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•Suspends him from practicing medicine in Nigeria over alleged act of negligence against 16-year-old patient
By Bianca Iboma-Emefu
Those who followed the predicament of 16-year-old Somtochukwu Ezi-Ashi, whose medical treatment at a hospital in Lagos, brought about trauma, would have heaved a sigh of relieve on August 28, 2023 when the Medical and Dental Practitioners (MDP) investigation panel bore its fangs. The body temporarily suspended Dr. Ejike Ferdinand Orji’s license to practice medicine pending the outcome of his trial at the tribunal.
Dr. Orji is accused of causing grievous bodily harm to Somtochukwu, endangering human life through negligent acts and breach of duty of person. He is also standing trial for allegedly endangering human life through dangerous acts. All the alleged wrongdoing violate sections 245, 251(1)(e), 209, 211 and 251(1)(e) respectively of the Criminal Law of Lagos State Cap C17 Laws of Lagos State 2015.
The nightmare of the parents of Somtochukwu started when the 16-year-old high school student in the United States came home on holiday and went to play basketball on July 26, 2018. During the game, he fell and sustained an injury.
A family member said: “The injury was later discovered to be a fracture of one of the bones in his left knee joint. He was rushed to Excel C Medical Center in Ikoyi Lagos, where Dr. Ejike Orji -the medical director -sedated him, had a police orderly and a basket ball coach who accompanied the child pull the limb in opposite direction before he applied fiberglass cast on the left leg from the thigh to the toe.”
It was alleged that the doctor did secure the consent of the child or the mother, as required. Also, he did not first x-ray the leg so as to understand the sort of fracture he was dealing with. After applying the cast, it was gathered, the doctor sent the patient for x-ray in another facility.
It was gathered that Somtochukwu awoke from the sedative to pain and tightness in his leg. His mother called Dr. Orji, who had left the hospital before she could even bring the result of the x-ray to him – and complained about the pain. Dr. Orji told her the pain would wear off in two days.
Somtochukwu’s mother took him home but returned the following day because the child was in constant excruciating pain and could not sleep or eat or do anything.
The boy’s mother, on return to the hospital, requested that the cast be removed but the doctor only cut out a square hole at the back of the patient’s knee and sent them back home. Upon getting home, the mother noticed that fluid was oozing out of the opened hole so she took him back to the hospital the following day, July 28, 2018.
Dr. Orji admitted the patient and removed part of the cast but the leg remained swollen with no improvement.
The family member said: “Somtochukwu’s father in desperation to save his child contacted two orthopedic surgeons to seek their opinions. It turned out the child had developed compartment syndrome caused by occlusion of blood supply to the limb for more than 48hrs by the tight cast.”
Somtochukwu was immediately moved to Reddington Hospital in Lagos where six surgical interventions had to be performed on him before he could be flown to the USA for further intervention. The limb was saved but he developed foot drop: difficulty lifting the front part of the foot.
According to an activist, Adanma Odefa Wachukwu, who has followed the case, insisting that justice must be done, the doctor’s action changed the boy’s life negatively. She said: “Somtochukwu suffered through all the symptoms of compartment syndrome as follows: Excruciating pain due to the tightness of the fiberglass cast, inability to move his toes, first degree burns at various parts of his leg, massive swelling of the leg, 15 major surgeries inside and outside the country and the loss of the full use of his leg till date.
“If only Dr. Orji had listened to the victim’s mom and removed the cast the day after he fixed it, that boy would not have had to live through the trauma he did. The boy’s uncle, who is a doctor in the USA got a picture of the x-ray, consulted with his colleagues and they determined that Orji’s course of treatment was drastic and unnecessary.
“He called Dr. Orji – who happened to be his classmate in Nigeria – and begged him to remove the cast. Dr. Orji arrogantly dismissed him and left the cast on. If only he had listened to his classmate, Somto would have healed normally as a young healthy child.”
Efforts were made in pursuit of justice as Somtochukwu’s mother made a complaint against Orji with the police. The police conducted an investigation and submitted their findings to the Lagos State Director of Public Prosecution (DPP) who filed charges against Orji in the Lagos High Court.
The mother also filed a complaint with the Medical and Dental Practitioners’ Investigation Panel against Orji in March 2019.
The NMDP panel carried out a detailed investigation, grilling four doctors at Dr. Orji’s Excel C Medical Center, five doctors at Reddington Hospital, including Dr. Ike Nwachukwu, who performed six surgeries to stabilize the child before he was flown out.
The complainant and the respondents also appeared before the panel. Documentary evidence, including the patient’s case notes, were all thoroughly examined.
In the course of investigation, the questions for Orji were: What informed his decision to treat the limb without first x-raying to determine the nature of the fracture? Why did he apply fiberglass instead of a Plaster of Paris (POP) cast? Why didn’t he remove the cast when the patient returned with excruciating pain and tightness? What did he hope to achieve by the square hole he cut behind the knee? Why did he not refer the patient to an orthopedic surgeon as the case was clearly outside his competence as a general and pediatric surgeon? Did he get informed consent from the patient’s mother before he commenced manipulation and application of cast? Why the mad rush to fit a cast and the stubborn insistence on keeping the cast on?
Interestingly, the findings of the panel were as follows: Dr. Orji is a general and pediatric surgeon and not an orthopedic surgeon. Orji applied fiberglass cast on patient at his medical centre before sending him for x-ray elsewhere. He did not seek or obtain appropriate consent. He would not remove the cast even after the child’s parents requested him to do so and even though the child was obviously suffering.
After the investigation, Orji was indicted and referred to the disciplinary tribunal. The disciplinary tribunal proffered a five-count charge against him: Gross negligence leading to compartment syndrome and foot drop, manifestation of incompetence in the assessment of the patient and failure to correctly diagnose his condition.
Others were failure to obtain appropriate informed consent before carrying out a surgical procedure on the patient and causing detriment to the patient by failing to refer him to an orthopedic surgeon when it was necessary to do.
Orji was to be tried by the disciplinary tribunal in 2021, but owing to his claims of ill-health, this was delayed. The doctor thereafter filed an enforcement of fundamental rights against the tribunal at the High Court of the FCT.
However, the Lagos State DPP arraigned Orji as follows: One count of causing grievous bodily harm to Somtochukwu Ezi-Ashi; Two counts of endangering human life through reckless and negligent acts as well as three counts of breach of duty of person doing dangerous acts and endangering human life through reckless and dangerous acts. All violating sections 245, 251(1)(e), 209, 211 and 251(1)(e) respectively of the Criminal Law of Lagos State Cap C17 Laws of Lagos State 2015.
At the trial, all the medical practitioners, who testified including Orji’s expert witness – Prof. Onyebuchi Chukwu, an orthopedic surgeon, confirmed that compartment syndrome sets in at four hours and becomes irreversible after eight hours and can lead to amputation and death, if not treated as an emergency by a qualified and competent orthopedic surgeon.
Orji was convicted on four of the six counts and sentenced to one year in prison for each count. He however emerged from prison on bail after spending only three months of incarceration.
A video of him dancing out of prison, has renewed the trauma of Somtochukwu and his family.
