By Sir S. B. Ozoana, Esq (JP)
It is becoming very fashionable for hospitals in Nigeria to detain their patients due discharge for the failure or inability of the said patients to liquidate the hospital bills.
Sometime ago the Lagos University Teaching Hospital was reported to have detained a baby and the mother for four months over unpaid medical bills.
Also, recently a woman, who had lost her baby just after delivering prematurely at the Ajeromi General Hospital in the Ajegunle area of Lagos State, was reportedly detained with the infant’s remains, for almost a month, by the management over her inability to settle her medical bill of over three hundred thousand naira. The detention was despite the State’s directive to all General Hospitals and Primary Health Centers to provide free antenatal care and child delivery services, including normal and cesarean section, to expectant women who are residents of the state.
This short write up is to examine the legality of such detentions.
The world over, whenever a patient goes into a health facility for medical treatment, and the hospital accepts the person for such treatment, parties have entered a contract creating the relationship of Patient/Doctor or Patient and the Health Facility involved.
By that contract, the patient has put himself forward to be treated, and the health facility accepts or agrees to treat the said patient with all due diligence.
At the end of the treatment the health facility has the right to submit its bill for the treatment of the patient or where the patient had died the health facility submits a medical bill based on Quantum Merit. And the patient is duty bound to pay or liquidate the sum on the medical bill.
What happens in the event that the patient proves incapable of paying the bill? Has the patient committed any criminal offence that could lead to his being detained or restrained from freely leaving the health facility?
We submit that the patient’s inability to pay the medical bill will only amount to the patient being a debtor to the health facility.
The inability to pay a debt is not normally met by detention or arrest of the debtor. But in Nigeria, the current trend is to detain or arrest a patient who is unable to pay his medical bill, by forcing the Patient to remain in the health facility against the wish of the patient, rather than exploring other means of recovering the outstanding medical bill, arising from the patient’s inability to pay same.
By detaining or restraining the freedom of movement of the patient, the health facility or doctor is romancing with the Tort of False Imprisonment.
In some other jurisdictions, like the United States, some hospitals have a department whose responsibility is to go after the debtor patients for the recovery of unpaid medical debts. Some health care providers also do assign the debt to a collection agency. In worse-case scenario, you could be sued for the unpaid medical bills. The debtor/patient is never detained or arrested.
In the course of my research to put down this small piece, I found out that even though this seemingly unlawful act by health facilities are becoming the order of the day, most of these detentions have gone unchallenged by the victims of such illegal acts by health facilities in Nigeria.
The only recorded challenge to such illegal detentions of patients by a health facility is the case of Mrs Ngozi Osegbo, Mr Chinonso Osegbo against The Registered Trustees of the Synod of the Dioceses of the Niger in Suit No 0/255/2017 in the High Court of Anambra State sitting in Onitsha.
The facts of the case are simple and straightforward as follows:-
The Plaintiffs have taken their 11 months old baby to Eyi Enu Mission Hospital Onitsha for treatment, but the baby died while undergoing treatment. The hospital was said to have locked up the plaintiffs and insisted that they would not be allowed to leave the hospital until all payments had been made. The hospital thus detained the Plaintiffs for more than 10 hours despite every plea to allow them put themselves together and sort for funds.
The Plaintiffs therefore approached the court for the following reliefs to wit:-
A Declaration that the defendants owed the plaintiffs’ child (Marvellous Osegbu) a duty of care, and they breached that duty which resulted in his death.
A declaration that the action of the Defendants security men in denying the plaintiffs egress from the Defendants hospital and threat of grievous bodily harm with gun amounted to false imprisonment and assault and general damages in the sum of 500,000 Naira and 35% interest per annum (or prevailing CBN interest rate) on the judgment sum from date of judgment until final liquidation of the judgment debt.
The court held that the act of the hospital locking up patients from exiting their premises on the guise that they must complete payment amounts to false imprisonment. The court also condemned the Defendants method of debt recovery as uncivil and illegal. It is hoped that this judgment will have the opportunity of being tested at the appellate level, and that more victims of this illegal detention by health facilities should challenge such illegal detentions by due process.