Medical Negligence: Patients, Doctors Pay Hidden Price

Medical negligence exacts far heavier tolls than the injuries patients suffer, imposing lasting burdens on families, doctors, hospitals and Nigeria’s already strained health system, experts warned at a Lagos symposium marking World Patient Safety Day.

Prof. Dike Obalum, a professor of orthopaedic surgery and medical jurisprudence, chief consultant surgeon and legal practitioner, delivered the keynote at the event themed “The Hidden Cost of Medical Negligence and the Conundrum of Justice.” Organised by Patient Academy International in partnership with Medilag Consult and the College of Medicine, University of Lagos, the gathering brought together clinicians, legal minds and patient advocates to examine accountability, prevention and the difficult path to justice.

Obalum stressed that while patients harmed by preventable errors deserve truth, explanation, appropriate compensation and accountability, an overemphasis on litigation risks fostering a culture of fear. That fear, he said, can drive defensive medicine—excessive tests, unnecessary prescriptions and cautious practice aimed more at self-protection than optimal care.

“Justice should not be underutilised so that patients suffer injury without compensation. However, it should not be overemphasised to the point where healthcare professionals practise out of fear of litigation rather than with care,” he said.

He reminded the audience that not every adverse outcome constitutes negligence. Healthcare operates in uncertainty; complications, deterioration or death can occur despite appropriate care. Negligence is established only when a practitioner breaches the required standard of care, causing harm. The four elements of a claim remain duty of care, breach of the applicable standard, causation and damage.

The doctor-patient relationship rests on trust. Patients enter hospitals believing professionals possess the competence, judgment and ethical commitment to protect their lives. When that trust is broken, justice must address responsibility, remedy and prevention.

Obalum outlined four categories of hidden costs. Patients and families face extra medical bills, prolonged hospital stays, rehabilitation, lost income, disability, psychological trauma and long-term dependence. Healthcare professionals endure stress, burnout, reputational damage, disciplinary probes, legal expenses and eroded confidence. Hospitals confront litigation costs, compensation payouts, regulatory sanctions, staff turnover and loss of public trust. Society and the health system absorb lost productivity, higher overall spending and declining confidence in institutions.

These pressures are intensified by Nigeria’s severe workforce shortage. More than 230 million people are served by roughly 55,000 practising doctors, according to 2025 data cited at the symposium—a ratio of about one doctor to 5,000 patients against the World Health Organization benchmark of one to 600. The number of practising doctors has declined sharply amid emigration.

Studies underscore the scale of the problem. Research has found medical error prevalence among health workers ranging from 42.8 per cent to as high as 89.8 per cent in some Nigerian settings. Estimates suggest hundreds of thousands of preventable deaths occur annually, while roughly one in five patients experiences harm during care—higher than the global average of about one in ten.

Yet access to justice remains limited. High litigation costs, protracted court processes, scarcity of expert witnesses, inadequate legal aid and low public awareness mean many harmed patients never reach regulators or the courts. Compensation, while important, cannot restore life, erase disability or fully rebuild trust.

A fuller concept of justice, Obalum argued, should deliver recognition of harm, explanation of what occurred, accountability, appropriate remedy and measures to prevent recurrence.

ADVERTISEMENT

He advocated greater use of alternative dispute resolution—mediation and negotiation—to resolve suitable cases faster and more affordably. Stronger patient complaint systems, clearer clinical negligence procedures, reliable digital medical records, professional indemnity arrangements and a safety culture that prioritises learning over blame are also essential. Investment in the workforce and facilities remains critical.

Kunle Thomas, chief executive of Patient Academy International, said the symposium aimed to raise awareness among professionals and the public on reducing preventable harm. He urged patients to speak up and lodge complaints rather than leave incidents unreported.

“We have to prevent risk. We have to manage risk so that we prevent harm,” Thomas said. Collective responsibility among patients, professionals, organisations and government is needed to build a safer system. The organisation has launched “My Voice, My Health,” a digital feedback platform that enables patients to share experiences and help identify areas for improvement.

The speakers agreed that the goal of accountability should not stop at determining who pays after harm occurs. It must ensure lessons are learned so preventable harm does not strike the next patient.

The discussion comes amid heightened national attention to patient safety. World Patient Safety Day 2026 is observed under the global theme “Safe care for noncommunicable diseases,” with the slogan “Safe care for life.” Nigeria’s Federal Ministry of Health has established a National Task Force on Clinical Governance and Patient Safety to strengthen standards. High-profile cases in recent months have further intensified calls for better training, regulation, documentation and accessible redress mechanisms.

Experts at the Lagos event concluded that protecting patients and supporting legitimate medical practice are not opposing goals. Both require systems that encourage transparency, continuous learning and fair, evidence-based resolution of disputes—fast, fair and grounded in reality.