SaharaReporters reports that a coroner’s inquest into the death of Mrs Adepeju Ugboma, a Lagos-based chef, has determined that her death was avoidable.
The inquest revealed that the chef died as a result of medical negligence.
The Coroner, Chief Magistrate Mukaila Fadeyi, gave the verdict on Thursday in Lagos.
In May 2021, SaharaReporters reported that #JusticeforPeju trended on Twitter as thousands of Nigerians called for an investigation into her death and for the prosecution of anyone found responsible.
The family revealed that Peju was admitted into the hospital on Thursday, April 22, as directed by the hospital, to carry out elective surgery for a fibroid issue.
A family source stated that she walked into the hospital by herself unaided as it was by no means an emergency surgical procedure.
The family added that she had concluded all the necessary tests required before the surgery, including ECG, PCV, and COVID-19 tests.
She died on April 25, 2021 after undergoing a hysterectomy (removal of the uterus) in a bid to remove fibroids.
The surgery was carried out on April 23, 2021, at the Premier Medical Centre in Lagos State.
Her family accused the private hospital of negligence, saying it led to her untimely death.
The Lagos State University Teaching Hospital, Ikeja, had carried out an independent autopsy on Peju which revealed that she suffered internal bleeding.
Ugboma was transferred to Evercare Hospital due to complications from the surgery but was pronounced dead shortly after.
However, the coroner said that the surgery lacked due diligence on the part of the physicians who performed it, the News Agency of Nigeria reports.
According to him, an autopsy revealed that the deceased died from massive inter-abdominal bleeding, as 500ml of blood and 900ml of clotted blood were found in her abdomen.
Fadeyi said that the deceased’s medical history was poorly documented and that doctors of Premier Medical Centre failed to involve appropriate surgeons.
According to him, the absence of vital machines and the unwillingness of the doctors to address the issues immediately after surgery were questionable.
The coroner noted that the deceased was a wife and a dutiful mother whose dreams of a great future with her family were cut short.
He recommended that the code of ethics for medical practitioners should be tightly reviewed, adding that relevant agencies should do more sensitisation for members of the public to know their rights.
“State governments should not limit funds to state-owned hospitals but extend funding to private hospitals.
“Government and medical regulators should ensure that the standards by World Health Organisation for Packed-Cell Volume (PCV) of 38 per cent before any surgical operation should be maintained,” he added.
But the coroner said he could not award damages as requested by counsel for the Ugboma family, noting that he only carried out an inquest.
Fadeyi commended the widower of the deceased, Mr Ijeoma Ugboma, and his family for seeking the truth.
Reacting to the verdict, the counsel, Mr Babatunde Ogungbami, said: “The dead is gone and will have to rest in perfect peace but I love the doggedness of the husband to seek the truth, to seek a closure.
“He decided to see through, and today it becomes very clear that we really need to pay particular attention to medical services in Nigeria.
“Clearly, this has been confirmed as medical negligence.
“The woman died leaving her children, and she paid a lot to get the best medical services yet, what happened?
‘Government has to come up and look to see how to rejig the system.”
NAN reports that a pathologist, Dr Olugbenga Oluwole, in 2021 testified that there was an ‘abnormal’ massive collection of blood in the deceased’s abdominal cavity.
Sometime in November 2021, the Medical and Dental Practitioners Council of Nigeria indicted three doctors at Premier Specialist Hospital, Lagos, with regard to the death of Ugboma.
The doctors are Akiseku Kazeem, Kelechi Renner and Motunrayo Amadu.
The indictment followed a petition by Mr Ijeoma Ugboma.
A family source had said, “Her vitals were okay and she had no preexisting conditions prior to surgery. All payments were made for the preliminary tests. The hospital demanded their account be funded to the tune of N1.5million and the family deposited N1million immediately.
“The surgery was carried out on the morning of Friday, 23 April, by Doctors Akinsiku, lwuh, Asemota, Renner, and some other medical personnel in Premier Specialist Hospital, Victoria Island."
Peju’s husband saw her after the surgery on Friday, and she complained about severe abdominal pain and discomfort, which he felt was not unusual for someone who had just come out of surgery.
“However, her blood pressure had dropped to as low as the range of 50/30. The doctors then gave her blood transfusion because she had lost a lot of blood during the surgery.
“Early on Saturday morning, she told her husband that the veins on her hands had collapsed and the hospital wanted to give her fluids on a vein close to her neck and collarbone. She also mentioned that the doctors said her kidneys were not functioning optimally, and a consultant nephrologist had been called in to come in that Saturday morning. This was a shock to them both as all tests prior to surgery were fine. The consultant eventually came in as scheduled but dismissed both their concerns.”
The family said Dr. Renner told the husband that they would need to move the woman to the ICU and they were asked to pay an additional N.5 million which they paid without delay.
The source continued, “By 6.30 am on Sunday, her husband was surprised to find out that his wife had been placed on a respirator. Dr Renner told him that her condition had deteriorated through the night. Her husband saw that she looked pale, and her eyes had been taped as if to keep them closed, but she was still breathing and the monitors were still reading. Peju’s husband had been in touch with a family friend who is a UK-based consultant gynaecologist. The consultant raised an alarm and insisted on speaking with the doctors at Premier hospital. He spoke with Dr. Asemota, Iwuh and the medical director, Dr Oshinowo.
“He stated expressly that he was of the opinion that she had severe internal bleeding and needed to be moved back to the operating theatre for the bleeding to be arrested immediately. Premier team however ignored his advice.
“Premier decided to move Peju to a hospital where she could have a CT Scan and possible dialysis. By 10 am on Sunday, her husband was informed that his wife would be moved to Evercare Hospital, Lekki Phase 1. However, it took 3 hours before she was moved to Evercare. Immediately she arrived there she was met by their medical team and taken to the ICU. Her husband was asked to pay another N.5 million at Evercare, and he made the payment immediately.
“The head of the ICU detected that Peju did not have a pulse and emergency CPR commenced immediately. This failed and she was pronounced dead by 2.20pm on Sunday. Premier Specialist Hospital offered to do an autopsy, however, the family insisted on an independent autopsy."