By Vincent Egunyanga, David Lawani, Ben Adoga, and Anthony Otaru
Misdiagnosis and medical negligence are increasingly emerging as one of Nigeria’s most lethal but least confronted public health threats, silently cutting lives short and leaving families traumatised, ThisNigeria report reveals.
At the same time, hospitals continue to operate under weak oversight and limited accountability.
Across the country, a disturbing string of fatal errors, ranging from wrong diagnoses and delayed investigations to preventable surgical and anaesthetic failures, has reignited public anger and renewed scrutiny of Nigeria’s healthcare system, both public and private.
In Kano State, the death of Aishatu Umar, a mother of five, has come to symbolise what many Nigerians describe as deep-seated systemic failures in hospital safety practices.
Umar underwent what was described as a routine surgical procedure at a government-owned specialist hospital. However, she reportedly complained of persistent abdominal pain for months after the operation. Rather than ordering comprehensive investigations, caregivers allegedly continued to manage her condition with pain relief.
It was only after her condition deteriorated that imaging revealed a shocking error: a pair of surgical scissors had been left inside her abdomen. She later died during a follow-up surgery to remove the object.
The incident sparked widespread outrage, not only because of its tragic outcome but because it highlighted failures in surgical counting procedures, post-operative monitoring and clinical response to persistent symptoms. Hospital authorities later acknowledged lapses in care and suspended some personnel.
For many Nigerians, the case reinforced fears that medical errors often remain concealed until irreversible damage is done.
Similarly, public attention intensified further following the death of Nnamdi, the toddler son of renowned writer Chimamanda Adichie, at a private hospital in Lagos.
The child was admitted for medical care but reportedly never recovered after being placed under anaesthesia.
The family alleged that lapses in care and monitoring contributed to the child’s death, raising questions about anaesthetic safety and emergency response protocols in private facilities often perceived as superior to public hospitals.
The hospital involved expressed sympathy but disputed claims of negligence, while state authorities ordered investigations.
The case resonated widely, challenging assumptions that high fees automatically guarantee safer medical care and underscoring the vulnerability of patients even in elite institutions.
Beyond high-profile fatalities, numerous patients have come forward with accounts of life-altering injuries linked to routine medical procedures.
In one such case, a patient alleged permanent damage following the incorrect insertion of a catheter, an error medical experts say should be rare when proper training and supervision are in place.
These experiences, health advocates say, point to deeper concerns about clinical competence, supervision and quality assurance across both public and private healthcare facilities.
*Survivors demand accountability as failures expose weak oversight
For survivors like Auwal Ibrahim, who said he was misdiagnosed repeatedly in Nigeria before receiving correct treatment abroad, the problem goes beyond individual errors.
“When it comes to complex cases, we lack capacity. The equipment is not here, and the competent personnel are abroad,” he said.
Ibrahim called for more decisive regulatory intervention, arguing that professional bodies must take responsibility for investigating complaints rather than leaving families to shoulder the burden.
Similarly, Victoria, a resident of Mabushi, Abuja, recounted how months of ulcer treatment at one hospital delayed the diagnosis of a serious heart condition.
“If we had not left that hospital, I would have been dead by now,” she said.
From Kano to Lagos, these cases point to a troubling pattern: assumptions replacing evidence, safety protocols ignored, delayed investigations, poor communication and weak accountability.
Public health experts warn that diagnostic errors are pervasive, particularly in the management of febrile illnesses.
Conditions such as malaria, typhoid, viral infections and sepsis often present with similar symptoms, yet laboratory confirmation is frequently skipped.
As a result, patients are sometimes treated based on assumptions rather than evidence, leading to delayed care, worsening illness and preventable deaths.
Director for Scientist Registration and Discipline at the Medical Laboratory Science Council of Nigeria (MLSCN), Dr Gregory Uchono, said proper diagnosis depends heavily on quality laboratory processes. This standard remains elusive in many facilities.
“There are requirements that must be met for laboratory results to support good diagnosis. Mistakes can occur at different stages, before examination, during testing or after results are produced,” he said.
Uchono explained that errors such as incorrect patient details, faulty equipment, or poor quality control could distort outcomes, stressing that such mistakes should be rare when proper quality management systems are in place.
He lamented that Nigeria has about 47,000 registered medical laboratory scientists, but only around 20 accredited laboratories nationwide, mainly due to funding constraints.
“Most laboratories are not accredited to international standards, and that affects confidence in results,” he added.
Speaking from Port Harcourt, Dr Clinton Nek of Meriden Hospital said while laboratory tests should ideally precede diagnosis, clinicians are sometimes forced to rely on experience due to inadequate facilities.
“Doctors are expected to run tests, but where quality laboratory services are unavailable, clinical judgement is sometimes used. However, there can be mistakes due to human error, faulty machines or even fake drugs,” he said.
President of the Conference of Non-Governmental Organisations (CONGOS), Bartholomew Okoudo, said negligence and systemic challenges have normalised the practice of diagnosis without confirmation.
“In many Nigerian settings, a large proportion of diagnoses are made without laboratory confirmation, especially for malaria,” he said.
He attributed the trend to lack of diagnostic tools, cost barriers, broken equipment, long waiting times and clinicians’ distrust of rapid tests.
“Because many febrile illnesses present with similar symptoms, malaria is often diagnosed by default. In some areas, over 70 per cent of malaria treatments are given without adequate testing,” Okoudo added.
Consultant public health physician, Dr Oluwaseun Opeyemi Adesoye, described misdiagnosis as a longstanding challenge worsened by workload pressure and limited resources.
“Diagnosis involves history, examination and investigations. While some ‘spot diagnoses’ are possible, many conditions, malaria, typhoid, meningitis, respiratory and haemorrhagic fevers, are frequently misdiagnosed because their symptoms overlap,” he said.
Adesoye cited poor skills, inexperience, burnout and lack of laboratory access as contributing factors, noting that staff shortages often compromise diagnostic accuracy.
“Clinicians are rarely punished for thoughtful delays aimed at improving diagnosis, but excessive workload can push health workers toward presumptive treatment,” he explained.
At Karshi General Hospital, Abuja, Dr Abraham Akawo acknowledged that misdiagnosis and negligence exist, though he argued they are often driven by systemic pressure.
“Most patients arrive in critical condition. While tests are requested, treatment may start immediately. If lab results are inaccurate, you end up treating the wrong condition,” he said.
Akawo described manpower shortages, outdated equipment, and the mass exodus of skilled professionals — popularly known as the japa syndrome — as major obstacles.
“Many trained doctors, nurses and laboratory scientists have left the country. Those remaining are overstretched and stressed, and as humans, mistakes can occur,” he said.
Senior nurse Joy Odeh of Orozo Primary Healthcare Centre said incomplete patient information complicates diagnosis.
“Some patients withhold information or present very late. Others exaggerate symptoms. Understanding which patient you are dealing with is a challenge,” she said.
Similarly, Mr Bayo Olowu, a senior nurse and head of a federal psychiatric facility in Benin, cited poor infrastructure, brain drain and weak regulation.
“Many hospitals lack modern diagnostic tools. Funding is poor, and trained professionals are leaving in large numbers,” Olowu said, urging increased health sector funding by all tiers of government.
The immediate past president of the Nigeria Association of Resident Doctors (NARD), Dr Osundara Tope Zenith, blamed misdiagnosis primarily on the lack of laboratory confirmation and the activities of unqualified practitioners.
“In standard practice, diagnosis should follow investigations. But many people are treated based on symptoms alone, especially by quacks,” he said.
He warned against reliance on unreliable tests, inappropriate antibiotic use and failure to seek second opinions, noting that burnout and poor doctor-patient ratios further compromise care.
“A ratio of one doctor to 10,000 patients will always result in suboptimal care,” he said.
