By Destiny Obinna
Medical negligence can leave behind a trail of hidden costs extending far beyond the immediate injury suffered by a patient, affecting families, healthcare professionals, hospitals and the wider health system, a Professor of Orthopaedic Surgery and Medical Jurisprudence, Prof. Dike Obalum, has warned.
Obalum, a Chief Consultant Surgeon and Legal Practitioner, spoke in Lagos at a symposium to mark the 2026 World Patient Safety Day, themed, “The Hidden Cost of Medical Negligence and the Conundrum of Justice.”
He said while patients who suffer preventable harm must have access to truth, explanation, appropriate compensation and justice, excessive reliance on litigation could create fear among healthcare professionals and encourage defensive medical practice.
According to him, the challenge is to ensure accountability 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 said.
Obalum explained that fear of lawsuits could cause doctors to order excessive investigations or prescribe unnecessary medications simply to protect themselves from possible legal action.
He urged stakeholders to distinguish between medical errors, adverse events, negligence, malpractice and civil or criminal liability, stressing that not every poor medical outcome amounted to negligence.
“Healthcare is an environment of uncertainty where complications, deterioration or even death can occur despite appropriate professional care,” he said.
According to him, negligence is established when a healthcare professional breaches the required standard of care and that breach causes harm to the patient.
He identified the essential elements of a negligence claim as duty of care, breach of the applicable standard of care, causation and damage.
The professor said the doctor-patient relationship was fundamentally built on trust, with patients entering hospitals believing that healthcare professionals had the competence, judgment and ethical commitment required to protect their lives and restore their health.
He said when that trust was broken, justice should address not only what happened but also responsibility, remedy and prevention.
Obalum identified four broad areas of hidden costs associated with 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 be left with additional medical expenses, prolonged hospitalisation, rehabilitation costs, loss of income, disability, psychological trauma and long-term dependence following preventable harm.
Healthcare professionals, he added, could face stress, burnout, reputational damage, disciplinary investigations, litigation expenses and loss of confidence, particularly when adverse events resulted in prolonged disputes.
Hospitals could also incur litigation expenses and compensation payments, while facing regulatory sanctions, staff turnover and loss of public confidence, he said.
Obalum attributed part of the problem to Nigeria’s stretched healthcare workforce, noting that inadequate staffing could reduce the time available for individual patients and potentially increase the risk of errors.
He also argued that justice in medical negligence cases must extend beyond 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.
He said a more complete approach to justice should provide five things: recognition of the harm, an explanation of what happened, accountability, an appropriate remedy and measures to prevent recurrence.
The professor also advocated greater use of alternative dispute resolution mechanisms, including mediation and negotiation, for appropriate medical disputes.
“Not every medical dispute needs to end in prolonged litigation,” he said, stressing that mechanisms for resolving disputes should be “fast, fair and grounded in evidence.”
Obalum called for stronger patient complaint systems, improved medical record standards, clearer clinical negligence procedures, better access to expert witnesses, professional indemnity systems and stronger patient-safety structures in hospitals.
He also urged greater investment in the healthcare workforce, reliable digital medical records and a patient-safety reporting culture that encourages learning rather than simply assigning blame.
Speaking at the event, 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 about ways to reduce preventable harm.
Thomas urged patients to speak up and lodge complaints when things go wrong instead of allowing incidents to go 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, and effective government policies were essential to improving patient safety.
The speakers agreed that the purpose of medical negligence accountability should go beyond determining who pays after harm has occurred, stressing that the ultimate goal should be to ensure that lessons are learnt and preventable harm does not happen to the next patient.
