Introduction

The relationship between a healthcare provider and a patient is founded on trust, professional responsibility and a legal duty to exercise reasonable skill and care. Where a healthcare professional falls below the standard reasonably expected in the circumstances and that failure causes injury, disability or death, the law may impose civil, professional or, in appropriate cases, criminal consequences.^[1]

Medical negligence does not arise merely because treatment is unsuccessful or a complication occurs. Medicine involves judgment, uncertainty and recognised risks. Liability therefore depends on proof that the practitioner or institution breached the applicable standard of care and that the breach caused the injury complained of. The Supreme Court emphasised this distinction in Ojo v Gharoro, where the occurrence of a surgical complication, without sufficient evidence of negligence, did not by itself establish liability.^[2]

In Nigeria, medical negligence is governed by an overlapping framework of the common law of negligence, statutes regulating healthcare delivery and professional practice, constitutional rights, professional ethical rules and judicial decisions. This article examines that framework, the duty and standard of care owed by healthcare providers, the principal rights of patients, the civil and professional liability of practitioners and healthcare institutions, and the remedies available where negligent care causes legally actionable harm.

The Legal Framework Governing Medical Negligence in Nigeria

The civil foundation of medical negligence lies in the law of tort. The modern duty-of-care principle is conventionally traced to Donoghue v Stevenson, and Nigerian courts apply the ordinary principles of negligence to professional medical relationships.^[3] A claimant must therefore establish a legally recognised duty, breach of that duty, causation and damage.

The statutory framework reinforces these common-law obligations. Section 303 of the Criminal Code Act provides that a person who undertakes, except in a case of necessity, to administer surgical or medical treatment has a duty to possess reasonable skill and to use reasonable care in doing so. The provision is important because it expressly recognises, in statutory form, the obligation of reasonable skill and care in medical treatment.^[4]

The Medical and Dental Practitioners Act establishes the Medical and Dental Council of Nigeria (MDCN), assigns it responsibility for regulating the medical and dental professions, and creates the disciplinary machinery through which allegations of professional misconduct may be investigated and determined.^[5] Professional liability under the Act is distinct from civil liability in negligence: conduct may attract professional discipline even where a claimant does not pursue, or cannot establish, a civil claim for damages.

The National Health Act 2014 is also central to patient protection. It prohibits the refusal of emergency medical treatment, requires healthcare providers to give patients relevant information concerning their health status and treatment options, requires health establishments to create and preserve health records, protects the confidentiality of health information, regulates permissible disclosure of health records and provides a mechanism for complaints concerning the manner in which a person is treated at a health establishment.^[6]

Constitutional guarantees further inform the legal relationship between patients and healthcare providers. The rights to life, dignity of the human person and privacy may be implicated by the manner in which healthcare is delivered, particularly in cases involving degrading treatment, unlawful disclosure of medical information or serious failures affecting life and bodily integrity.^[7] The MDCN’s Code of Medical Ethics in Nigeria also governs professional conduct and sets ethical standards for medical and dental practice.^[8]

Duty of Care and the Applicable Standard

Once a healthcare professional undertakes the diagnosis, treatment or management of a patient, the relationship ordinarily gives rise to a duty to exercise the care and skill reasonably expected of a competent practitioner in the relevant field. The duty extends to diagnosis, selection and performance of treatment, monitoring, referral, and follow-up where those matters fall within the practitioner’s responsibility.

The law does not demand perfection or guarantee a cure. The relevant inquiry is whether the practitioner acted with the level of competence and care reasonably expected in the circumstances. In Ojo v Gharoro, the Supreme Court rejected the proposition that the breaking of a surgical needle during an operation automatically established negligence. The claimant had to prove that the occurrence resulted from a breach of the professional standard of care rather than a recognised accident or complication.^[9] This approach protects patients from substandard treatment without converting every adverse medical outcome into actionable negligence.

The same standard is reflected in section 303 of the Criminal Code Act, which speaks in terms of reasonable skill and reasonable care rather than absolute success.^[10] What is reasonable depends on the circumstances, including the nature and urgency of the treatment, the practitioner’s field of expertise, the information reasonably available at the material time, and the clinical choices open to a competent professional.

Healthcare institutions may also incur liability. A hospital may be directly liable for institutional failures within its own responsibility, such as deficient systems, unsafe facilities, inadequate equipment maintenance, defective record management, or failures in supervision. It may also be vicariously liable for torts committed by employees acting in the course of their employment, subject to the ordinary principles governing vicarious liability.^[11] The existence of institutional liability does not necessarily extinguish the personal liability of the practitioner whose negligence caused the injury.^[12]

What Constitutes Medical Negligence?

A claimant alleging medical negligence must prove four essential matters: the existence of a duty of care, a breach of the applicable standard, a causal connection between the breach and the injury, and legally recognised damage. The burden does not end with showing that a patient suffered harm while receiving treatment. The evidence must connect the harm to negligent conduct attributable to the defendant.^[13]

Medical negligence may arise from acts or omissions at different stages of care. Depending on the facts, examples may include an unreasonable failure to diagnose or refer, administering an incorrect medicine or dosage, performing a procedure without the required competence, leaving a foreign object in a patient after surgery, failing to monitor a patient appropriately after treatment, or failing to take reasonable precautions against an avoidable risk. Whether any particular act amounts to negligence remains a fact-sensitive inquiry measured against the applicable professional standard.

Information and patient choice are also important components of lawful medical care. Section 23 of the National Health Act requires a healthcare provider to give the patient relevant information concerning health status, available diagnostic procedures and treatment options, and the benefits, risks, costs and consequences generally associated with those options. It also recognises the patient’s right to refuse health services and requires the provider to explain the implications, risks or obligations of refusal. The section therefore provides a strong statutory basis for meaningful medical decision-making. However, it should not be overstated as a free-standing statutory formula for every question of informed consent.^[14]

The Supreme Court’s decision in Medical and Dental Practitioners Disciplinary Tribunal v Okonkwo provides the stronger Nigerian authority on patient autonomy. The Court recognised that a competent adult is generally entitled to decide whether to accept or refuse medical treatment, even where the refusal may expose the patient to serious risk. The practitioner’s obligation is to provide competent advice and relevant information, not ordinarily to substitute the practitioner’s preference for the informed decision of a competent patient.^[15]

Patients’ Rights under Nigerian Law

Nigerian law protects several interests that are central to the healthcare relationship. Under the National Health Act, a patient is entitled not to be refused emergency medical treatment; to receive relevant information about health status and available treatment options; to be informed of the benefits, risks, costs and consequences generally associated with those options; to refuse health services after being informed of the implications of that refusal; to have health information treated as confidential, subject to statutory exceptions; and to make a complaint concerning the manner in which the patient was treated at a health establishment.^[16]

Medical information is also protected by the Nigeria Data Protection Act 2023. The Act classifies health status as sensitive personal data and imposes heightened obligations for its processing. It also gives data subjects rights of access and related control over personal data processed about them, subject to the Act’s terms and lawful exceptions.^[17] These protections complement the confidentiality regime in the National Health Act and the constitutional guarantee of privacy.

The constitutional rights to dignity and privacy are particularly relevant where healthcare delivery involves degrading treatment, unjustified exposure of a patient’s medical condition or misuse of confidential information.^[18] These rights do not convert every clinical disagreement into a constitutional claim, but they shape the legal environment in which healthcare providers must exercise professional judgment and handle patient information.

Professional and Institutional Liability

Professional liability may attach directly to a doctor, dentist or other healthcare professional whose negligent act or omission causes injury. Liability is personal to the extent that it arises from the practitioner’s own breach of duty. Where several professionals participate in a patient’s care, responsibility must be assessed by reference to each defendant’s role, duty, and conduct rather than attributed collectively without proof.

A healthcare institution may also bear responsibility for negligence occurring within its operations. Direct institutional liability may arise from failures for which the institution itself is responsible, while vicarious liability may arise where an employee commits a tort in the course of employment. General Nigerian law of vicarious liability permits a claimant, where its requirements are satisfied, to hold an employer liable for an employee’s tortious conduct committed in the course of employment.^[19] In medical cases, the employment or contractual relationship and the degree of institutional responsibility must therefore be examined carefully rather than assumed.

Available Legal Remedies

1. Civil Liability

The principal remedy for actionable medical negligence is a civil claim for damages. The purpose of compensatory damages is, so far as money can do so, to compensate the claimant for loss caused by the defendant’s breach. Depending on the injury proved, recoverable losses may include reasonable medical and rehabilitation expenses, proved loss of earnings or earning capacity, and general damages for pain, suffering or disability. The claimant must still establish causation and prove any special damages with the degree of particularity required by law.^[20]

A civil claim should be distinguished from a complaint about an undesirable outcome or poor service that does not satisfy the elements of negligence. Where the complaint concerns confidentiality, unlawful processing of health data or another distinct legal wrong, additional statutory or constitutional remedies may be available depending on the facts.

2. Professional Discipline

A patient may also pursue professional disciplinary processes where the complaint concerns conduct regulated by the Medical and Dental Practitioners Act. The Act establishes the Medical and Dental Practitioners Investigation Panel and the Medical and Dental Practitioners Disciplinary Tribunal. Where the statutory conditions are satisfied, the Tribunal may direct that a practitioner’s name be struck off the relevant register, suspend the practitioner from practice for a period not exceeding six months, or admonish the practitioner.^[21] These sanctions should be stated in their statutory terms; professional discipline is not synonymous with a civil award of damages.

3. Criminal Liability

Serious medical misconduct may also attract criminal liability where the facts satisfy the elements of an offence. Section 303 of the Criminal Code Act imposes the duty of reasonable skill and care on a person undertaking medical or surgical treatment. In contrast, section 343 criminalises, among other conduct, giving medical or surgical treatment in a rash or negligent manner that endangers human life or is likely to cause harm.^[22] Criminal liability is not established merely because civil negligence is proved; the prosecution must establish the particular offence and its required elements beyond reasonable doubt.

4. Proof and Evidentiary Considerations

Medical negligence litigation often turns on evidence rather than on the abstract existence of a duty of care. The claimant bears the burden of proving the alleged breach and its causal connection with the injury. Where the dispute concerns a technical medical question outside ordinary knowledge, expert evidence may be necessary to establish the appropriate standard, explain whether the defendant departed from it and connect that departure to the injury. Ojo v Gharoro is particularly important on this point: the Supreme Court treated the absence of expert evidence as material in a technically complex claim and rejected an automatic inference of negligence from the mere occurrence of the surgical mishap.^[23]

Medical records are equally important. Section 25 of the National Health Act requires the person in charge of a health establishment to ensure that a prescribed health record is created and available for every user of health services. In contrast, section 29 requires measures to prevent unauthorised access to health records and storage facilities.^[24] Accurate, contemporaneous records may therefore be decisive both in protecting patients and in enabling practitioners and institutions to demonstrate what treatment was considered, explained and provided.

The doctrine of res ipsa loquitur may assist a claimant only where its conditions are satisfied. It is not a substitute for proof in every medical case. Where the event is capable of a non-negligent explanation or the defendant provides evidence explaining how it occurred, the court must evaluate the entire evidence rather than assume negligence from the outcome alone.

5. Preventing Medical Negligence

Sound clinical governance can reduce many disputes. Healthcare providers should maintain clear, contemporaneous records; communicate material information in a form the patient can understand; document important treatment decisions and refusals; observe confidentiality; follow appropriate clinical protocols; make timely referrals when a case exceeds available competence or facilities; supervise staff properly; and maintain equipment required for safe treatment. Health establishments should also maintain accessible complaint procedures and ensure that concerns are investigated promptly and fairly.^[25]

Preventive practice does not require defensive medicine or the elimination of professional judgment. It requires exercising clinical judgment competently, documenting it responsibly, and communicating it honestly. Strong institutional systems are particularly important because patient safety depends not only on individual practitioners but also on the quality of the environment in which treatment is delivered.

Conclusion

Medical negligence remains an important issue at the intersection of healthcare, professional regulation and patients’ rights in Nigeria. The law does not impose liability merely because treatment fails or a recognised complication occurs. It requires proof that a healthcare provider or institution departed from the applicable standard of care and that the departure caused legally actionable harm.

Nigeria’s framework combines common-law negligence, patient protections under the National Health Act, professional discipline under the Medical and Dental Practitioners Act, constitutional and data protection rights, and criminal liability where the elements of an offence are established.

Effective accountability also depends on clear communication, careful records, respect for patient autonomy, supervision, timely referral and confidentiality. These measures can reduce avoidable harm while strengthening professional accountability and public confidence in Nigeria’s healthcare system.

Reference

1. Oludamilola Adebola Adejumo and Oluseyi Ademola Adejumo, ‘Legal Perspectives on Liability for Medical Negligence and Malpractices in Nigeria’ (2020) 35 Pan African Medical Journal 44 <https://doi.org/10.11604/pamj.2020.35.44.16651> accessed 31 August 2026. ↑
2. Ojo v Gharoro (2006) 10 NWLR (Pt 987) 173 (SC). ↑
3. Donoghue v Stevenson [1932] AC 562 (HL). ↑
4. Criminal Code Act Cap C38 Laws of the Federation of Nigeria 2004, s 303. ↑
5. Medical and Dental Practitioners Act Cap M8 Laws of the Federation of Nigeria 2004, ss 1(2), 15–16. ↑
6. National Health Act 2014, ss 20, 23, 25–30. ↑
7. Constitution of the Federal Republic of Nigeria 1999 (as amended), ss 33, 34 and 37. ↑
8. Medical and Dental Council of Nigeria, Code of Medical Ethics in Nigeria (2008 edn). ↑
9. Ojo (n 2). ↑
10. Criminal Code Act Cap C38 Laws of the Federation of Nigeria 2004, s 303. ↑
11. Ifeanyi Chukwu (Osondu) Co Ltd v Soleh Boneh (Nig) Ltd (2000) 5 NWLR (Pt 656) 322 (SC). ↑
12. Adejumo and Adejumo (n 1). ↑
13. Ojo (n 2). ↑
14. National Health Act 2014, s 23; Medical and Dental Practitioners Disciplinary Tribunal v Okonkwo (2001) 7 NWLR (Pt 711) 206 (SC). ↑
15. Okonkwo (n 14). ↑
16. National Health Act 2014, ss 20, 23, 26 and 30. ↑
17. Nigeria Data Protection Act 2023, ss 30, 34 and 65. ↑
18. Constitution of the Federal Republic of Nigeria 1999 (as amended), ss 34 and 37. ↑
19. Ifeanyi Chukwu (Osondu) Co Ltd v Soleh Boneh (Nig) Ltd (n 11); Adejumo and Adejumo (n 1). ↑
20. Adejumo and Adejumo (n 1). ↑
21. Medical and Dental Practitioners Act Cap M8 Laws of the Federation of Nigeria 2004, ss 15–16. ↑
22. Criminal Code Act Cap C38 Laws of the Federation of Nigeria 2004, ss 303 and 343. ↑
23. Ojo (n 2). ↑
24. National Health Act 2014, ss 25 and 29. ↑
25. National Health Act 2014, ss 23, 25, 26, 29 and 30; Medical and Dental Council of Nigeria, Code of Medical Ethics in Nigeria (2008 edn). ↑