⦿ CASE SUMMARY OF:
Dr. Godit Milam v. Medical And Dental Practitioners Investigation Panel & Anor (2018) – CA
1. Dr. Godit Milam
1. Medical And Dental Practitioners Investigation Panel
2. Medical And Dental Practitioners Disciplinary Tribunal
Court of Appeal
⦿ LEAD JUDGEMENT DELIVERED BY:
Tijjani Abubakar, J.C.A.
⦿ LAWYERS WHO ADVOCATED
FOR THE APPELLANT
– Dele Oye
FOR THE RESPONDENT
– A. I. Adebayo
One Mrs. Florence Abatan (now deceased), a 37-year-old housewife was admitted on the 13th day of February, 2004 into the Maitama General Hospital and was subsequently delivered of a baby girl on the 14th day of February, 2004 at about 4:26am through a caesarian section and Bilateral Tubal Ligation (BTL).
After the delivery, the deceased was stable until the early hours of the next morning, 15th February, 2004 when her situation took a different turn for the worse and she began to lose blood. It is the case of the Appellant that the 2nd and 3rd Respondents, who undertook the surgeries respectively requested the deceased’s husband Mr. Gabriel Abatan to arrange for blood for the purpose of surgery to be carried out on the wife, but no blood was made available in the theatre before the Doctors proceeded with the surgeries.
The post-operative directives outlined and signed by the 3rd Respondent included that the patient was to be “transfused with 1 unit of “O” blood by doctor on call when blood is available.” Still, no blood was provided by the deceased’s husband before and after the operation because he claimed it was against his faith as a Jehovah’s Witness.
Subsequently on the said 15th February, 2004, the Consultant Obstetrician Gynecologist and Head of Department was called upon to review the patient, whereupon it was ordered that the deceased be transfused with two pints of packed cells of blood, but same was declined by the deceased’s husband.
It is also the case of the Appellant that with the condition of the deceased, there was no alternative to blood transfusion at the critical stage of excessive blood loss even though the deceased’s husband stated that he had procured alternative drugs to blood transfusion with the help of his fellow Jehovah Witnesses.
The patient eventually passed on.
Following this sad event, the Appellant was arraigned before the Lower Tribunal following investigation by the Medical and Dental Practitioners Investigating Panel in respect of the complaint received alleging negligent conduct in handling the case of the deceased who died in the care of the Appellant.
Judgment was delivered against the Appellant.
1. Whether having regard to the evidence before the Tribunal, particularly the evidence of PW2 and the expert evidence of DW1 and DW2, was the tribunal right in finding the Appellant liable and sentencing the Appellant to suspension from medical practice for a period of six (6) months?
⦿ HOLDING & RATIO DECIDENDI
1. The Court of Appeal held that the tribunal was right in finding the Appellant liable.
i. It is on record that Exhibit 7 is the confidential case note containing entries made by several doctors who attended to the deceased patient regarding her treatment in the Appellant’s hospital; it contains factual commentary of the patient’s physical, mental and other conditions as well as the treatment given to her by the medical practitioners who attended to her from the moment she was admitted till the time of discharge. As a matter of fact, it is on record that the Appellant made entries regarding the care given to the deceased patient, and it is on the basis of Exhibit 7, that he copiously deposed to facts in his affidavit stating the effort he made towards caring for the patient. Therefore, the evidence elicited from the Appellant in his Affidavit filed, as well as his evidence in chief and cross examination speak to the content of Exhibit 7. Who can give credible evidence explaining the purport of Exhibit 7, other than the maker himself; the Appellant herein is one of the makers and the charge he was made to face at the lower tribunal was no doubt hinged on the recordings he made in Exhibit 7.
ii. In the instant case, there is evidence on record establishing the fact that the operation of Bilateral Tubal Ligation (BTL) carried out by the Appellant was not justified. The fact that the Complainant and the deceased consented to the procedure does not free the Appellant from responsibility, as it is obvious that same was suggested by the Appellant, without any indication on record warranting the procedure. It is not enough for the Appellant to argue that the Complainant and the deceased were counselled and consented to the procedure, a necessity for the procedure must be shown to be justified by the Appellant, and in this case, the evidence shows the contrary.
⦿ SOME PROVISIONS
⦿ NOTABLE DICTA
Standard of proof can be loosely defined as the level of certainty and quantum of evidence that must be presented before a fact can be said to exist or not to exist. – Tijjani Abubakar, J.C.A. Dr. Godit Milam v. Medical And Dental Practitioners Investigation Panel & Anor (2018)
It is well understood that unethical behavior and/or misconduct by members of the profession can have symbolic effect on public confidence in the profession. Therefore, disciplinary proceedings and attendant penalties are not to be seen as punishment but rather in the interest of protecting the community from unsuitable practitioners, to entrench quality control in service delivery to the community by the practitioners. – Tijjani Abubakar, J.C.A. Dr. Godit Milam v. Medical And Dental Practitioners Investigation Panel & Anor (2018)
It does not augur well that professional disciplinary proceedings are viewed as criminal, thereby requiring that the standard of proof before these tribunals be consistent with the standard of proof in criminal trials, so doing may portend danger to the consumer community and place the practitioner in a position where at every point he may afford to be reckless and demand proof beyond reasonable doubt. Therefore, beyond the binary choice of either the civil or criminal standard of proof, it is my humble view that, just like other ad-hoc proceedings, for instance, election petition, professional disciplinary proceedings ought to be treated in a class of their own, being sui generis, neither civil nor criminal but specific to the relevant profession and be designed to be purpose made to address the needs of the Society. Therefore, since the tribunals are more often than not permitted to dictate how proceedings before them are conducted, it is proper that the standard of proof in such proceedings be that, clear and convincing evidence. – Tijjani Abubakar, J.C.A. Dr. Godit Milam v. Medical And Dental Practitioners Investigation Panel & Anor (2018)