BABY NKANU: NEGLIGENCE OR MENINGITIS?

By Onikepo Braithwaite

Condolences
First, I must express my heartfelt condolences to Chimamanda Adichie, her Husband, Dr. Ivara Esege, and their whole family, on the very sad death of their beloved son, Nkanu Nnamdi. The loss of a child is the greatest nightmare of a parent, and I’m sure I speak for all Nigerians when I say, we deeply sympathise with them, and pray for God’s comfort and strength for them during this most difficult time. Amen.

Cases of Alleged Medical Negligence Reported by Me
In my career as the Editor of This Day Lawyer, this is the third time I have written on issues bordering on deaths in hospitals, in which families of the deceased have cried ‘unnatural death/medical negligence’. Nkanu’s case is the third.

The first time was very early in my career as Editor, in December 2016, in my article, “Doctors in Nigeria: Healers or Killers”, when Child X died in a children’s hospital in Victoria Island. The second time was in March 2024, “In Defence of Citizen Rebecca”, when Miss Rebecca Sekidika, who went for a simple Hysteroscopy at Paragon Clinic and Imaging Centre, Port Harcourt, instead of being given an injection to numb her cervix, was given a spinal epidural which is used for an operative Hysteroscopy, and that led to her death under questionable circumstances.

In the case of Child X, I was given the opportunity to interview Child X’s Parents and the Hospital, and I was able to lay out a detailed account of the versions of events on both sides, from the day Child X took ill until Child X died. In the case of Rebecca, it wasn’t necessary, as her case wasn’t a long drawn out one – she went into Paragon on her two feet, hale and hearty, for a minor investigative procedure to check the cause of the irregularity of her menstrual period, and as a result of what transpired during the procedure, a more or less healthy person didn’t come out alive. It was so heartbreaking.

Nkanu Nnamdi Adichie-Esege’s Case
Nkanu’s case appears to be similar to that of Child X, not necessarily in whatever ailments they were both suffering from, but, in the fact that the events that culminated in their deaths, spanned a number of days.

I watched an interview of Professor Alero Roberts on Arise TV’s Morning Show last week, and she made the point that, in such cases, everything that occurs from the time a child takes ill until death, is very important. But, instead, the popular narrative that has made the rounds about Nkanu, excludes what occurred on his journey from when he took ill and was said to have initially received home care, to when he was first admitted at Atlantis Hospital for a few days, and the blame for his death has been placed solely at the feet of Euracare Hospital, where he was taken for specific diagnostic tests requested for by Johns Hopkins Hospital, Baltimore, Maryland, USA (JH) a world renowned Teaching Hospital and Research Centre, in anticipation of his evacuation there. It was reported that, Nkanu was at Euracare for less than 24 hours – January 6-7, 2026.

Allegations
Ms Adichie has alleged principally that Nkanu was given an overdose of the sedative, Propofol, and this caused his death. She claimed in a statement, that one Dr M at Euracare, informed her that Nkanu was given an overdose of Propofol. She also stated that JH had requested for a Lumbar Puncture (LP) and an MRI. It was as a result of this request made while Nkanu was at Atlantis, that he was taken to Euracare for these procedures to be carried out. The request shows that Nkanu was in a serious condition, and JH suspected that he may have had Meningitis or some neurological symptoms, which is what LP diagnoses, with the MRI to provide detailed images of the brain and spinal cord to check a possible spread, if indeed, that was the case.

Meningitis is an extremely serious condition, that can kill a patient within 24 hours. Is it then possible, to completely ignore such a serious condition which may have remained untreated, and blame the death of such a patient, solely on a sedation overdose? This is a question, that is begging to be answered.

Autopsy
And, to determine whether a Propofol overdose was indeed, the cause of Nkanu’s death, or what the cause of his death is, an Autopsy, that is, a postmortem examination upon his death would be required. One doesn’t need to be a Doctor, to know that. It is therefore, stunning and bizarre that investigative journalism appears to point to the fact that Nkanu’s remains may have already been cremated by his Parents, without any duly authorised autopsy having been carried out on him. In such circumstances, medical representatives of all the parties concerned, should be present during the autopsy carried out by the Medical Examiner.

Section 48(1) of the Coroners’ System Law of Lagos State 2007 (CSL) provides that the chemical preservation, dismemberment or disposal of a body of a person who died in circumstances that require a Coroner’s Inquest, without the approval of the Coroner, is an offence and upon conviction, attracts 15 years imprisonment without an option of fine. In the circumstances of Nkanu’s death, where a specific allegation has been made as to the cause of his death, that he was given an overdose of Propofol, no sensible Coroner would approve the disposal of the body that is required to prove or disprove such allegation. It makes no sense. It appears that the evidence required to prove this particular allegation, or determine the cause of Nkanu’s death, may have been deliberately destroyed. Any Lawyer would have reservations, if indeed, he was cremated. A reasonable observation would be that, if there is certainty about something, why destroy the evidence that would prove it? I use the word ‘deliberately’ because, it is obvious that once a corpse is cremated, it will no longer be available for a physical autopsy, which is the best way to determine the cause of death. Even with technology, a virtual autopsy for example, still requires imaging of the corpse, and while analysing medical images and medical history may be useful, they cannot take the place of a traditional physical autopsy. Whatever samples that were taken from Nkanu at Atlantis Hospital or even Euracare on his arrival there, may only testify to the condition of his health as of that time.

In Abelegah v State (2015) LPELR-24793 (CA) per Obande Festus Ogbuinya, JCA (now JSC), the Court of Appeal held thus: “In the clinical field, autopsy means “dissection of a body after death, to determine the cause of death; a postmortem examination of a body”. In Okolie v State (2014) LPELR-23256 (CA) per Uwani Musa Abba Aji, JCA (now JSC), the Court of Appeal held thus: “The main purpose of autopsy is not for identification of the corpse or the body of the deceased, but for ascertainment of the cause of death, though identification may be integral”. Also see Lawal v State (2025) LPELR-80000(CA) per Muslim Sule Hassan, JCA. The cause of death of a patient in circumstances of sickness, cannot be determined simply by the say so of anybody, social media, or the court of public opinion.

In Aderinkomi v State (2021) LPELR-56340 (CA) per Mistura Omedere Bolaji-Yusuf, JCA, the Court of Appeal held inter alia that a postmortem report may not be a legal necessity, “where there is cogent, credible and compelling evidence…..which unequivocally established the cause and circumstances of ……death”. Let me give an example. If three friends are walking down the street and an armed robber attacks them, steals their phones and cash and then shoots one of them dead, it is clear that the man was killed by the bullets. With the eyewitness accounts and the bullet ridden corpse, there is cogent and compelling evidence regarding the deceased’s cause of death.

But, a case in which a very sick patient dies in blurry, unnatural circumstances, having been moved from one hospital to another, with a plan to be evacuated to a third foreign hospital that also made diagnostic requests – this wouldn’t qualify as one that a postmortem examination isn’t required. In fact, it qualifies as one that the Hospital is expected to report to the Coroner, about being a death in unnatural circumstances, so that an Inquest follows.

It is trite that, he who alleges must prove. Where a specific cause of death is alleged, the person making that allegation must prove it, beyond reasonable doubt. See State v Chukwu (2021) LPELR-56610(SC) per Mohammed Lawal Garba, JSC. Therefore, determining if Nkanu died from a Propofol overdose, requires proof from an autopsy – see Abelegah v State (Supra). I watch a lot of real life US Crime Channel Programmes, and the Pathologists say that a deceased tells the story of the cause of their death themselves, through the postmortem examination.

The Procedure
A Coroner’s Inquest is a judicial public inquiry, held to determine the cause of death. Sections 14 & 15 of the CSL provide inter alia that, a report of death shall be made to the Coroner’s Office when there’s reasonable cause to believe that the cause of a death is unknown, unnatural, suspicious, violent, sudden, unexpected or by the negligence of others; and the Coroner shall hold an inquest when he/she is informed of the death of a deceased person lying in his/her Coroner District who has died in any of the aforementioned circumstances, amongst others. In such a case as Nkanu’s, by virtue of Section 26 of the CSL, the Coroner should direct a postmortem examination (see Section 54 of the CSL) on the completion of which the Medical Examiner will issue a Report to the Coroner who requested for the autopsy and the Chief Coroner of the State.

In a case such as this, a forensic autopsy would be ordered, as is the case when there may be a likelihood of a court trial. Additionally, being a child, Nkanu’s autopsy should involve at least two types of Pathologists – Forensic and Paediatric.

During the Inquest, the Coroner, inter alia, summons witnesses, takes evidence on oath and even documents (Section 39 of the CSL). On conclusion of the Inquest, the Coroner shall give a written verdict as to how and when the deceased met their death, and forward it to certain officials including the Divisional Police Officer (DPO) in the District which the Inquest was held (Section 41 of the CSL). On the conclusion of a Coroner’s Inquest, the death may be ruled natural, thereby more or less resting the case (aside from the necessary administrative actions required to be completed on its conclusion), or an arrest may be ordered, or an order for further investigation by the Police which is expected to lead to the arrest of other unknown suspects.

Medical Negligence
It is true that, too regularly for comfort, Nigerians hear of cases of medical negligence. Patients are certainly, owed a duty of care. There are numerous reasons for medical negligence, including the Medical and Dental Council of Nigeria, not being particularly up and doing, and the punishments prescribed for medical malpractice in the Code of Medical Ethics 2008 (CME) which governs the activities of Medical and Dental Professionals, being too lenient. The level of monitoring of professionals, also appears to be extremely low; there must be a review of the CME and better monitoring processes of Medical and Dental Professionals by the Health Facility Monitoring Agency at the Federal Ministry of Health.

Section 30 of the CME provides that where a professional’s negligence results in the permanent disability or death of a patient, the professional is guilty of gross negligence, and is liable to six months suspension, or having his/her name struck off the Medical or Dental Register. Of course, this gross negligence may amount to manslaughter which is a grave criminal offence. In Popoola v State (2018) LPELR-43853(SC) per Olabode Rhodes-Vivour, JSC, the Supreme Court defined Manslaughter thus: “….the unintentional killing of a human being. Such a killing is not premeditated but accidental, in the sense that it was not intentional”. Sections 224(b) & 229 of the Criminal Law of Lagos State 2015 (CLLS) provide for the offence of Involuntary Manslaughter as a result of gross negligence or reckless disregard for human life, and prescribes a punishment of life imprisonment upon conviction.

However, in Ojo v Gharoro (2006) LPELR-2383(SC) per Niki Tobi, JSC, His Lordship cited a chapter ‘Doctors at Law’ in Lord Denning’s book, ‘The Discipline of Law’, where it was stated thus: “A medical man for instance, should not be found guilty of negligence unless he has done something of which his colleagues would say “He really did make a mistake there. He ought not to have done it”….”. While it is normal to administer a numbing substance on the area that the fluid will be taken from to do a LP, it is common practice to sedate a child (even adults, in some cases) while undergoing an MRI, to keep the patient completely still. How do we determine, if Nkanu was given too much sedative? An autopsy.

Conclusion
Allegations of medical negligence, must be made following due process, and dealt with on a case by case basis. What I said in the past, I still say today: “As a Lawyer, I will never be a party to determining liability based on the judgement of the court of public opinion without proper evidence being taken in a court of competent jurisdiction, or without the due process of the law being followed; and I will not join a crowd to shout ‘crucify him, crucify him’, if the rule of law has been ignored. I also will not join those who have decided to usurp the role of others to hand down a premature verdict, which the law does not give them the right to give….”.

What was the result of Nkanu’s LP? If it was positive for Meningitis, in the reports making the rounds there’s no mention of Meningitis, nor has any emphasis whatsoever been placed on Meningitis at all. There are three types of Meningitis – bacterial, viral and fungal. Bacterial meningitis appears to be the most severe, and has a high mortality rate, if treatment is delayed. These are the questions we should be asking, and discussions we should be having first, not a blanket, international condemnation of the Nigerian medical system without the complete facts. Of course, the incessant penchant for medical tourism by Nigerian leaders and elite, also fuels this negative narrative.

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