Ifedolapo Oladepo is gone and we are sad sore. Different accounts of what led to her death have surfaced. But on the quest to get more facts that led to Ifedolapo’s tragic death at the Kano NYSC Orientation camp, a doctor with ties to one of the corps member doctors that attended to her, Chibuike Joseph Chukwudum has gone a step further into an enquiry and has given us this balanced, professional and well-written reportage below, via his Facebook page. Kindly read through. (See pictures of the investigative conversation after the text)
MY THOUGHTS ON IFEDOLAPO:
The Other Side Of The Story
There are three sides to every story; one from each of the two sides involved, and then the truth.
In order to be able to make an informed and unbiased judgment, one must consider the two sides without prejudice. Only then can one be able to make a balanced judgment.
Hence the legal maxim: audi alteram partem, which is a reminder, an injunction rather, for one to “hear the other side.”
Yesterday I ATTEMPTED an unbiased analysis of the unfortunate events, as told by the sister, that led to death of Ife. Today, I’m here with an account from the “other side” of the divide.
Even though this is clearly a “ONE SIDED” account, and may therefore not be the whole truth,for fairness sake, I will assume every bit of it to be true [just like I did with Ife’s sister’s account.]
Read with an open mind, or read no further.
*LET’S GET ORIENTED*
This account was synthesized from the story as told by two different persons, who both gave an account of events from their own perspective, and as BEST KNOWN TO THEM, without any influence from the other.
They both work in the camp clinic where the incident took place : one as a physiotherapist, and the other a doctor who passively participated in the management of the deceased girl.
My conversation with the physiotherapist was via FB chat[see attached pictures], and he admitted his information was second hand. While my conversation with the doctor, who was my schoolmate, was via a phone conversation [I didn’t even know he was serving in Kano, not until about 3 hours ago].
The two stories are similar except in two places:
1. The timeline: the doctor’s timeline tallies with that of Ife’s sister’s account, while that of the physiotherapist is totally out of sync with both.
2. The doctor’s account is more detailed and reliable as he participated in the management of the patient.
She presented to the clinic, for the very first time around 5pm, with complaints of high grade fever, generalized body pains, dizziness, and malaise. She had been having those “malaria-like” symptoms since that morning, so it is possible that she MAY have come to the clinic earlier before then, when she may not have been “taken seriously” as alleged by the sister. However, the doctor whose account this story is based on, is not aware if there was an earlier visit in the morning/afternoon, as he wasn’t on duty at those times.
On close examination, the doctor on duty noticed pin-sized [petechial] rashes on her hands and foot. She [Ife] however dismissed this and attributed it to her reacting to “something” she’s using. The rashes were not associated with itching, or any other worrisome symptom, so much attention wasn’t paid to it.
A rapid diagnostic test done was positive for Malarial Parasite. That, coupled with the aforementioned suggestive symptoms, made them to settle for the diagnosis of “Acute Malarial Fever.” Full Blood Count, and other ancillary investigations, was not done to rule out other possibilities [and also check level of Platelets, especially where she seemed to be having petechial rashes,] as they weren’t available.
Based on this, an antimalarial injection [Artemether], along with an anti pyretic [Diclofenac, for controlling the fever and body pains,] was given to her through the muscle [and not vein]. And she went back to her hostel to be on bed rest.
About 3 hours later– 8pm [unlike in the previous account where her condition worsened IMMEDIATELY following intravenous injection of an “unknown substance,”] she came back to the clinic with worsening symptoms: the fever had worsened [38.8°c], and so had the dizziness, weakness, and in addition she had developed palpitations and breathlessness.
Furthermore, the rashes had coalesced, forming purpura under the skin [petechial rash, what she was initially having, is actually small bleeding under the skin; if it worsens and becomes larger and more obvious, it becomes purpura] , and spreading farther to involve more parts of the body. Also, she had conjunctival injection. This in simple term means that the eyes were blood shot, that she was not just having small bleeds into her skin, but it was also happening in her eyes.
At this point, the blood pressure had dropped, and the pulse and respiratory rates had skyrocketed: shock!
With this picture, they were thinking of the following possibilities:
1. Viral Hemorrhagic Fever [ the likes of Lassa Fever,Ebola, and others in that same family]
2. Septic Shock [with organisms that can cause petechial rashes, like Meningococcus, as the probable culprit]
3. Still Malaria or Sepsis, with a background allergic reaction, perhaps to Artemether.
However, because she already had the rash before the administration of artmether, and because there was no itching, stridor, nor the alleged tongue swelling, they weren’t really thinking of allergic reaction. Hence why they made it their last differential.
She was cannulated, and IV Hydrocortisone and IM Adrenaline given. Also she was placed on Normal saline drip.
Seeing that it was no longer a case that could be handled in the camp clinic, and more importantly AFRAID OF THE POSSIBILITY OF A VIRAL HEMORRHAGIC FEVER, they informed NYSC officials on the need for URGENT referral.
The referral was official written between 9pm and 10pm.
NYSC officials not ready to convey her yet, advised them to continue managing her while they made arrangements.
From 9 to 10pm till about 12am to 1am, she was still in the camp clinic on the aforementioned treatment, before she was taken to the General hospital which is about 40 minutes to 1 hour road distance from the camp clinic.
At about 3am she gave up the ghost, within minutes of arrival to the general hospital. While the doctor, whose account forms about 90% of this story, said he cannot tell what happened in the General hospital [in fact he said he’s not sure she lasted long enough to be seen by a doctor, which tallies with the Sister’s account,] the Physiotherapist [whose account is in the screen-munched chat,] claims the diagnosis in the General hospital where she was taken, was “Septicemia” [ which is loosely the same thing as “Sepsis” and can lead to “septic shock,” agreeing with number 2 possibility above.]
The NYSC Director General sent a team to the camp clinic to investigate the events surrounding the unfortunate demise of the deceased, including reviewing their clinical notes and establishing a timeline.
Also, an autopsy has been carried out to determine the cause of her death.
While both, the doctor and the physiotherapist, admitted that they are not aware of the autopsy findings, they are both of the opinion that whatever it was it seemed to have exonerated them as no one has hassled them since then. This, at best, is just a hunch.
Also the team sent by the DG didn’t find them wanting, as more of the blame seemed to be on the approximately 3 to 4 hour delay, from the time of referral, to the time of ACTUAL transfer.
*VERACITY OF THE TWO SIDES OF THE STORY*
Having heard both stories, we can’t say as a matter of certainty which is true, and which is not.
However, we will all agree that THIS account brings a whole new angle to the whole issue.
The following are reasons while we may not trust either stories completely:
1. On the side of Ife’s sister; for the fact that she wasn’t present, and that grief sometimes clouds people’s judgment, we can’t be too sure if her account is 100% accurate. [Heck! I have had a grieving deceased patient’s relative accuse me of strangling the mum, whereas I was doing CPR]
2. On the side of the camp health team; for the fact that they stand to lose so much, it is possible that their account was also doctored. All the same, it provides an enlightening insight.
That said, the only way we can be sure of what really happened is if the autopsy result is made public.
1.There’s always two sides to a story; and the first side, the side of the victim, may not always be a true representation of the facts. Therefore, we must always hear from the other side. Audi Alteram Partem.
2. With the huge discrepancy in both accounts, they seem to agree on two things: the timeline, and indictment of NYSC.
3. While we are mourning Ifedolapo, we should all hold our breaths and pray, for a far worse calamity may be looming as we speak. If it was actually Viral Hemorrhagic Fever, IF….
*shudders at the thought.
THE SCREEN GRABS
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