Medical negligence carries consequences that extend far beyond the immediate harm suffered by patients, imposing significant hidden costs on families, healthcare workers, hospitals and Nigeria’s health system, a leading orthopaedic surgeon and medical jurisprudence expert has said.
Prof. Dike Obalum, a chief consultant surgeon and legal practitioner, delivered the warning at a symposium in Lagos organised to mark the 2026 World Patient Safety Day. The event, themed “The Hidden Cost of Medical Negligence and the Conundrum of Justice,” was convened by Patient Academy International in partnership with Medilag Consult and the College of Medicine, University of Lagos.
Obalum stressed that patients who suffer preventable harm deserve access to the truth, a clear explanation, appropriate compensation and justice. At the same time, he cautioned that an excessive focus on litigation risks creating a culture of fear among healthcare professionals and encouraging defensive medical practice.
“Justice should not be underutilised in such a way that patients will suffer injury and will not be able to receive compensation. However, justice should not be overemphasised to the point where healthcare professionals begin to practise out of fear of litigation rather than with care,” he said.
Fear of lawsuits, he noted, can lead doctors to order excessive investigations or prescribe unnecessary medications simply to protect themselves. He emphasised that not every adverse outcome amounts to negligence. Healthcare involves inherent uncertainty, and complications, deterioration or death can occur even when appropriate care is provided.
Negligence is established only when a professional breaches the required standard of care and that breach causes harm. The essential elements of a claim, he said, are duty of care, breach of the applicable standard, causation and damage.
Obalum identified four broad categories of hidden costs: the burden on patients and families (extra medical bills, prolonged hospital stays, rehabilitation, lost income, disability, psychological trauma and long-term dependence); the burden on healthcare professionals and facilities (stress, burnout, reputational damage, disciplinary probes, legal costs and loss of confidence); the economic and societal burden; and the strain on the wider health system.
Hospitals, he added, face litigation expenses, compensation payouts, regulatory sanctions, staff turnover and eroded public trust. These pressures are compounded by Nigeria’s stretched healthcare workforce, where inadequate staffing reduces time for individual patients and raises the risk of error.
Compensation alone is insufficient, Obalum argued. A fuller concept of justice should deliver recognition of the harm, an explanation of what happened, accountability, an appropriate remedy and measures to prevent recurrence. He called for greater use of alternative dispute resolution mechanisms such as mediation and negotiation to resolve suitable cases
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