While we sympathize with the family on the loss of a beloved member, the Management of the University of Ilorin Teaching Hospital, Ilorin, is constrained to respond to a story published on your website and credited to Mrs. Oluwakemi Elizabeth Oduwaiye. Please note that we have given information relating to the case within the limits afforded by the ethics of our profession in maintaining the confidentiality of our patient.

The facts of the matter as seen from four perspectives, are as presented below.

Negligence

This patient referred to in the publication stayed a total of nine days in our hospital. Following the normal process of admission, the patient was reviewed within 24 hours of admission by a senior Consultant Surgeon, having been referred from a private hospital where he had been on admission for 5 days. The initial clinical assessment was that of intestinal obstruction from fecal impaction. Manual evacuation was done serially and other supportive management was given in this regard. This included administration of intravenous fluids and insertion of a nasogastric tube amongst others. The passage of a nasogastric tube is part of the normal protocol in the management of intestinal obstruction and was in place, draining bilious effluent until he deliberately removed it 2 days later due to discomfort.

There was a noticeable initial improvement which was not optimal enough as expected for the working diagnosis. This necessitated the request for an abdominal CT-scan in order to evaluate for other possible cause(s). Unfortunately, this could not be done immediately because of a deranged blood chemistry, a known contraindication to the administration of contrast agent necessary for the investigation.

While measures were being taken to correct the deranged blood chemistry, a decision was taken to undertake an exploratory laparotomy to relieve the obstruction and to confirm the diagnosis.

His clinical condition deteriorated rapidly over the next couple of hours and on the morning of the planned surgery, patient died.

Autopsy report

An autopsy report that contained histopathological findings was available as at 17th December, 2015, for the next of kin documented in the Hospital records for collection.

Legal frustration

Our legal interaction on this issue has been with three different lawyers. The first lawyer wrote to request for the postmortem report. He was called immediately the report was ready to inform the next of kin to pick it up but she has since not come for it. The second lawyer requested for the treatment records. He was similarly informed that the next of kin could come for the documents. The third lawyer only made verbal request on the management of the patient which was adequately provided. There was never any incidence of intimidation or bribery.

Gender discrimination

The hospital has no aversion to any gender as regards care to its patients or release of necessary documents in the unfortunate incidence of patient demise as long as the relative is the documented next of kin which in this case is a woman but not the complainant.

Conclusion

The University of Ilorin Teaching Hospital wishes to state here unequivocally there was no negligence at any point in the management of this patient and we strive to do the best to deliver quality health care to all our patients.

Kindly grant this rejoinder the same consideration that was given to the original story.

Mrs. Funmilayo Omojasola

Public Relation Officer

University of Ilorin Teaching Hospital

University of Ilorin Teaching Hospital

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