This article by Learned Senior Advocate of Nigeria, Kayode Enitan, gives an overview of what transpired, leading up to the sudden and suspicious death of his friend, Commissioner of Police, Akwa Ibom State, Waheed Ayilara, who had gone to the Lagos University Teaching Hospital for an elective prostrate surgery. The cause of his death is unclear, and the fact that an autopsy was not performed, even though his death qualifies as one that should have been investigated, raises even more questions
This article by Learned Senior Advocate of Nigeria, Kayode Enitan, gives an overview of what transpired, leading up to the sudden and suspicious death of his friend, Commissioner of Police, Akwa Ibom State, Waheed Ayilara, who had gone to the Lagos University Teaching Hospital for an elective prostrate surgery. The cause of his death is unclear, and the fact that an autopsy was not performed, even though his death qualifies as one that should have been investigated, raises even more questions
Introduction
That the Nigerian public, and I daresay private hospital system, is filled with many dangers in spite of the many brilliant individuals comprising it, is a very known fact.
My first personal experience with the lethal effect of using the Nigerian public hospital system was about five years ago when my mother called me on 30th September, 2019 to say that she wasn't feeling too well, and would be going to see her Doctors at the Nigerian Airforce Hospital located int the Ikeja Air Force Base. I told her to proceed and keep me updated, and she went off on that journey of about 10 minutes from her Mafoluku residence, a journey which ended up being her last one alive. Between when she presented that afternoon till we got there in the evening, as we were later informed, there were many inconsistencies in her encounter with the health service providers, such that by the time we arrived she was on oxygen support. We left her at about 11pm when it seemed she was better, and the Doctors had confirmed to us that there were additional oxygen canisters available in case the one she was on got exhausted. We were later informed that the oxygen was exhausted, but when the extra were brought out from the store they couldn't be opened and because she was asphyxiating due to lack of oxygen, she was referred to LASUTH, where a comedy of errors ranging from a lack of bed space to non-availability of Doctors led to her death in the early hours of October 1st 2019.
Another in the comedy of errors that the Nigerian health sector has become, is the recent case of Alhaji Yusuph Olaniyonu as contained in his article "At 58, God has given me another chance", wherein he recounted his six month experience after going to the hospital for an elective operation. It is a recommended read for all.
This piece is however, not about my mother nor about recommended readings, but about my friend Waheed Ayilara, the recently deceased serving Commissioner of Police, Akwa Ibom State.
CP Waheed Ayilara
Waheed was reported to have driven himself to the hospital, for an elective prostrate operation. By elective, it is meant that the operation was not as a result of an emergency, or resorted to because of some unplanned and accidental event that necessitated that the surgical procedure be conducted. So, that was an event that was planned between the patient, Waheed and his caregivers, meaning, they agreed of the need to do the operation, agreed a date and time and had walked through what would be required and what was to be the outcome!
So, Waheed arrived the hospital presumably on Wednesday, and the operation was conducted, successfully as we were told, and he was taken to the post-operative and recuperating room. It was also reported that he had even come to and chatted with the Consultant. There ended the clarity, as we were all shocked to read later on Thursday 29th , not only of his demise but of his burial. When I saw the newslink from my son at about 2.35 pm, I was shocked and promptly called our mutual friend Olumide Ekisola, who not only confirmed the death, but the fact that they were at the cemetery where he was already being buried. I asked what about autopsy? The response was that whilst the wife was interested in an autopsy, as a Muslim he needed to be buried same day and the autopsy was said to require a likely time frame of 24hours. The body was therefore, released for burial.
Having reflected over the weekend about this and having further discussed with several people who should know, it has become apparent that too many questions are begging for answers, and why were the provisions of extant legislation blatantly breached by the hospital authorities and the Police authorities who were directly involved and responsible for ensuring that the law was complied with were derelict in their duties? Why was the family informed that an autopsy requires 24 hours, when in fact one could be conducted and concluded within three hours, leaving room for burial on the same day? Why were the Chief Coroner and the Chief Medical Examiner of Lagos State, not informed of his death immediately?
Coroner's System Law
The Coroner's System Law of Lagos State provides in its Section 14 as follows in respect of reportable deaths which mandatorily must be reported and in respect of which an autopsy is mandated;
Report of death
(1) A report of death shall be made to any of the agencies for the report of death or the office of the Coroner and be subject to post-mortem examination where there is reasonable cause to believe that the cause of death was:
(a) unknown; and
(b) sudden or unexpected and natural;
(c) unreported after occurrence;
(d) violent, unnatural or suspicious;
(e) accidental or misadventured;
(f) due to self-neglect or negligence by others;
(g) an industrial disease, accident at work or industrial poisoning;
(h) due to a negligent medical intervention, misconduct or malpractice;
(i) due to neglect during surgery or before recovery from anaesthesia or diagnostic or therapeutic procedure;
(j) as a result of non-conventional medical procedure or medication;
(k) suicide, suspected suicide or assisted suicide;
(l) a known or unknown cause while in custody or shortly afterwards;
(m) due to an ailment within twenty-four (24) hours of hospital admission;
(n) a maternal death occurring during or following pregnancy or that might be reasonably related to the pregnancy;
(o) as a child in care;
(p) an infant death as in Sudden Infant Death Syndrome (SID) and non-accidental injury;
(q) unnatural stillbirth and intrauterine death;
(r) an ailment in a nursing home or hospice.
From the provision of the law and the facts as known, Waheed's death is a reportable one as at least four of the conditions were clearly evident in the circumstances of his death, to wit, unknown; (probably) due to a negligent medical intervention, misconduct or malpractice; (probably) due to neglect during surgery or before recovery from anaesthesia or diagnostic or therapeutic procedure; (probably) due to an ailment within twenty-four (24) hours of hospital admission;
One will be in a safe place to assume that the hospital authorities and the Police were aware of the above cited provision of the law, and the need to ensure compliance. It is therefore, befuddling, that both the Police and the hospital ignored the provisions of the law and elected to have the body buried, in spite of the desire of Waheed's wife and the Consultant Urologist that did the operation, for an autopsy to determine the probable cause of death after a successful operation.
Questions and Answers
Some answers suggest themselves to my mind, but before proffering those answers , there are further questions to be asked as follows - why was there a need for blood transfusion post operation, who brought the blood, who was responsible for delivering it, what was the chain of custody of the blood, could it have been tampered with, was there a compatibility issue with the blood.
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The suggested answer to the first question, is that someone in the hospital hierarchy overruled the request of the Consultant Urologist for an autopsy to cover up some malfeasance on the part of the hospital. The answer to all the other questions would however, help in assuaging the suspicion of a cover up.
An autopsy, had one been conducted as requested and samples taken of organs, tissues, the blood in the deceased's system and whatever is remwaining in the blood pack, would have assisted greatly in definitively answering all the questions both real and imagined!
Conclusion
It was gladdening to read that the Lagos State Government has belatedly ordered that an inquiry be conducted into the circumstances that led to the death of this most gallant officer, who served diligently in the Lagos State Police command for many years, and also a number 4 officer in the Police organogram being a serving Commissioner of Police. There's however, concern about the independence and neutrality of the Panel with its being headed by the Chief Medical Director of the hospital 'responsible' for the death of the officer. What happened to one not being permitted to be a judge in his own cause (Nemo judex in causa sua)?
Its therefore, necessary that the Panel be seen to be independent by being comprised of those totally unconnected with the hospital, and who would be seen as independent by the whole world.
Would this bring Waheed back from the dead, the answer is definitely a No, but it will help everyone to get answers to the many questions being asked and consequently, some closure on the untimely passage of Waheed Ayilara, CP.
Kayode Enitan, SAN
