MEDICAL NEGLIGENCE IN NIGERIA

ABSTRACT

Medical negligence remains a pressing concern in the Nigeria’s healthcare system, with profound implications on patients’ safety, professional accountability, and public trust. A patient generally approaches a doctor expecting to get the right medical treatment with all the knowledge and skill that the doctor possesses to relief him or her of the medical problem. Though the doctor may not be in a position to save his patient’s life at all times, he is expected to use his special knowledge and skill in the most appropriate manner keeping the interest of the patient in mind. Failure of a doctor to discharge this obligation results into tortious liability which leads to civil proceedings. This paper examines the legal, ethical, and institutional dimensions of medical negligence in Nigeria.

INTRODUCTION

In tort law, negligence in its generic sense is the failure to exercise the level of care that a reasonable person would under similar circumstances, resulting in harm to another. Medical negligence is an offshoot of the generic tort of negligence. Medical negligence also known as “medical malpractice” is simply defined as a breach of the duty of care owed by a healthcare professional to a patient, resulting in injury or harm. It occurs when a healthcare professional’s actions or omissions fall below the accepted standard of care. In Delta Hospitals Management Board & Ors v. Onome[1], the Court of Appeal held that the plaintiff must prove that the defendant owes him a duty of care and was in breach of that duty. The basic elements for proving medical negligence include:

• Duty of Care

Duty of care refers to the defendant’s obligation to act with reasonable care to prevent harm to another. The outcome of a case of negligence depends on whether the defendant owed a duty of care to the plaintiff or injured party. A duty arises when the law recognizes a relationship between the defendant and the plaintiff, requiring the defendant to act in a certain manner.

• Breach of Duty of Care

This occurs when a person fails to uphold their duty to act with reasonable care. It is not enough for the plaintiff to prove that the defendant owes him or her duty of care, the plaintiff must show that the defendant breached that duty of care. An example is a doctor failing to diagnose a patient’s condition despite having information that would allow the doctor to reach the correct diagnosis. In a medical negligence lawsuit, the onus or the burden of proof lies on the patient/plaintiff to substantiate their claim against the medical practitioner[2]. This is also stated in the case of Abi v. C.B.N[3]. However, where the patient is a minor or lacks competence on the basis of any mental incapabilities, the proxy such as parent or legal guardian can initiate complaint processes on the minor’s behalf. Where the negligent act results in death, any competent survivor or successor of the deceased can initiate action.

• Causation

Cause –in-Fact

Under the rules of legal duty in cases of negligence, a plaintiff must prove that the actions of the defendant were the actual cause of the plaintiff’s injury. This is often regarded as the “but-for” causation, meaning that, but for the defendant’s actions, the plaintiff’s injury would not have occurred.

Proximate Cause of Harm

It relates to the scope of the defendant’s responsibility in cases of negligence. A defendant in a negligence case is only responsible for those harms that the defendant could have reasonably foreseen through their actions. If a defendant has caused damages that are outside the scope of the risks that the defendant could have foreseen, then the plaintiff cannot prove that the defendant’s actions were the proximate cause of the plaintiff’s damages[4].

• Damages

The final element of a negligence claim is called “damages’. It is not enough that the defendant failed to exercise reasonable care. The failure to exercise reasonable care must result into actual damages to a person to whom the defendant owed a duty of care. A plaintiff in a negligence case must prove a legally recognized harm, usually in the form of physical injury to a person (personal property) or damage to a property (real property). If a plaintiff successfully proves duty of care, breach of duty and causation, the plaintiff will be eligible to receive compensation for the injury or harm that has been caused. Damages are awarded for both economic and non-economic loss. In some cases, damages may be reduced if the plaintiff’s action or inaction contributed to the damage or injury caused, and it is called “contributory negligence”. There are instances where the medical practitioner displayed the required standard of care but the patient still died, and it was held that the medical practitioner cannot be found guilty of negligence as in the case of Unilorin Teaching Hospital v. Abegunde[5].

Some acts considered as medical negligence include: incorrect diagnosis, prescription of the wrong medication or dosage, improper or incompetent assessment of a patient’s condition, failure to attend to a patient in an emergency situation or to refer a patient to a specialist in a timely manner, surgical errors (like leaving a surgical instrument in the body of a patient, perforation of organs, or nerve damage), and failure to obtain consent before proceeding on any surgical procedure or course of treatment when such consent was necessary[6].

The relationship between a medical practitioner and a patient is one of trust and confidence, that is, a fiduciary relationship. This relationship is to commence immediately the medical practitioner consents to undertake a medical examination of the patient. A medical practitioner is obligated to observe the following duties: duty to render emergency medical services, duty to provide treatment, duty to caution patients regarding their treatments, duty to protect and respect the patients’ privacy, and duty to exercise due diligence.

LEGAL FRAMEWORK FOR MEDICAL NEGLIGENCE IN NIGERIA

The legal framework in Nigeria plays a crucial role in defining the rights, duties, and liabilities of healthcare practitioners in cases of medical negligence. There have been regulatory bodies that have been established to provide rules of professional ethics governing the practice and discipline of healthcare practitioners. The practice of medicine in Nigeria is governed by a framework of laws, rules and policies, which includes but not limited to:

1999 Constitution of the Federal Republic of Nigeria (as amended)

The constitution is the supreme law of the country binding on all authorities and individuals. It serves as the foundation from which all other legislations are derived, establishing fundamental rights for all citizens. The 1999 constitution recognizes the right to health as a fundamental human right. In Chapter II, section 17(3)(c)[7] states that “health, safety, and welfare of all persons in employment are safeguarded and not endangered or abused”. This provision establishes a constitutional basis for the protection of citizens’ health, creating a context in which medical negligence can be assessed. Section 17(3)(d) of the Constitution states that ‘the state shall direct its policy towards ensuring that there are adequate medical and health facilities for all persons”. This provision implies that citizens have a constitutional right to access adequate medical facilities, and any negligence leading to denial of this right may be challenged. The legal interpretation of right to life as provided under section 33 of the Constitution[8] has extended to encompass right to health, this implies that access to healthcare services and facilities is deemed essential for the preservation of human life. As a result, individuals can now seek redress if their health is infringed upon.

Evidence Act, 2011

One of the crucial aspects of medical negligence cases is the need for expert testimony to establish the standard of care and whether it has been breached. Under the Evidence Act, Section 68 provides for the admissibility of expert evidence. In cases of medical negligence, this provision is essential as it allows qualified medical professionals to serve as expert witnesses. Section 68(2) of the Evidence Act addresses the admissibility of expert reports. In medical negligence cases, expert reports are often crucial in providing in-depth analysis of the facts and establishing whether there was a breach of standard of care. An expert witness is to explain whether the defendant did not conform to those standards.

The National Health Act, 2014            

The Act represents a pivotal legal framework in Nigeria, aiming to provide a comprehensive and sustainable foundation for the healthcare system. Among its objectives, the Act addresses the critical issue of medical negligence, establishing guidelines for the provision of healthcare services and offering a legal framework for individuals seeking redress for harm suffered due to substandard medical care. Section 2(3) of the Act highlights the importance of ensuring that health services meet the possible standards of quality. This quality assurance principle is crucial in the context of medical negligence. Section 20 imposes a duty on healthcare providers to act in the best interest of the patient and to exercise duty of care. Section 48 addresses the liability of healthcare providers for damages.

Medical and Dental Practitioners Act, 1988

The MPDA was enacted in 1988 and later amended in 2004. It established the Medical and Dental Council of Nigeria (MDCN) to regulate the practice of medicine and dentistry in Nigeria.  The MDCN registers and sets standards for doctors, dentists, and alternative medicine practitioners. Section 12 of the MPDA outlines standards of professional conduct expected from medical and dental practitioners. Section 15 of the MPDA establishes the Medical and Dental Practitioners Disciplinary Tribunal, which maintains medical ethics and discipline within the medical profession. The tribunal serves as a recourse for victims of medical negligence seeking resolution and redress.  Section 20 addresses civil liability for practitioners. Claimants can invoke section 20 to pursue legal action against healthcare practitioners.

CONCLUSION

It is important to note that not every action or omission by a medical practitioner will lead to medical negligence. The law protects the medical practitioners to the extent that criminal liability for medical negligence must be proved beyond reasonable doubt. Patients should be aware of their rights as this will enlighten them to be bold enough to challenge the infringement of those rights. Where doctors act below their professional standards, it is expected that law as a tool of social control should intervene in the preservation of the interests of the affected citizens. Medical practitioners and institutions ought to be accountable for their actions and face the imposed on them.

REFERENCE(S):

[1] (2022) LPELR-59333(CA)

[2] Oyetola Muyiwa Atoyebi, ‘An Insight into Medical Negligence under Nigerian Jurisprudence’ (LawPavilion Blog) <https://lawpavilion.com/blog/an-insight-into-medical-negligence-under-nigerian-jurisprudence/> accessed 25 August 2025

[3] (2012) 3 NWLR (Pt. 1286) 1 (CA)

[4] Lark Lewis, J.D, ‘What Are the Elements of Negligence’ (FindLaw) <https://www.findlaw.com/injury/acciden-injury-law/proving-fault-what-is-negligence.html> accessed 26 August 2025

[5] (2015) 3 NWLR (Pt. 1447) 421 (CA)

[6] ‘A Review of Medical Negligence in the Nigerian Healthcare Sector’ (Spa Ajibade & Co.) <https://spaajibade.com/a-review-of-medical-negligence-in-the-nigerian-healthcare-sector-utilising-the-law-as-a-panacea/> accessed August 26 2025

[7] The Constitution of the Federal Republic of Nigeria 1999 (as amended)

[8] The Constitution of the Federal Republic of Nigeria 1999 (as amended)