Can The Law Tame Murderous Doctors?

A Medical malpractice is a serious problem. It is said to fall behind only heart disease and cancer as the leading cause of death, according to a study by Johns Hopkins. It is difficult to accurately estimate how often medical malpractice occurs because it often goes unnoticed or unreported, especially where accurate statistics is not readily available. However, instances of misdiagnoses abound. There is, therefore, the need for increased medical rights awareness in Nigeria, experts have said. Activist-lawyer Bamisope Adeyanju said it was ironic that there were not too many lawsuits arising from medical negligence or cases that border on the enforcement of medical rights in a country with a well documented failing health system. In contrast, the average number of medical malpractice suits filed yearly in the United States is about 85,000, according to a recent report by a US personal injury law firm, Galfand Berger LLP. Despite having advanced medical facilities, the Johns Hopkins study, which analysed medical death rate data over an eight-year period in 2016, calculated that more than 250,000 deaths per year are due to medical errors in the United States. The Nigeria situation According to statistics by the Medical and Dental Council Nigeria (MDCN) Disciplinary Tribunal, only 190 complaints of professional negligence were disposed off in seven years (2000 – 2007). Between 1963 and 1999, a period of 36 years, the Tribunal handled mere 92 cases of medical negligence. The number of cases handled by the tribunal between 2000 and 2007 represented an increase of over 200 per cent. According to World Association of Medical Law (WAML) Vice President Mr ‘La-olu Osanyin, “this current statistics would have quadrupled by now had the Medical and Dental Council of Nigeria (MDCN) not been dissolved incessantly by governments.” Osanyin, who also chairs the Nigerian Bar Association (NBA) Section on Business Law (SBL) Medicine and Law Committee, believes there is need for more awareness on medical rights. A 2018 study by Uwakwe Abugu and Dike Obalum of the Faculty of Law, University of Abuja and Department of Surgery, State House Medical Centre, Aso Rock, Abuja, says only about 1.1 per cent of all medical malpractices cases are enforced through legal action. Yet, medical errors and malpractices are prevalent. A study which focused only on Abia State highlights how serious the problem is. The study, conducted by Gabriel Iloh, Abali Chuku and Agwu Amadi of the Department of Ophthalmology, Federal Medical Centre, Umuahia, and the Department of Public Health, Federal University of Technology (FUTO), Owerri, sampled 145 medical practitioners in the state. The team found the prevalence of medical errors. The three most common errors committed by the participants were an error of medication prescription (95.2 per cent), error of radio-laboratory investigation ordering (83.9 per cent), and error of physician diagnoses (69.4 per cent). Sixty-two (100 per cent) of the participants who committed medical errors had a negative attitude to error disclosure to the patients and their families. Of the 62 participants who committed medical errors, 33.8 per cent were depressed. Significantly, among those who were medically negligent, the study found that “none was involved in a lawsuit for medical errors”. Medical rights According to Osanyin, some enforceable medical rights fall within the right to life guaranteed by Section 33 of the 1999 Constitution (as amended), the right to dignity of human person guaranteed by Section 34, and the right to personal liberty guaranteed by Section 35. A patient also has a right to privacy (as guaranteed by Section 37), but there are exceptions to the doctrine of confidentiality, as in the case of disclosure under compulsion of law or in public interest. Other medical rights, Osayin said, include the right to free choice of a physician, right to a second medical opinion, right to refuse to be informed about a medical condition, right to continuity of medical care, and the right to accept or refuse any recommended medical treatment, such as transfusion. According to him, medical negligence occurs when the standard of care a doctor gives to a patient is inadequate. A Senior Advocate of Nigeria (SAN) Mr Seni Adio said for a medical provider to be found liable, there must have been a duty of care, a breach of that duty, and the patient must have suffered an injury/damage as a result of the breach. To succeed in an action for medical negligence, Adio said a plaintiff must establish the three elements. According to lawpadi.com, patients can sue a hospital or medical professional for negligence and claim compensation if they received poor or substandard treatment, were misdiagnosed, given the wrong medication, or foreign objects were left in the body after an operation, among others. On who can sue, the website says: “Generally, only the person who has been a victim of the medical error can sue. However, the situation is different if the patient has passed away or the patient is a child. “If the patient has passed away, then the next of kin of the patient e.g. husband, wife, parents, children etc can sue for compensation. If a child, it will be the parent or the legal guardian of the child. “Doctors, nurses, dentists, opticians and all other medical professionals owe what is legally known as a duty of care towards their patients. When this duty is breached and the patient suffers some damage then it gives rise to a potential claim for compensation. “It is important to note at this point, however, that the law does not require the medical professionals to be perfect every time they carry out their job. One hundred per cent perfection is not humanly possible. What the law requires is that the medical professional must exercise a reasonable standard of care from them. “So, if a doctor, nurse or other health professional treats you with reasonable care, then you will probably not have a claim for compensation. If the treatment you received was not of a reasonable standard and this caused your injury, then you may have a claim. “The critical thing though is that if you are suing for compensation, the claimant (the person suing) must have suffered some harm as a result of the negligence of the act being complained about. “You have a period of three years to make a claim for compensation and this time period runs from the date when you first received the negligent treatment complained of or the date on which you first discovered that the treatment was negligent.” Agbakoba, Raji, Adegboruwa: Why medical malpractice litigations are low A former NBA President Dr Olisa Agbakoba (SAN) said there was need for more enlightenment on medical rights. “Medical malpractice is a nightmare in Nigeria. As a result of weak regulatory and legal frameworks not much is in place to prevent medical abuse. “I believe general ignorance of Nigerians has not helped check this menace, so it’s important that regulators, particularly medical and dental practice board, should take a stronger view of medical malpractice,” he said. African Bar Association (AFBA) Justice Sector Programme Commission Chairman Mr Ebun-Olu Adegboruwa blamed low enforcement of medical rights on ignorance. According to him, majority of patients believe that doctors and other medical personnel are beyond control. “So, there is need for awareness in this regard in educating the people on their rights,” he said. Adegboruwa also identified poverty as a factor, saying: “In most cases of medical negligence, the patient is at the mercy of the doctor, who is taken as God-sent to save the life of the patient, such that it may be counted as ingratitude where cases are subsequently pursued. “The patient in most cases does not have the resources to pursue meaningful redress. Even at that, cultural practices tend to portray aggrieved patients as trouble makers, especially where the doctor involved is well known.” On why less number of such cases ends up in court, he continued: “Perhaps the most common factor, however, is the technicalities of proof on the part of the complainant. “Because parties did not set out for dispute initially, usually there is no documented evidence to back up the complaints, as the case file will usually be with the doctor. “Even when there are resources and evidence, the procedure for ventilating grievances is too technical and laborious to discourage complainants.” A Senior Advocate of Nigeria (SAN) Ahmed Raji, on why he thinks there are not too many medical malpractice litigations, said until recently, apart from general law of torts, medical law was not taught in most of law faculties, nor are there enough specialists in the area of medical negligence. Also, most individuals who have the capacity to pursue such matters in court do not receive medical treatment in Nigeria, he said. Raji added: “Majority of the victims either lack awareness and/or resources to prosecute such matters in court. A lot of issues are rationalised on ground of faith, hence most victims don’t bother about courts as everything is attributed to God especially where death is involved.” Why some don’t sue Many are discouraged by a tedious legal system in which cases hardly end in court. Others are overwhelmed by a murderous system that leaves potential litigators confused as to whom to hold liable. For instance, a political analyst and social commentator Mr Jide Ojo found himself in such a situation. His sister, Mrs Tolulope Brimah, a mother of four, would have been 41 on August 15, 2016, but she was the victim of a failed health system. She took ill in 2016 and was admitted to the University College Hospital (UCH), Ibadan. After being diagnosed with a heart related ailment, she was placed on oxygen. But, she was weaned off the oxygen after about a week later. The family was asked to pay N3million for mitral valve replacement. They rallied to raise the money. But Mrs Brimah had to be stabilised before she could go through the procedure. She was in the process of being stabilised when UCH resident doctors embarked on a week’s warning strike around May 2016. “Since it was a warning strike and not indefinite strike, and since consultants as well as other medical staff were working, I did not expect in-patients to be forcefully discharged. “It was the forceful discharge of patients in critical conditions that led to my sister’s relapse and eventual death the following week at the Babcock University Teaching Hospital,” Ojo told The Nation. The manner of Mrs Brimah’s death could have been a subject of litigation, with possible multiple defendants, including demands for refunds and compensation. Despite the treatment being terminated due to strike, the family made full payment to the hospital, Ojo said. Ojo is not even sure of who to hold responsible had the family decided to seek compensation or legal remedies. He was also discouraged by a legal system that is full of obstacles. “There is no point seeking redress since my sister did not die in UCH. I am not even sure the Medical and Dental Council has been reconstituted by this administration. “The wheel of justice also grinds very slowly due to bureaucratic bottlenecks,” a clearly frustrated Ojo said. “My sister was murdered by the system.” As the Executive Director of Molluma Medico-Legal Centre at the House of Justice in Kaduna, whose work focus on accountability for medical malpractice and mass atrocities, Ms. Ballason Gloria Mabeiam has been involved in several medical negligence litigations. On why low rate of medical negligence litigations in Nigeria, she to The Nation: “There are many factors. First is there is low public enlightenment about the rights of patients. “Quite often patients do not know that they have the right to know what exactly the health practitioner is doing and that when things go wrong, they have a right to legal redress. “Second, the question of who to hold responsible is a challenge. Do you hold the laboratory technician for the wrong test results or the doctor for wrong diagnosis or the nurse for the wrong injection or pills? “So understanding causation is more than cause and effect. It involves proving that someone did or neglected to carry out a preventable act which led to injury or death of a patient” Mabeiam was also of the view that a person who suffered an injury may not want to take it up because they think the cost is high, coupled with the perception that justice may be delayed or denied. “To these, I often say the legal system must first be engaged before people can say for real that it doesn’t work. Too often the assumptions are sweeping,” Mabeiam said. Another major factor, she said, are beliefs. “Something goes wrong and instead of demanding accountability, some say: ‘It’s how God wanted it’ or ‘Let’s leave it to God.’ In actuality, God wills ill to no man and He has given man the right to call matters to account here on earth,” said Mabeiam. On challenges, the lawyer said they include patients reporting and sometimes refusing to follow through because they get emotionally exhausted from the slow grind of the judicial system. Also, doctors sometimes use the Hippocratic Oath to shield their colleagues by refusing to give information or evidence that will be useful in securing convictions or proving claims. The Centre found that quite a number of health practitioners make assumptions that have no medical or factual basis as far as diagnosis is concerned. “It’s typical to go to a hospital and instead of running tests the doctor just asks basic questions and rounds it up to malaria or typhoid. They rarely document the process. So, finding sufficient medical records to identify negligence or malpractice could be challenging,” she said. Proving medical malpractice The Molluma Medico-Legal Centre handled the case of State vs Sunday Oppah, which highlights the difficulty in proving medical negligence. Mr Sunday Oppah was said to have touted himself as a medical doctor. He claimed to be an oncologist and a field worker with the World Health Organisation (WHO). He ‘treated’ many cancer patients. By the time a complaint got to the Centre, Oppah had stopped a young lady battling breast cancer from receiving any other treatment from India, Ahmadu Bello University Teaching Hospital or the National Hospital because he claimed higher expertise. Oppah had also told the lady she could skip mastectomy and instead use a ‘new’ medical intervention he was employing on her. Tragically, the lady died. Oppah had also given a young man a wrong cancer diagnosis. The young man was fortunate because when the Centre intervened, another doctor ran a different test which showed he was cancer-free. The medication was discontinued, but there was quite some damage on the young man. The Centre got the Police to arrest Oppah. The case was prosecuted from Magistrate to the High court. The verdict? The court sentenced Oppah to two years imprisonment with an option of fine. The court claimed the state was unable to prove that Oppah had any intent/motive to kill and, therefore, the charge of homicide could not be sustained. “By the way, it was very difficult to get people to testify and give evidence. To my mind, where there is wanton disregard for a person’s safety resulting in death or injury, it should be sufficient to ground criminal convictions. “Where death results, even if motive cannot be proved but there is evidence that inextricably links and explains a death, then a case of negligent homicide should be found,” Mabeiam argued. To underscore the difficulty in proving medical negligence, a lawyer and partner at Cass Legal, Mr Adebajo Odutola, said his firm received a complaint from a patient who suffered a serious medical injury due to a doctor’s negligence. They interviewed 17 other doctors who all agreed that their colleague was negligent. However, none of the doctors agreed to testify in court should a suit be filed. Odutola said: “Our firm was retained by a woman who intends to sue her doctor for negligence. It remains one of the worst cases of medical negligence I have encountered. “The curious thing, however, is that none of those doctors (all 17 of them) agreed to testify as an expert witness. “They all bluntly refused, mumbling something about professional courtesy and their reluctance to ‘spoil someone else’s life’. “It is shameful that professionals continue to aid each other even where such professional has acted in a way that falls short of the standard expected of them.” A medical doctor, Ugonna Ajoku, gave an insight into why his colleagues would not testify. “I’m a medical doctor with a keen interest in medico-legal issues. I’m quite sure you won’t find a Nigerian doctor practicing in Nigeria who’ll agree to testify. “The testifier would be marked as a ‘snitch’ and after you’ve won your case as a happy lawyer, the doctor is made to face the hostilities within the practice…Your doctor will testify if there’s a way to keep him anonymous,” he said. He suggested a way out: “Find a way to keep your testifier anonymous or get someone who preferably isn’t Nigerian and doesn’t practice here.” Political will needed The government’s neglect of the health sector does not help matters. That the sector is poorly funded is no longer news. The rich prefer to go abroad for treatment. The Muhammadu Buhari administration dissolved the MDCN about three and half years ago. While it remained dissolved, the Medical and Dental Practitioners Disciplinary Tribunal (MDPDT) could not function. The board was only inaugurated in November 2018, after much damage had been done. Osanyin noted that the Council was reconstituted only after several bodies clamored for it, with the Nigerian Medical Association threatening strike. “The Medical and Dental Practitioners Disciplinary Tribunal (MDPDT) is saddled with the responsibility of sanctioning erring practitioners who have been indicted by the Medical and Dental Practitioners Investigative Panel after they have established a prima-facie case against the practitioner. “However, the tribunal doesn’t award compensation,” he said. Osayin believes that the delay in constituting the MDCN led to the emergence of what he called defensive medicine in Nigeria. “The major reason for this is that doctors who have pending cases at the investigative panel or disciplinary tribunal, in an attempt to avoid another reoccurrence of a petition, over-diagnose, over-investigate and exaggerate treatment of patients. “Do not forget that some of these cases have been left pending for four to five years. You can imagine a practitioner having such encumbrance for such a lengthy period of time. “Essentially, hospitals practice defensive medicine which invariably leads to high cost of medical treatment.” ‘Review Medical Act’ A prosecutor at the MDPDT, Mr Ahmed Adetola-Kazeem, called for an amendment of the Medical and Dental Practitioners Act to make the MDCN more professional. According to the Lagos lawyer, cases of medical negligence and medical malpractice have been on the rise and most do not get reported to the MDCN, which regulates the practice of medicine in Nigeria. “Even even when such cases are reported, justice is either delayed or totally denied due to the incessant dissolution of the Council at the beginning of every administration and failure to constitute it on time. “It took the present administration about three and half years to constitute the Council which have the powers to investigate and discipline erring medical and dental practitioners. “From my experience as a prosecutor before the MDPDT, many cases of medical negligence and professional misconduct have been abandoned half way at the MDPDT since the dissolution of the Council in 2015.” Despite the Council being constituted, Adetola-Kazeem said a lot of damage had been done. “It will be difficult if not impossible for the victims to get justice in 2019, when the tribunal will reconvene. Most witnesses would have lost interest in the cases or be absent at the trial due to travel, ill health, death or any other reason. Files might also not be found in some cases. “The cases will also have to start de-novo (afresh), thereby putting the victims in a very difficult situation of having to travel to Abuja where the sitting holds, irrespective of the stage where the matter was before the dissolution,” he said. He said the situation makes it easy for many doctors to keep engaging in unwholesome activities that lead to avoidable deaths. Calling for a review of the enabling law, Adetola-Kazeem said: “Sadly, many of the Council’s dissolutions have, at many times in the past, been engineered by some top officials of the Council who benefit from the dissolutions. “It is hoped that the Medical and Dental Practitioners Act will be reviewed so that the requirement of the President appointing the Chairman and some members of the Council will be removed and the Council can act like other professional regulatory bodies that don’t get dissolved by the political class but simply ran like a professional body that it is. “I sincerely hope that a time comes when victims of medical negligence are sure of getting justice and erring medical practitioners are equally sure of reaping the fruit of their negligence through warning, suspension, fines or having their names struck off the register of Medical and Dental Practitioners in Nigeria.” Endless litigations The slow wheel of justice is another factor that discourages patients who suffer injuries from seeking legal redress. For instance, trial started in October 2018 after almost a four-year delay in the case of Nabil Hanga, which was filed in 2014. The Estate of Nabil Hanga and the deceased’s father Mr Mustapher Hanga sued Royal Cross Medical Center Ltd, De Flight Medics Ltd, Olamide Orekunrin, Oyedele Jibayo and Olukunle Orekunrin at the Lagos State High Court, Igbosere. The claimants, who accused the defendants of causing Hanga’s death through negligence, are suing for N1.1 billion and are demanding a refund of $135,000 which they paid for the air ambulance. The claimants sought an order compelling Royal Cross Medical Center to pay them N300 million, being damages for loss of income and costs incurred in Hanga’s treatment. They are praying the court to order De Flight Medics and its management to pay them N500 million in general damages for emotional distress, financial and social disability caused by their alleged reckless behavior; N200million as aggravated damages; N100 million, being the cost of initiating and prosecuting the case, and 10 percent interest on the judgment sum until final liquidation. The late Hanga was a 26-year-old post-graduate student of Stamford University and a businessman. According to the family, the late Hanga went to Royal Cross Medical Center on May 10, 2012 for treatment. The claimants said he died “prematurely” on board the plane in which the second to fifth defendants were conveying him to the United Kingdom for further treatment. They alleged that his body “was eventually dumped at Kano where the family collected the corpse”. The claimants alleged that the hospital misdiagnosed the late Hanga and the doctor that treated him “erroneously allowed him to go home” when treatment had not been completed. According to them, his condition deteriorated overnight and he was rushed to another clinic for urgent medical attention, from where he was later transferred to another Lagos hospital, but he died on May 12, 2012. The family said Hanga would not have died had Royal Cross Medical Center not been allegedly negligent at first. The claimants, through their lawyer Mr Bruce Ighalo, said Royal Cross Medical Center “negligently failed to provide the medical treatments that Nabil Hanga required which he was at their facilities to receive.” The family said the deceased should have been admitted for follow-up procedure and tests rather than allowing him to go home on that occasion. On the hospital’s alleged negligence, the claimants said it was discovered that the late Hanga had blood in his urine. “The first defendant (Royal Cross Medical Center) failed to carry out urgent tests, investigations, and scans ordinarily necessary to establish the extent of damages and or illness that Nabil Hanga came to them for,” the claimants said. They further alleged that De Flight Medics, which was allegedly paid to fly the late Hanga to the United Kingdom, does not have or own an air ambulance and is not authorised to operate any but leases private passenger planes not designed as air ambulances “through which they extorted money from the claimants”. They alleged that the company was set up “to extort money from unsuspecting victims like the claimants who at desperate and precarious situations will usually not have enough time to make investigations before parting with money for their services”. The claimants said family members rallied to get foreign exchange within a short time and a total of $135,000.00 was paid at De Flight Medics office in Lagos in the early hours of May 11, 2012. The claimants averred that Hanga died about one and a half hours after the take-off of a De Flight Medics plane, which allegedly had to detour to Kano to dump the dead body with the family. The family said Olamide Orekunrin, a medical doctor at De Flight Medics, “is not a registered medical doctor in Nigeria”. “Though she was registered in the United Kingdom, she was subsequently suspended for misleading a hospital authority in the United Kingdom,” the claimants alleged. The claimants alleged: “The aircraft provided by the second to fifth defendants was in no way a medicalised air ambulance as it was not equipped for advance life support and did not have an interior that reflected this. “The aircraft ambulance did not have ventilators, medications, ECG and monitoring units, cardiopulmonary resuscitation (CPRA) equipment and stretcher. “The aircraft had no provision for drips/drips-stand, no convenience, no sockets to plug medical gadgets. We hereby plead the report prepared by Dr Shirley N. Amaechi…” But, Royal Cross Medical Centre, in its statement of defence, denied every allegation contained in the original statement of claim and urged the court to dismiss the claim with substantial cost. De Flight Medics denied the allegations, saying the late Hanga was already at a critical stage before being evacuated. It also denied the claim that its aircraft was not an ambulance, saying the plane was equipped with medical facilities. Olamide Orekunrin denied that she was not qualified to practice in Nigeria as a medical doctor, while the De-Flight Medics and management denied the extortion allegations, adding the claimants were not entitled to any refund. They urged the court to dismiss the suit. The trial will continue on February 6, but with appeals still likely to follow after defence and judgment, is there an end in sight? Another medical negligent case that is yet to make a headway in court is the one initiated in 2016 by an Abuja law firm, Abalaka and Co, on behalf Portia Sambo, the mother of late Sandra David. The estate of Portia Sambo sued the Federal Staff Hospital, Abuja for allegedly negligently causing the death of her daughter. The plaintiff is demanding a compensation of N500 million from the hospital for alleged ineptitude in the treatment of the late Miss David for correction of a complication in her gallbladder. The plaintiff accused the hospital of causing the late Miss David’s condition to deteriorate. The deceased, 29, who worked at the Bank of Agriculture, was in March diagnosed with gall bladder complications requiring surgical correction. She had asked for only a few days off work and went for treatment. The hospital denied the allegation of negligence. The suit, filed in 2016 at the Federal High Court in Abuja, is yet to be heard. When the case came up on November 15, it was further adjourned until next month due to docket congestion. Way forward Consumer Protection Council (CPC) Director-General Babatunde Irukera, speaking at an NBA Section on Business Law (SBL) conference on Medicine, Accountability and Law, called for holistic reforms and improvement of critical components of patient care, including infrastructure. “Can professional responsibility bridge the infrastructure and outcomes gap?” he wondered. Among others, he wants a code that defines standard of care. A pharmacist, Taiwo Dairo, said good medical practice also involves allied healthcare professionals, such as pharmacists, who he said must not supply to patients any drug or medicine likely to be abused and which may be detrimental to health, such as counterfeit medicine. A professor of surgery at the Benue State University, Shima Gyoh, said each doctor must recognise and accept their limits. General medical practitioners cannot do what specialists who deal in in-depth treatment of conditions can, he noted. Patients, he said, should participate fully in all major health decisions. He also wants a review of the law which provides that the Minister of Health can act when the MDCN does not exist. To him, this is wrong as the ministry cannot perform the functions of the medical tribunal. According to Gyoh, many medical practitioners go through training and start practicing without knowing anything about medical regulation, which he said “does not happen in the legal profession”. A medico-legal consultant, Dr Joel Akande, called for a review of some state laws that appear to be in conflict with federal laws. He added: “The critical issue affecting laws and medico-legal practice in Nigeria is enforcement. “Supremacy of the rule of law in general is subsumed and/or affected by customary issues, religion, ethnicity, poor access to justice, need for restructuring of the legal system for speedy, efficient, accessible and fair dispensation of justice; insurance structure and enforcement, and poverty and ignorance. “Also, we have an obsolete mental health law (a part of healthcare that accounts for 20 per cent). No effective medico-legal system can exist without addressing these issues,” he said. Adio called for better enforcement of existing laws, saying: “Section 303 of the Criminal Code provides for holding a medical practitioner criminally liable for acts constituting gross negligence.” Osayin, who is the convener, Nigerian Medical Law Summit, said as the “medical law malpractice industry” has come to stay, healthcare and legal professionals need to develop capacity in the area. He called for compulsory professional indemnity insurance for healthcare practitioners, as well as compulsory teaching of medical laws in all medical schools / colleges of medicine, as well as public enlightenment. Adeyanju, a lawyer with the Socio-Economic Rights and Accountability Project (SERAP), urged other civil society organisations to beam their searchlights on activities of health institutions and workers. “People are not aware that they have medical rights. SERAP and a few others are doing advocacy on medical rights and health sector reforms but others need to join. “More people should file cases even at the ECOWAS Court so that there will be more pronouncements to drive advocacy. We need more hands on deck. “The rights in Chapter 2 of the Constitution are now justiceable because the ECOWAS has pronounced on it, but there is limited jurisprudence on it. The African Charter on Human and Peoples Rights has been domesticated, as well as other international conventions that have been ratified, which make health rights justiceable. So it means anyone can go to court and enforce them,” she said. For Mabeiam, the chicken is coming home to roost. She said: “This year, there was the tragic case of a medical doctor who died due to medical malpractice. A hospital secretary also reported to our centre on the notorious situation of wrong or assumed tests. People just scribble down test results without checking a patients. “It is now becoming increasingly clear that stakeholders need to agree to take up the issue of accountability squarely as the victim could be anyone. We are some way off but we are glad that we are well into the journey. “I will call for more awareness about patient rights. This should be included in the primary documents a patient receives in the hospital. Knowing your rights enables you to ask questions and to keep track of the process. “We also call on the MDCN, who often say their mandate is to regulate medical practice not medical practitioners, to widen the scope of their mandate in order to accommodate both. “What needs to be done is to ensure that patients who do not have to die stay alive and when they are killed when they shouldn’t die, that we pull legal and medical resources to ensure accountability. “This will create a big win for everyone because quacks will be flushed out of the system so the real health practitioners can thrive, medical and health standards will be raised and lives will be saved.” Culled from Thenation]]>