Sunday 26 August 2018

How Lagos Hospital Injected Patient With ‘Formalin’ During Surgery, Crippling Her

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May 30, 2017, was supposed to be the start of a new beginning in her marriage. Weeks earlier Christina Ohunyan, 40, had been diagnosed of myomectomy, commonly known as fibroid.
Doctors had told her that a tumour growing in her uterus was the reason she had not been pregnant four years after she got married to John.
As she walked into the operating theatre of the Orile-Agege General Hospital, in Lagos that Tuesday afternoon, she was also trying to balance a mixture of emotions.
Though she was happy that she would finally be rid of a malignant growth that had stood between her and the joy of motherhood, like many patients going under the knife, she was scared that something may go wrong. A devout Christian, Mrs Ohunyan said a quiet prayer that everything should go as planned.
That prayer was not answered.

After asking routine questions about her medical history, a doctor at the hospital handed her a consent form to sign.
Minutes later she was lying on a bed in an operating theatre with about six medical operatives arranging surgical knives and arranging other equipment in preparation for the surgery. Moments later, a lady, who was later confirmed to be an anaesthetist approached her with an injection and inserted it around her lumbar spine.
Immediately the fluid in the injection was pumped into her she started feeling a burning sensation around her lower limbs. The sensation was unbearable, and she was yelling so loud that the anaesthetist had to quickly discontinue the procedure.
“The injection they gave me, after they administered it, I started feeling a peppery sensation and I was shouting. They asked what was the problem? I said I could no longer feel my legs. The peppery sensation was so much, that they said they could no longer continue with the surgery,” she said in her near-whisper voice.
By the time she was wheeled back to the ward, she discovered she could no longer feel her lower limbs. Doctors encouraged her to lay still hoping that after some hours the effect of the injection would wear out.
She was also told that the surgery had been rescheduled for two weeks later but when she woke the next day she discovered she had become paralysed from the waist down. The surgery to remove the myectomy was never done.
She later discovered that she had urinary or faecal incontinence – the inability to voluntarily control urination and defecation. She now permanently wears adult diapers.
Mrs Ohunyan said since the incident happened, several top officials of the Lagos State Ministry of Health, including the commissioner, Jide Idris, have visited her but nobody has told her or her husband what really happened in the operating theatre that afternoon and how she became paralysed.
“They were just telling me there is no problem that everything would be all right,” the woman told PREMIUM TIMES.
Despite assurances from the hospital and officials of the Lagos State Ministry of Health, her condition has only minimally improved – more than 15 months after the botched surgery, Mrs Ohunyan is still mostly confined to her narrow bed in a ward with 10 other patients at the hospital.
After months of physiotherapy at the Lagos State University (LASUTH) she has managed to regain partial use of her lower limbs – she can now sit and can move around with the help of elbow crutches.
“Injected With Formalin”
While the hospital and state government continue to keep the couple in the dark about what happened on May 30, 2017, and how she immediately became paralysed after being injected, PREMIUM TIMES has been reliably informed by sources knowledgeable of the incident that Mr Ohunyan may have been injected with a fake anaesthesia, which ruined her pelvic floor.
Pelvic floor is a layer of muscles that supports the pelvic organs. The Continence Foundation of Australia says the pelvic organs are the bladder and bowel in men, and bladder, bowel and uterus in women.
“Weakened pelvic floor muscles mean the internal organs are not fully supported and you may have difficulty controlling the release of urine, faeces or flatus (wind),” the CFA explained.
One of our sources, a former medical practitioner at a Lagos State-owned hospital, who asked not to be named for fear of being victimised by the government, said after the botched surgery, the state Ministry of Health carried out an internal investigation and the outcome of the enquiry revealed that the medical director of the hospital at the time, Aduke Odutayo, was reportedly purchasing medication for the hospital through unregulated drug vendors.
“The medical director, Dr. Odutayo usually skips procurement process to go buy drugs herself from Idumota. It turns out that her purchases have ruined a patient,” the source said.
The source said a toxicology test was conducted on the anaesthesia administered on Mrs Ohunyan and when the result came out it revealed that instead of Lidocaine, which was the prescribed anaesthesia, the substance in the injection vials was formalin.
Formalin is a liquid solution of formaldehyde, a gas used in pathology for embalming dead bodies. A mixture of the formalin with methanol and other substances is used to temporarily preserve a dead body.
A 2016 study by Tasnim Masmoudi et al of the Department of Legal Medicine, and the Department of Hospital Hygiene of University Hospital Centre Farhat Hached, Sousse, Tunisia, published in the Pan African Medical Journal said the injection of formalin can result in cell lysis and tissue necrosis.
The medical dictionary defines cell lysis as the “destruction or decomposition, as of a cell or other substance, under influence of a specific agent”.
“In view of its widespread use, exposure to formaldehyde is significant for human health because of its acute and chronic toxicity,” the study noted.
“Cover Up”
The source said that after the investigation, officials of the hospital found culpable were not properly punished for their role in the botched surgery, instead, the Health Service Commission and the Ministry of Health demoted some, others were hurriedly transferred from the hospital.
The source alleged that the first decision taken by the hospital and the State Ministry of Health was not to disclose what actually happened to Mrs Ohunyan and her husband.
“The cover up has been massive. Pages from her records are missing,” the source said.
“Dr Odutayo has been transferred to Randle (Randle General Hospital Surulere), and the doctors who administered the drug as well and most of the nurses who attended to her during the surgery have been transferred.”
Many medical practitioners working at state-own hospitals were shocked by the incident and how the state government has handled it so far but have been talking about it in hushed tones.
Fifteen months after the botched surgery, the Ohunyans told PREMIUM TIMES the hospital’s management and the Lagos State Ministry of Health have refused to tell them what happened to Christiana on the day of the surgery, despite several direct requests and multiple letters from their lawyer for details.
“We have no information about the stage she is and what needed to be done. If I don’t go to meet the medical director to ask what is going on, nobody tells me anything. Even when I go, he just tells me, ‘we are working on it. You can see she is going to physio(therapy).’ But what is the next step? What is being done? Nobody tells you anything,” said Mr Ohunyan.
“We actually requested for a report, but the hospital has not given us a report. All we just know is that she has issues with her limbs and the pelvic floor. But we still do not know what happened. I learnt that they took the sample of the injection for test but the result of the test, we don’t even know,” he added.
Shoddy Treatment
Mrs Ohunyan also suggested that the entire process of the surgery was handled unprofessionally. She said despite informing her that surgery would be conducted several days before, the doctors did not even take a decision on what kind of anaesthesia would be administered on her until she entered the operating theatre.
She said she was not told of risk of spinal anaesthesia or told of alternative options available before the anaesthesia was administered.
“It was just before the surgery while I was in the operating room that they started debating among themselves that ‘what do we give her?’ Do we give her GA (general anaesthesia) or spinal anaesthesia? Majority of them agreed that they should give me spinal anaesthesia.
“They were about seven or eight personnel in the theatre. After they made the decision they didn’t tell me the risk involved in spinal anaesthesia. Nobody asked me for consent before the anaesthesia was administered or explained the process of the spinal anaesthesia to me,” she said.
The Ohunyans further told PREMIUM TIMES that the quality of the treatment she has been receiving after the botched surgery has left much to be desired. They said for about a month after the incident, the hospital management did not bring in a specialist to assess her condition and made them pay for necessary tests and drugs.
“After what happened, they wrote out some tests that I should do, they asked us to pay,” Mrs Ohunyan said.
“We were paying for the tests we were doing. We were even buying drugs. But after a while, some of the doctors assisted. There was a particular drug that was sold for N40,000 a dose we bought that as well. Even the diaper, we were the ones buying them,” she added.
She, however, said the hospital only started providing diapers and some basic drugs after it received a letter from her lawyer.
The Ohunyans said the hospital has been doing the barest minimum since then. They also said perhaps if the hospital had started treatment immediately after the botched surgery, her condition would have been better.
She said originally the hospital management had no idea how to treat her condition and a specialist was only invited more than a month after the incident.
The management of the hospital only invited a specialist to look at her after two months, she added. Before then, doctors (non-specialists) in the hospital tried to treat her themselves and at a point were feeding her an overdose of a certain drug.
“Before they invited a neurologist, we later realised that the drugs that we were buying were all the same composition, but their names were different. It was when a neurologist came that he pointed out that the drugs I was taking were basically the same but have different brand names,” Mrs Ohunyan said.
She said the neurologist who pointed out the mistake in prescription was not even provided by the hospital or the Lagos State government.
“The doctor was the one that now said that, because it wasn’t official he couldn’t write out the test for me, if I can afford it, he would suggest that I go for MRI scan.
“I think after two months, they invited another one. So, since August last year they haven’t brought in a neurologist to examine me. They later brought another doctor from Igbobi (National Orthopaedic Hospital Igbobi, Lagos) who told them to get me a water bed to prevent bedsore and he also wrote some drugs.”
Mr Ohunyan said he feared his wife’s medical records were being tampered with. He said the hospital once wrote a ‘false report’ on her condition.
“In fact, from one report they gave, they said her pelvic floor is okay. How can her pelvic floor be okay whereas she is still on adult diapers and cannot control her bowel flow?” he said.
Mrs Ohunyan said sometimes in June 2017, the hospital management started taking her for physiotherapy sessions, thrice a week, at LASUTH.
Months after she can now sit and manages to move around with the help of elbow crutches. But she said the incontinence has not shown any sign of improvement.
She also said the management of the Orile-Agege General Hospital and the Lagos State government have refused to carry out tests recommended by doctors at LASUTH.
“The neurologists sent a report in June (this year). I have not heard anything about their recommendations from the hospital. Over there at LASUTH, they kept asking me what was happening as they have not heard from them here (Orile-Agege Hospital) maybe there are some payment they need to make, and this hospital needs to respond to the report they sent to them.”
She said that it was not the first time the hospital had refused to act on the recommendation of doctors at LASUTH.
“In January they (doctors from LASUTH) sent a report here and there was no response. They even sent some delegates to come here and ask them what was the next step? They (the management of Orile-Agege General Hospital) told them they have written reports and they haven’t heard from them (The State Ministry of Health),” she said.
Mr Ohunyan said he has lost hope that his wife would ever get the quality of treatment she requires at the Orile-Agege General Hospital.
“I think they can do more than they are doing. To me, they are not treating her. Right now, the doctors are not even attending to her. She is just there. Apart from the physio, the doctors are not giving her a particular drug or special treatment. If not for the pelvic floor issue, I would have said we should go home. I can continue the physio at home. The doctors here don’t even know what to do. They don’t even know what they are doing.”
“The government should take her to where she can get better treatment. If they would have to take her out of the country, I don’t mind. If they would have to take another hospital, LASUTH, anywhere she can get better treatment, I don’t mind. They are not doing anything for her here,” he said.
Lawyer’s Fruitless Intervention
Weeks after the botched surgery, the Ohunyans contacted a lawyer who wrote multiple letters to the Lagos State government but only received one terse response from the management of the Orile-Agege general Hospital.
When this reporter visited the lawyer, Ibukun Ajomo, at his Anthony Village office in Lagos, he could not hide his anger at how the state government was treated the Ohunyans.
He said he has become increasingly frustrated by the government’s blatant disregard of his requests for a report at what happened to Mrs Ohunyan.
Mr Ajomo added that if the state continued to ignore his request of full disclosure of what happened during the surgery, he might be forced to approach a court of law to seek redress for irreparable bodily harm done to his client.
In his first letter written on June 29, 2017, exactly a month after the botched surgery, Mr Ajomo demanded a full medical report detailing the physical state of Mrs Ohunyan prior to the administering of the Lidocaine, the risks involved in the administering Lidocaine and whether the risks were conveyed to Mrs Ohunyan, and the methodology used in administering the Lidocaine.
He also asked to know if alternatives to administering Lidocaine were offered to his client and why the method was preferred over the alternatives, an assessment of Mrs Ohunyan’s present condition and the cause of her condition and a prognosis and recommended future treatment.
The letter, however, did not say anything about Mrs Ohunyan’s incontinence.
On July 7, 2017, Mrs Odutayo sent a terse response to Mr Ajomo without addressing any of the requests demanded in his letter.
“This is to acknowledge the receipt of your letter received 30th June 2017 at 6:00 pm. And to inform you that the issues raised concerning the above client are being looked into.”
Mr Ajomo said the Ministry of Health did not respond to his letter.
When asked why the lawyer did not mention his wife’s incontinence in his original letter, Mr Ohunyan explained that at the time the letter was written, his wife was still paralysed and bedridden.
“We thought she was defecating on herself because she was then paralysed from the waist down and couldn’t leave the bed. It about two months later, when she regained some movement of her limbs that she complained that she could no longer control the movement of her bowel.”
On August 28, 2017, Mr Ajomo wrote a remainder to the hospital and the state’s Ministry of Health repeating his request for information of what happened during the botched surgery.
“In the event, we can only presume that the severe injury to our client was occasioned maliciously or by reason of gross negligence on the part of the hospital and its functionalities.
“Also, since this catastrophic incident, we are not satisfied with the overall treatment of our client. She has not been told anything of her condition or prospects and is constrained to purchase diapers at her own cost, having lost feeling in her sacral nerves,” he wrote.
He said neither the hospital management and nor the Ministry of health responded to his letter.
On May 22, he wrote yet another letter acknowledging that his client can now “move slowly and painfully with the aid of crutches” after undergoing physiotherapy.
“It is however of grave concern to us that our client still has no feeling in her sacral nerves and is therefore condemned to using diapers.
“We would urge that alternative and tested methods be used to address our client’s pelvic problem. Even if it means resort to expertise and equipment outside the Lagos State system,” he added.
Evasive, Unconvincing
When contacted for details of what happened, Lagos State Commissioner of Health, Jide Idris, told PREMIUM TIMES he could not reveal details of what happened to Mrs Ohunyan.
“Due to doctor-patient confidentiality I cannot tell you what happened,” Mr Idris said during an interview with this reporter in his office.
He, however, claimed that the Ohunyans had been told what happened during the botched surgery. He claimed the investigation was ‘open’ and even involved the Ministry of Justice. But when asked if the couple were part of the discussions during the investigation Mr Idris gave an evasive response.
“I believe several people were spoken to,” he said.
Mr Idris also denied that the anaesthesia was bought from an unregulated vendor.
“No, the drug was not fake. It is totally wrong,” he said.
Perhaps in an attempt to discourage this reporter from continuing with the story, Mr Idris wondered why he was interested in reporting it, claiming it was not a new story.
“It happened over two years ago. It is not a new thing. Several newspapers have written about it, The Punch, and I think the Guardian too. Why are you interested in it now?” he asked.
An online search however, shows the story had not be reported before. Also, the Ohunyans said they had not spoken to any journalists or media house before they were contacted by PREMIUM TIMES.
Mr Idris also denied that the hospital management or his ministry tried to cover-up the incident, adding that all those ‘found culpable’ were sanctioned according to civil service rules.
He, however, did not disclose what offences they were sanctioned for.
The commissioner said Mrs Ohunyan was receiving the best medical care available and that she was not being sincere if she said she was not.
The new medical director of Orile-Agege General Hospital, Olawale Adegbite, told PREMIUM TIMES he could not provide much detail about what happened as he was not working at the hospital at the time. He however said Mr Ohunyan is getting proper treatment.
“I can assure you she is getting the best of treatment. Two, I am an orthopaedic surgeon, so it is not my area of specialty, I cannot speak like an expert in that sense,” he said during a telephone interview.
But when pressed to respond to specific claims of the hospital’s alleged shoddy treatment of Mrs Ohunyan, Mr Adegbite said she (victim) was being economical with the truth.
He said contrary to the claim of our source, the transfer of medical practitioners involved in the case had nothing to do with the botched surgery.
“The case is one that the state government is taking quite seriously. It is well beyond the Orile-Agege General Hospital. It was not what led to the change of guard or whatever, I can assure you that is not true. The transfer of staff are done at specific intervals. I can assure you it has nothing to do with that.
“It is being handled by either the health Service Commission or the Ministry of Health. They have all the information,” he said.
But he declined to comment on what went wrong during the surgery.
“Some of the things they said are actually not true or are not complete. I don’t have all the facts to tell you. There is nothing I can tell you about my patient.
“And there is no question she asked that I have not answered her. Even if I can’t answer I will call on another doctor to answer her because it is her right. To say they are not telling her anything, that cannot be true because it runs against the medical practice.
“That some of the things she said are incomplete does not mean it is false but they are not just complete. For her, I will tell her everything about herself if I know. If I don’t know, I will tell her I don’t know because saying that ‘I don’t know’ is a response. Keeping quiet is not answer, ‘I don’t know’ is an answer,” he said.
Alleged Culprit
When reached for comments, Mrs Odutayo originally said she could not remember the incident.
“I left the hospital two years ago, I can’t remember her,” she said in a telephone interview.
She requested for the name of Mrs Ohunyan to be spelt. Afterwards, she then declined to speak.
“I’m a civil servant. I cannot talk to the media. Go and talk to the hospital’s management or the Ministry of Health,” she said.
Similarly, Funmilayo Ige, the anaesthetist who reportedly injected Mr Ohunyan as well as the head of the pharmacy, Mrs Farinloye, declined to comment when contacted saying as civil servants “they were not allowed to speak to the press”.

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