It was supposed to be a simple child birth, but the recklessness of doctors at the University College Hospital, Ibadan, endangered 27-year-old Bukola’s life and prompted a decision to remove her uterus, leaving her sterile.
At 8:30pm on February 24, Doctor I. C. Onigwe, who was on duty at the Obstetric and Gynaecology Department of the University College Hospital (UCH) in Ibadan, told Theophilus Adeleke that the 67-year-old federal teaching hospital could no longer attend to his wife Bukola. He advised them to seek help elsewhere.
Dr. Onigwe did not understand why Bukola continued bleeding profusely eight days after birthing her child at the hospital.
By the time they arrived at Vine Branch Medical Centre, a private hospital, the huge towel Bukola used to collect the blood flowing from her vagina had become soaked and the proportion of her blood that is made up of cells, also called the Packed Cell Volumn (PCV), had become dangerously low at 12 percent, making her unconscious.
At the hospital, medical personnel scrambled to resuscitate Bukola. They placed her on nNon-pneumatic Anti-Shock Garment (NASG), a first aid device used to stabilise women who are suffering from obstetric hemorrhage and shock. She also received intravenous fluids and was transfused with four pints of blood.
The medical team eventually diagnosed Bukola with secondary postpartum haemorrhage caused by retained conception product, including placenta residues and blood clot.
With a new baby to nurture together with her first child and a body that continued bleeding, Bukola was traumatised. The family told FIJ that the delivery would have been successful if members of staff at the UCH were not reckless.
GENESIS OF THE PROBLEM: MEDICAL INSTRUCTIONS IGNORED
The UCH, Ibadan became the first choice of the Adeleke family to have their second baby following the successful delivery of their first child through a caesarian section. Dr Bello, the consultant when Bukola was pregnant with her first child, was reassigned to the second.
At 2:30am on February 16, two days before she was due for an elective or planned caesarian section, Bukola was rushed into the emergency section of the UCH. When the contraction persisted, she was wheeled into a ward where doctors attempted a vaginal birth for about seven hours. The family, citing a case note, told FIJ that the action contradicted advice by the consultant who should have been present but was not.
Adeleke said that a caesarian section was advised because of his wife’s short stature and short spacing between the first pregnancy and the second.
But UCH doctors resorted to emergency c-section after the vaginal delivery failed due to prolonged obstructed labour. It was successful.
But their joy was cut short when bleeding, beginning slightly on the morning of February 23, deteriorated to a heavy flow within 24 hours, prompting a doctor to stuff two sanitary pads in her vagina. But the blood continued flowing, so doctors recommended a series of tests.
68-YEAR-OLD UCH IBADAN UNABLE TO FIGURE OUT WHAT TO DO
“When we returned to UCH with the test results at about 7:30pm on February 24, around 8:30pm, one doctor told my husband that if he wanted me alive, he should take me to another hospital,” Bukola told FIJ.
From UCH Ibadan, Adeleke got his wife into the emergency unit of Vine Branch Medical Centre at 12:30pm.
On February 25, sedated, Bukola went through uterine curettage — a surgical procedure where abnormal tissues are removed from the uterus. About 700mls of retained conception product and clot were obtained, her medical report showed.
Two days after the surgery, she was discharged when the bleeding ceased and her PCV increased to 26 percent. But the relief was short-lived. Bukola returned to the hospital when heavy vaginal bleeding resumed, dropping her PCV to 25%.
All surgical interventions failed to stop the bleeding until doctors performed a total hysterectomy, a surgical procedure to remove a woman’s uterus.
“She had evacuation of retained products par abdomen but the bleeding persisted, she had a subtotal hysterectomy and it still persisted till we had to do a total hysterectomy before the bleeding stopped,” Charles Kolade, gynaecologist at Vine Branch Medical Centre, stated in a report.
The mother of two kids went through six hours of hysterectomy procedure during which she was revived with an anti-garment shock and transfused with three units of blood, the consequence of a slipshod ceasarean section done at the UCH, Ibadan.
“It’s a matter of life and death. When I was carrying her in my hands, she was already gone,” Adeleke said about approving Vine Medical Centre’s doctor’s request to remove her uterus. “It’s either I kept her alive without the uterus or I kept her with the uterus and she died.”
‘JUST THANK GOD AND FORGET JUSTICE‘
After two weeks, Bukola was discharged from Vine Branch Medical Centre; the bleeding stopped and her PCV rose to 32 percent but the family is still burdened with debt and every day reminds Bukola that the recklessness of UCH doctors had taken the ability to conceive from her.
“This damage can subject anyone to trauma and depression,” Adeleke said. “The entire procedure culminating in four surgeries has the capacity to subject anyone to psychological and emotional trauma.”
While the UCH bill was covered by Bukola’s health insurance, the couple had to pay out-of-pocket for treatments at Vine Branch.
Adeleke said in March that his business had gone bankrupt because of debts accumulated in the aftermath of the treatments, making it difficult to pay the N500,000 outstanding bill to Vine Branch Medical Centre.
“UCH is not taking responsibility for the distressing situation they put us in. The hospital claimed we brought her late at 10pm. That is a lie. Doctors at Vine Branch told them that as of 10pm, we had arrived their own facility after UCH told us to go to another hospital,” Adeleke said.
The family now gets pressures from everyone, including church members, to let go of their quest for justice.
“There is serious pressure because the CMD of UCH attends our church, Vine Branch Church. Church members who had heard that we were suing UCH questioned why we had to sue the teaching hospital. Meanwhile, none of them is talking about the bills we had paid even though the church owns Vine Branch Hospital.
“We got disappointed. Those we felt should talk to the CMD said nothing. Instead, they said we should not sue and we should thank God she did not die. But I am not backing down. My business has crumbled. I alone know what I am going through.”
Adeleke has sued the UCH Ibadan and is demanding a N250,000,000 compensation.
EXPERT: A CONSULTANT DIDN’T WITNESS THE SURGERY; THAT’S THE REAL PROBLEM
A medical expert who asked to be anonymous, told FIJ that it was not proper for UCH, a teaching hospital at the highest level of medical care, to refer a patient to another hospital.
“It should be the other way round; patients are referred to teaching hospitals. Even if a referral was necessary, it should be between teaching hospitals,” the expert said.
The expert condemned the absence of the consultant and the attempt to make the patient go through vaginal birth when she had been elected for a caesarian section.
“If a consultant was there, he’s the most experienced, he knows what to do and what not to do. Most of the time, they are not there; it is a problem plaguing Nigeria’s healthcare institutions; all of them. It is even worse at the Lagos State University Teaching Hospital (LUTH).”
The problem of retained conception products occur sometimes and only experienced doctors know what to do when it happens.
“There is what we call Morbid Adherent Placenta (also called Adherent Placenta). It happens when a placenta entrenches itself so deep into the walls of the uterus that separating it is difficult,” the medical expert explained.
“Some doctors who are not experienced will do it but there will still be products left. That product will lead to bleeding later and that is what happened to this woman.”
Three months after the family’s life was disrupted by the UCH, the family has not received redress. The hospital has not made the findings of its investigation known to the Adeleke’s family despite promising it would.
Toye Akinrinola, the Public Relations Officer of the the University College Hospital, Ibadan, told FIJ he was neither aware of the matter nor the investigation that was said to have been carried out.
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