you human at all?
Doctor: I am not a human being? Do whatever you want to do; all of you get out of my office.
Mother: Why did you say we should get out of your office? I only said this is not the paper and I explained to you what was written on the other paper because this is definitely not what I saw yesterday.
Sunday Vanguard learnt that the doctor dragged the bereaved mother, her husband, elder sister and mother to the police station for struggling with the baby’s file with him. A sister of the baby’s mother, who apparently got annoyed on the discovery that the file was allegedly tampered with, made effort to get hold of the file so as to scan it but the doctor was smarter to retrieve the baby’s file from her. Further findings revealed the doctor instigated the arrest of the bereaved parents and relatives over allegation of attempted theft of hospital document. They were in the police station till about 2am the following day, Sunday, before they were released.
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