By Sola Ogundipe, Chioma Obinna & Gabriel Olawale
No negligence on our part – LUTH Management
THE management of Lagos University Teaching Hospital, LUTH, has denied the allegation of negligence in the death of one of its patients, Mrs Ngozi Udebu, who was admitted to the hospital three weeks ago, but the widower, Ausbet Udebu, insisted that LUTH’s response clearly showed that his wife was suffocated to death.

Udebu who vowed to begin a medical revolution said the hospital’s personnel were never in the know  when his wife passed on.

Late Mrs. Ngozi Udebu

In a statement made available to Vanguard by LUTH Management, the hospital explained that the report of the independent panel it set up to look into the circumstances of the patient’s death didn’t find any doctor or nurse culpable of neglect.

The statement, entitled: “Response to the Death of Mrs Ngozi Udebu”, noted that the panel comprising senior medical personnel from three different departments, established that during the period of the deceased’s admission and after her demise, no report of poor treatment or negligence was brought to the notice of the managing team or LUTH management.

In setting the records straight, the statement read: “We have deliberately restrained ourselves from responding earlier because a detailed investigation was underway and it would have been premature to comment before the final outcome.

Effects of  inflammation

“Mrs Ngozi Udebu was a patient in our hospital, having been admitted on March  26, 2016, and died about 51 hours later. She was afflicted with abdominal pain from her monthly menstrual periods shortly after 40 days of religious fasting. She had taken an overdose of Piroxicam (50mg thrice daily for two days) a non-steroidal anti-inflammatory pain killer, which is known to be associated with side effects of inflammation or ulceration of the stomach, even at a regular dose. She was admitted, seen by the medical team, including an experienced consultant physician.

“She was commenced on medications for peptic ulcers or dyspepsia after ultrasound scans and other tests. She was admitted to the medical wards within 24 hrs of presentation and monitored by the medical personnel (doctors and nurses). A few hours to her demise, she started to have difficulty in breathing, and was commenced on oxygen therapy which she continued to have till her demise. While making the rounds to see how the patients fared in the night, the nurse on duty noticed the patient had stopped breathing and attempts to resuscitate her failed.

“There was no distress call by the patient, other patients or any other person around her in the ward prior to her sudden death. In view of the strange and sudden death of our patient, the managing team immediately requested for an autopsy to unravel the immediate and remote causes of her demise as it’s the standard practice in such cases of unusual death. This autopsy was prompted by LUTH. The autopsy preliminary report demonstrated evidence of asphyxia, though no foreign body or evidence of strangulation was found.

Evidence of  strangulation

Further specialised histology report obtained later confirmed fluid in the terminal air passages which support aspiration of food, fluids or secretions. The stomach was inflamed but not actively bleeding or perforated which is not surprising, considering that she was already on anti peptic ulcer therapy. “We can understand why the layman may be confounded by the apparent disparity of the admitting diagnosis and the final pathological diagnosis. The pathological diagnosis confirmed the actual and final cause of death as the ulcers were already healing.”

Giving a reconstruction of the events leading to the patient’s demise, LUTH management said: “A known patient with dysmenorrhoea who was fasting took an overdose of non steroidal anti inflammatory drugs, the analgesics suppressed the menstrual pain but damaged the stomach leading to excruciating pain in the abdomen which brought her to LUTH. “Our doctors correctly diagnosed gastritis promptly and gave appropriate treatment. Ulcers do not show up on ultrasound scans, explaining the negative ultrasound scan findings. The pains started to abate by the second day.

“However, on the day of demise, while the patient was asleep late at night, she most probably aspirated food,(sucking food into the airway) throat secretions or water leading to bronchospasm, (abnormal contraction of the smooth muscle of the bronchi) and respiratory distress which rapidly culminated in her death. She was found dead and all attempts to revive her failed. Nothing the doctors or nurses did or didn’t do could be described as the cause of death. Alternatively, she could have suffered an idiosyncratic reaction (rare, unusual and bizarre reaction) to any of the medications she took before or during her admission to the hospital. This is not describable as negligence and no one could have known or prevented it.

“Autopsy preliminary report demonstrated evidence of asphyxia, though no foreign body or evidence of strangulation was found. Further specialised histology report obtained later confirmed fluid in the terminal air passages which support aspiration of food, fluids or secretions. The stomach was inflamed but not actively bleeding or perforated which is not surprising, considering that she was already on anti peptic ulcer therapy.”

Deceased’s husband reacts:

In a quick reaction, the deceased’s husband, Mr. Ausbeth Udebu, dismissed LUTH’s response, insisting that the report of the investigative panel clearly showed that his wife suffocated to death.

In a telephone reaction with Vanguard, Udebu who called for immediate review of the policy that patient’s relatives must not sleep over said it was further clear to him that that they only discovered his wife’s  death while on Ward rounds. “I didn’t expect anything less, because I know they would want to come out with something to exonerate them, but at the end I can see that they have answered the questions I even wanted to ask. They have been able to tell me that my wife died without them knowing at the point she died.

“It is clear to me that she suffocated to death, because there was nobody on ground monitoring the oxygen they put on her. If you put a patient on oxygen somebody should be kept to monitor it to see the progress of the whole thing. When I came the next day and meet the lifeless body of my wife, I confronted the nurse that was on night duty the nurse brought out the oxygen and told me that they have to change the oxygen because they discovered that it was not working. I remember asking her, at what point did you realise that the oxygen kit was no longer working, but she was unable to give me an accurate answer.

“With this response, it was clear to me that they saw her dead when they are going for Ward round, who are they trying to deceive? It is now clear to me that negligence was actually what leads to my wife death. It is now become clearer to me that assuming I was with my wife at that ward, she wouldn’t have died,” he added.

He said the policy that the patient’s relatives must not be there should be expunged, querying, “The private ward in that LUTH where people paid more, they allow patient relation to stay with them. But in a ward where only two nurses attend to 35 patients, they said relatives are not allowed.

“My campaign is that medical revolution must start with the death of my wife because they cannot continue to kill people the way they are doing now.

“They claimed in their report that a Consultant attended to my wife that is a pure lie, because no single consultant saw my wife. It is only the student doctors that wearing white came and aside two senior doctors that came during ward rounds. No single experienced hand was there to look at my wife,” he argued.

Medical revolution

On the allegation that he failed to appear before the LUTH committee, Udebu said he was sent a text message and not an invitation which he argued could come from anybody. “I was invited by a text message, is that a way they suppose to handle a case of this nature?  First, I don’t know who was sending the text message, on the second thought; if they really wanted to invite me they should have written a letter with LUTH letter head paper and not a text message. My address was on our document at LUTH,” he explained.

 On allegation of overdose,  Udebu said his wife never took an overdose. “I only told them she was in her menstrual period and took a painkiller and not overdose. What did they mean by overdose? Just because they did not take necessary precaution to ensure her life was saved they are now talking about overdose. You could imagine how many hours I waited, running from pillar to post, going outside to find drugs, coming back and having to wait for them till they came for Ward rounds. Common Gascol I had to find it outside.

“They have turned LUTH to where they kill people. I have received up to 2,000 calls from people that have lost their loved ones in LUTH due to their staff negligence. Life does not mean anything to them; the consultants want people to come to their private hospitals to get good medical attention,” he noted.

Further, he said: “Court is my last option. My option is to make enough noise in this country to start medical revolution because we must change how things are done in hospitals. The doctors should explain the treatment procedure to relatives of patients.  Here, they just write a full page without explaining anything.

“Medical science has gone to a stage whatever they are doing, patients’ relatives must be carried along. In some advanced countries, patient’s relatives are allowed in operating rooms to see what is happening.  For the fact that they don’t have a camera to capture what happened in the wards is unacceptable in this modern age and only two nurses are attending to over 35 patients.”