The authorities at the University of Abuja Teaching Hospital (UATH) have described as “false and inaccurate” the allegation of poor management of the former deputy governor of the Central Bank of Nigeria (CBN), Obadiah Mailafia, by the staffers of the facility.
The hospital’s management in a statement released on Monday evening that Mr Mailafia died of coronavirus disease “due to comorbidities.”
This revelation was reluctantly made by the hospital’s management, which had insisted that the confidentiality of its patients is sacrosanct.
According to the hospital’s chief medical director, Bissallah Ekele, a professor, Mr Mailafia had been managed at two other hospitals where his COVID-19 status was confirmed positive before being referred to the UATH’s isolation centre “when his case had fast degenerated.”
On Sunday, Nigerians received with shock the news of the death of the financial expert and a former presidential candidate of the African Democratic Congress (ADC), in the 2019 general elections.
Mr Mailafia’s vociferous positions on national issues and sharp criticisms of President Muhammadu Buhari-led administration’s alleged poor governance capacity may have informed the concerns and suspicions raised by some Nigerians on the cause of his death.
An ethno-regional group, the Middle Belts Forum, on Sunday, issued a statement accusing the hospital of misconduct in the treatment of the late 64-year-old.
The statement, which was signed by the group’s national publicity secretary, Isuwa Dogo, claimed that the wife of the deceased was requested to make a deposit of N600,000 before proper treatment.
The statement also said when Mr Mailafia complained that he had breathing problems and pleaded with the doctors at the hospital to place him on a ventilator, he was”flatly refused.”
“The doctors in Gwagwalada refused all entreaties by the family members of Mailafia to follow the advice of the foreign consultants, insisting that they have already pronounced him dead and that even when the wife could feel the pulse of her husband, the doctor flatly declared that there was nothing they could do since they had already pronounced him dead,” the statement claimed.
Meanwhile, other public commentators including a former presidential aide, Reno Omokri, in a youtube video, said the death of Mr Mailafia was fishy and thus should be independently investigated.
Similarly, Deji Adeyanju, convener of a rights group- Concerned Nigerians- in a statement on Sunday, also sought inquest into the circumstances leading to the death of the former banker.
In his reaction, Mr Ekele described all the allegations against the hospital as false, even as our reporter was conducted round the health facility on Monday.
He said: “I can confirm in my honor that all the allegations circulating in the media are false. We never asked for any deposit before commencement of treatment. The doctor on duty that day was on ground and received the patient and he was never at any point refused oxygen. In fact, he was placed on a high-flow-oxygen to enable fast breathing.”
Mr Ekele said the late Mailafia had COVID-19 with other comorbidities and that his situation was already severe before he was referred to the facility.
Visitors room at the safe wing of the infectious Disease Centre UATH
“It was unfortunate that his health deteriorated rapidly despite all efforts to save his life”, he explained.
The medical director also questioned the motive of those he said were spreading what he described as fake news. He said the leadership of the Middle Belts Forum never approached the hospital before issuing its statement.
The doctor, who was on duty at the hospital’s infectious disease centre when Mr Mailafia was brought into the facility on Saturday, Usman Galadima, said he was surprised to read the allegations flying around on social media.”
Mr Galadima, a member of the hospital’s COVID-19 management team, noted that the hospital had been duly informed of the referral and was fully prepared to receive Mr Mailafia when he was eventually brought in.
He said: “I was on duty between Saturday, September 18, and Sunday, 19. So when I resumed work in the morning, I was informed that we would be expecting a patient from CBN and I informed my staff -the nurses and a hygienist to prepare the VIP room and the general medical ward.
“An ambulance from EHA clinics arrived in the afternoon. We adorned our PPE and rushed to meet the patient. He was already on the ambulance oxygen and from his oxygen consumption level, I noticed he was in a severe condition. We placed him on a highflow oxygen with no delay and wheeled him into the VIP section in a wheelchair.”
Mr Galadima said based on the medical report he received and subsequent history from the patient and his wife, Mailafia, had been ill for about a week, and that he was first taken to the CBN health facility before he was transferred to EHA clinics from where he was eventually referred to the UATH infectious disease centre.
The doctor added: “We are a tertiary referral centre for severe and moderate cases of such conditions. I discussed with the patient and the wife the kind of illness he has, the cause and treatment procedure before we started treatment.
“The wife informed us that the CBN is fully behind the patients’ management and that we should give him the best and that is exactly what we did.
“The patient got a bit uncomfortable later in the night so we attached an official to stay with him and monitor his vital signs because of the severity of his condition. We used about four cylinders of oxygen on him throughout the night.
“In the early hours of the following day, we noticed he was deteriorating in spite of all the treatment procedures. He could no longer sustain breathing and we had to start resuscitation. Sadly, we couldn’t save him.
He said he, alongside his colleagues, called the family and informed them of the development. “The wife thanked us for the effort and prayed for us and then asked for a moment with him alone.”
On foreign doctor’s intervention
Mr Galadima said as soon as the wife went to see the body, he also left for the office to document certain things while other staffers were on ground for monitoring.
“About an hour later, a phone was brought for me to speak with the eldest son of the deceased who introduced himself as a lawyer and said he had with him a Belgian medical consultant. I narrated to them the sequence of events before the patient was pronounced dead.
“The Belgian consultant insisted that I should do chest compression on the deceased but I told them I am a senior doctor who have been practicing for over 20 years and I already certified the patient dead more than an hour ago but she kept insisting on the chest compression which I find quite unprofessional.
Inside the safe wing of the Infectious Disease Centre UATH
“I informed them that they should come down to the hospital if they want to make further investigations. The wife of the late Mailafia later called my attention to a sign showing in the monitor asking if it meant the man was still alive, I told her we already stopped resuscitation after the man died and that I am deeply sorry for the loss.
“I now asked the nurse to go tidy up the corpse and when she went she saw that they were already doing the chest compressions. The wife later came and met me in the office and asked what is the next step now that the man is dead. I called the public health department and they put the body in the body bag. An ambulance took him to the mortuary for preparation for burial based on the protocol for such deaths.”
On N600,00 deposit claim
Mr Galadima also reaffirmed that the facility never asked for a deposit before treatment, saying such was not a prerequisite for admission at the centre.
“People that come here are mostly in dire situations. So we start treatment first. In his case, we started treatment even before a file was opened,” he said.
Decision on ventilator
On the allegation that the patient was refused to be placed on a ventilator, Mr Galadima said due to the condition of the deceased when he was brought in, the risk of his health escalating if he was put on a ventilator outweighed the benefit. He said that was why he was managed in a highflow oxygen.
EHA Clinics speaks
On its part, the management of EHA Clinics, Abuja branch, where Mr Mailafia was transferred to UATH, said it did its best within its limit before making a case for the referral.
In an email as a response to PREMIUM TIMES’ inquiry on the issue, the hospital said the deceased was received at the facility on Friday, 17 September , following a referral by the CBN clinic “after a prior discussion with our managing consultant.”
The email, which was signed by the manager in charge of practice and quality assurance unit, Ifunanya Ilodibe, however, cautioned that the medical condition of any of its clients would not be disclosed to a third party except with the permission of the client or their next of kin.
The response reads in part: “First and foremost, EHA Clinics would like to send its heartfelt condolences to the family of Dr. Obadiah Mailafia.
“Dr. Mailafia in question was referred to us on Friday, September 17, 2021, by the CBN clinic after a prior discussion with our managing consultant. As per our centre protocols, the patient was immediately evaluated by the medical team, upon arrival to determine suitability for management at our centre. The patient was initially admitted and managed by our medical team using standard protocols for the management of his medical condition.
“After close monitoring and careful review of this patient’s medical status by the managing consultant, it was determined that the patient would be better managed at a medical facility with an Intensive Care Unit (ICU).”
According to the manager, EHA clinics is a level 2 centre that does not offer intensive care support, and so it usually refers patients requiring those services to tertiary facilities.
“We appropriately communicated this decision to the medical team at the CBN clinic who also agreed with the decision. The family was counselled on the need for transfer and arrangements were made with the receiving facility and the patient was transferred promptly on Saturday, September 18, 2021.
“Please note that it is against medical ethics to discuss the details of a client’s diagnosis without the express permission of the client or their next of kin. EHA Clinics is a comprehensive health care facility that prioritizes the health, safety, and well-being of each of our clients.”
Another health official, who was privy to the condition of the deceased late politician but who does not want to be quoted, explained how Mr Mailafia contracted COVID-19.
He said the deceased was confirmed positive of the virus at the EHA, adding that late testing and underlying health conditions had rapidly worsened his condition.
The source said: “The patient took ill on September 12, after he came back from Akure. At first, he was treated at home for malaria before he was later taken to the CBN health facility. He was later referred to EHA clinics where he tested positive.
“The problem is that the condition was not detected earlier. We always advise early testing once the symptoms are similar to COVID-19 because if the disease is not detected earlier and the patient has other underlying conditions, the situation becomes severe and there could be little or nothing the doctors can do except a lung transplant.
“If someone contracts COVID-19 and has underlying health conditions, it weakens the body immunity faster.”
The UATH CMD also harped on early testing for the disease, saying: “The earlier it is diagnosed, the higher the chances of the patient surviving.”
“Another problem is that some are diagnosed but they still live in denial. When you manage this condition with an underlying condition it becomes severe that is why early testing and treatment is highly recommended,” he said.
“One challenge we face is that some patients will go to four different hospitals before they are brought to the infectious disease centre and by that time the condition would have already become severe. And we don’t reject patients even if it’s just an hour that is left for the patient; that is why we are here.”
Meanwhile, efforts to speak with the wife of the deceased, Mrs Mailafia, on the matter were unsuccessful as she neither picked calls to her mobile lines nor responded to messages sent.
COVID-19 in Nigeria
Nigeria is currently battling the third wave of the coronavirus pandemic which has resulted in a spike in infections and deaths in recent weeks.
More than 201,000 infections have been reported from the disease with a total of 2,661 fatalities as of Monday, September 20.