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MEDICAL MALPRACTICE
AND
NEGLIGENCE
DR OCHIGBO EZEKIEL
Consultant Obstetrician / Gynaecologist
FMC, Makurdi.
OUTLINES
• INTRODUCTION
• TYPES OF MALPRACTICE
• MEDICAL NEGLIGENCE
• ACTS THAT AMOUNT TO MEDICAL NEGLIGENCE
• EXAMPLES OF MEDICAL MALPRACTICE SUITS
• TIPS FOR AVOIDING LIABILITY
• CONCLUSION
• RECOMMENDATIONS
NEWSPAPER HEADLINES !!!
• 10 erring pharmacists face disciplinary tribunal – Daily Trust, 22
Feb 2023
• Tribunal sacks 3 doctors, suspends 12 in 3years – Punch, 17
June 2022.
• Quack doctor removes ovaries of teenager during appendix
surgery in Benue, victim may never bear a child – Sahara
Reporters, 3 Feb 2022.
• NBA AGC 2019 – Medical Negligence: Time to change the
narrative
INTRODUCTION
• Public awareness towards medical
malpractice/negligence is on the increase
• Increased use of technology
• Patients are becoming aware of their rights

(Patients’ bill of rights)
INTRODUCTION
• Medical profession is one of the noblest professions,
still vulnerable to negligence which at times leads to
death
• No one wants to be negligent. Ignorance is not an

excuse.
• It is not only medical doctors that are liable to

negligence.
MEDICAL MALPRACTICE
• The defect in a way a doctor / health worker

behaves professionally.
• Medical malpractice is carelessness, wrong or

illegal behaviour while engaged in professional
medical practice.
TYPES OF MALPRACTICE
• Negligence
• Assault and battery
• Fee splitting
• Itinerant surgery
TYPES OF MALPRACTICE
• Advertising
• Invasion of privacy
• Abuse of death certificate / medical report
• False imprisonment (kidnapping)

ASSAULT AND BATTERY
• Failure to obtain
consent resulting in
assault and battery
e.g. a doctor
removing testicles
during hernia
operation.
FEE SPLITTING
• Payment of a commission to the referrer with the
express intention of ensuring that the referring
doctor/health worker directs referrals of patients to
the payee.
• It is unethical.
• It represents conflicts of interest.
Itinerant Surgery
• When a hospital doctor operates on a

patient away from the hospital.
Invasion of privacy
• A doctor / health worker must not release
information without consent of patient.
• Confidentiality is one of the core tenets of medical
practice.
• Keep all information between you and your
patients private.
Abuse of death certificate / medical
report
• This is a serious professional misconduct which if

proved may result in the doctor's name being
removed from the medical register including criminal
charges against the doctor.
MEDICAL NEGLIGENCE
DEFINITION
•The omission to do what a reasonable medical
practitioner would do, or doing something
which a prudent and reasonable medical
practitioner would refrain from doing.
MEDICAL NEGLIGENCE
• Negligence is the failure to exercise that care which
the circumstances demand.
• Medical negligence is a failure to reach the requisite
professional standards in the treatment of a patient
either by omission or commission as a result of which
some harm or damage is caused to the patient.
The 3 Elements to Negligence
• A duty of care owed by the health giver to the patient.
• Breach of the duty by the health giver
• Damage or injury to the patient resulting from the

breach
What is duty of care?
• A legal obligation which is imposed on a

professional, requiring that they adhere to a
standard of reasonable care while performing
any acts that could foresee-ably harm others.
Sanctions
Professional bodies
• MDCN - Medical and Dental Council of Nigeria.
• PCN - Pharmacy Council of Nigeria.
• NMCN –Nursing and Midwifery Council of Nigeria.
• MLSCN - Medical Laboratory Science Council of Nigeria.
• Physiotherapy Council of Nigeria.
• CHPRBN – Community Health Practitioners Registration Board of Nigeria.
• HRORBN – Health Records Registration Board of Nigeria, etc.

Sanctions
• Courts - pay compensation
• Criminal prosecution of Health Care Practitioner by

the state prosecutor.
• They have status of High Court - medical court

Sanctions
• Sanctions against Doctors by the tribunal
• Striking off the doctor's name from the register
• Suspension - not exceeding 6 months
• Admonition of the doctor.
• Medical quackery is on the increase, yet everyone is

Types of acts that amount to
medical negligence
• Failure to attend promptly to a patient requiring
urgent attention when the practitioner was in a
position to do so
• Manifesting incompetence in the assessment of a
patient / making incorrect diagnoses regardless of
obvious features.
medical negligence
• Failure to advise or giving wrong advice to a
patient on the risk involved in operation or
treatment especially if it will result in side effects
like deformity or loss of organ.
• Making mistakes in treatment eg. Amputation of

wrong limb, prescribing wrong drug
medical negligence
• Abandonment of foreign objects in patients
• Failure to refer a patient in good time, when such

referral or transfer is necessary - know your limit
and limitation of the health facility where you
practice.
medical negligence
• Failure to do anything that ought reasonably to have been
done under any circumstance for the good of the patient
• Failure to see the patient as often as his medical condition

warrants or make appropriate comments in the case notes
of the practitioner's observations and prescribed
treatment during such visits.
medical negligence
• Failure to communicate with the patient or his relatives
as may be necessary with regards to any development,
progress or prognosis in the patient’s condition.
• Failure to do anything that ought reasonably to have

been done under any circumstance for the good of the
patient.
medical negligence
• Failure to keep proper records
• Failure to obtain consent
• To sufficiently deny Negligence, you need
proper medical records!!!
• PRESERVE YOUR RECORDS!!!
Examples of Medical Malpractice
Suits
• Failure to diagnose or misdiagnosis.
• Administering wrong medication to patients
• Failure to monitor and assess a patient's
condition
• Child birth injuries
Suits
• Injuries to a patient with medical equipment

• Misinterpreting or ignoring laboratory results
• Surgical errors or wrong site surgery
• Improper medication or dosage
Suits
• Poor follow up or after care
• Disregarding or not taking appropriate patient
history
• Failure to order proper testing
• Failure to recognize symptoms
TIPS FOR AVOIDING LIABILITY
• Make a favourable first impression
• Establish your baseline (know your patient)
• Be aware of your own strengths and weaknesses
• Delegate carefully and legally
• Administer drugs carefully
• Maintain rapport with patients
• Think before you speak
• Document care accurately
• Comply with laws about advanced directives
• Adhere to your facility policies
• Keep up to date in changes in policies
• Provide a safe environment.
Conclusion
• Nigerian patients have become aware of their
rights and are willing to assert these rights.
• Patients could easily become litigious particularly
with prospect of monetary compensation.
• There are so many petitions and litigations
against doctors and other health workers
Conclusion
• Patients are becoming enlightened and aware of
their rights - patient bill of rights.
• Consultants, supervising doctors, hospital
administrators, etc will always be called to question
when allegations of Negligence are made against
any of their subordinates.
Recommendations
•Periodic medico-legal trainings
•MEDICAL LAW IS VERY WIDE !!!

Recommendations
• Apprise yourself in relevant areas such as doctor
patient relationship, confidentiality, consent and
informed consent to treatment, Jehovah's
witnesses, gunshot victims, euthanasia, ART, etc.
Recommendations
• Need for professional indemnity insurance for
healthcare practitioners from any licensed
insurance company.
THANK YOU
FOR
YOUR AUDIENCE

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MEDICAL MALPRACTICE

• Increased use of technology

• Patients are becoming aware of their rights

• No one wants to be negligent. Ignorance is not an

• It is not only medical doctors that are liable to

• The defect in a way a doctor / health worker

• Medical malpractice is carelessness, wrong or

• Assault and battery

• Abuse of death certificate / medical report

• False imprisonment (kidnapping)

• When a hospital doctor operates on a

• This is a serious professional misconduct which if

• Breach of the duty by the health giver

• Damage or injury to the patient resulting from the

• A legal obligation which is imposed on a

• PCN - Pharmacy Council of Nigeria.

• NMCN –Nursing and Midwifery Council of Nigeria.

• MLSCN - Medical Laboratory Science Council of Nigeria.

• Physiotherapy Council of Nigeria.

• CHPRBN – Community Health Practitioners Registration Board of Nigeria.

• HRORBN – Health Records Registration Board of Nigeria, etc.

• Criminal prosecution of Health Care Practitioner by

• They have status of High Court - medical court

• Striking off the doctor's name from the register

• Suspension - not exceeding 6 months

• Admonition of the doctor.

• Medical quackery is on the increase, yet everyone is

• Making mistakes in treatment eg. Amputation of

• Failure to refer a patient in good time, when such

• Failure to see the patient as often as his medical condition

• Failure to do anything that ought reasonably to have

• Injuries to a patient with medical equipment

•Periodic medico-legal trainings

•MEDICAL LAW IS VERY WIDE !!!

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