By Chioma Obinna
A Professor of Orthopaedic Surgery and Medical Jurisprudence, Prof. Dike Obalum, has said that medical negligence carries consequences far beyond the immediate injury suffered by patients, and often imposing hidden costs on families, healthcare professionals, hospitals and the wider health system.
Obalum, a Chief Consultant Surgeon and Legal Practitioner, who spoke at a symposium in Lagos to mark the 2026 World Patient Safety Day, themed: “The Hidden Cost of Medical Negligence and the Conundrum of Justice” said while patients who suffer preventable harm deserved access to truth, explanation, appropriate compensation and justice, excessive emphasis on litigation could also create a culture of fear among healthcare professionals and encourage defensive medical practice.
According to him, the central challenge is to protect patients without undermining legitimate medical practice.
“Justice should not be underutilised in such a way that patients will suffer injury and will not be able to receive compensation. However, justice should not be overemphasised to the point where healthcare professionals begin to practise out of fear of litigation rather than with care.”
He explained that fear of litigation could lead doctors to order excessive investigations or prescribe unnecessary medications as a means of protecting themselves against possible lawsuits.
Obalum stressed that not every bad outcome in medical practice constituted negligence, urging stakeholders to distinguish between medical errors, adverse events, negligence, malpractice and civil or criminal liability.
He said healthcare was an environment of uncertainty where complications, deterioration or even death could occur despite appropriate professional care.
According to him, medical negligence becomes established when a healthcare professional breaches the required standard of care, causing harm to the patient.
He identified the key elements of a negligence claim as duty of care, breach of the applicable standard, causation and damage.
Obalum said the doctor-patient relationship was fundamentally based on trust, adding that patients entered hospitals believing that healthcare professionals possessed the competence, judgment and ethical commitment required to protect their lives and restore their health.
He warned that when that trust was broken, justice must address not only what happened but also responsibility, remedy and prevention.
The professor identified four broad categories of hidden costs arising from medical negligence: the burden on patients and families; the burden on healthcare professionals and facilities; the economic and societal burden; and the burden on the health system.
He said patients and their families could face additional medical expenses, prolonged hospitalisation, rehabilitation, loss of income, disability, psychological trauma and long-term dependence following preventable harm.
He added that healthcare professionals could suffer stress, burnout, reputational damage, disciplinary investigations, litigation expenses and loss of confidence, particularly where adverse events resulted in prolonged disputes.
Obalum said hospitals also faced litigation expenses, compensation payments, regulatory sanctions, staff turnover and loss of public confidence.
He argued that the problem was compounded by Nigeria’s stretched healthcare workforce, noting that inadequate staffing could reduce the time available for individual patients and increase the risk of errors.
Noting that justice must go beyond compensation, the professor said justice in medical negligence cases should not be limited to financial compensation.
“Compensation can provide financial support, access to rehabilitation, recognition of harm and economic redress. But compensation alone cannot restore life, erase disability, restore lost trust or reverse psychological trauma,” he said.
According to him, a more complete concept of justice should provide five things — recognition of the harm, explanation of what happened, accountability, an appropriate remedy and measures to prevent recurrence.
He also advocated greater use of alternative dispute resolution, including mediation and negotiation, to resolve appropriate medical disputes faster and at lower cost.
“Not every medical dispute needs to end in prolonged litigation,” he said, adding that mechanisms for resolving disputes should be “fast, fair and grounded in evidence.”
Obalum called for stronger patient complaint systems, better medical record standards, clearer clinical negligence procedures, improved access to expert witnesses, professional indemnity systems and stronger hospital patient-safety structures.
He also recommended investment in the healthcare workforce, reliable digital medical records and a patient-safety reporting culture that encourages learning rather than simply assigning blame.
Speaking, the Chief Executive Officer of Patient Academy International, Kunle Thomas, said the symposium was organised to raise awareness among healthcare professionals and members of the public on ways to reduce preventable harm.
Thomas urged patients and members of the public to speak up and lodge complaints when things go wrong rather than allowing such incidents to remain unreported.
“We have to prevent risk. We have to manage risk so that we prevent harm,” he said.
He called for collective responsibility among patients, healthcare professionals, healthcare organisations and government in building a safer healthcare system.
Thomas disclosed that Patient Academy International had established “My Voice, My Health,” a digital feedback platform designed to enable patients to share their experiences and provide information that could help healthcare organisations and policymakers identify areas requiring improvement.
He said better training of healthcare workers, regular updating of professional knowledge, improved facilities and equipment, as well as effective government policies, were essential to improving patient safety.
The speakers stressed that the objective of medical negligence accountability should not simply be to determine who pays after harm occurs, but to ensure that lessons are learnt and preventable harm does not happen to the next patient.
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