A Nigerian lady who was misdiagnosed with breast most cancers and had her breast lower off has been confirmed to not have the illness.
It began when 33-year-old Serah Shimenenge Yugh was identified with Stage I invasive ductal carcinoma of the left breast in 2017.
Her plight started when she began dropping pounds whereas present process her Nationwide Youth Service Corps (NYSC) task in Ekiti State. She went to the hospital the place checks had been achieved however outcomes didn’t level to something.
Whereas self-examining her breasts in 2017, she felt a tiny lump on her left breast. This bothered her a lot that she first went to the Federal Medical Centre, Makurdi earlier than going to the Benue State College Educating Hospital at her sister’s suggestion. What was imagined to be a easy check developed right into a three-year-long backwards and forwards with the hospital.
It was such a tiny lump that — when a biopsy was carried out on the Benue State College Educating Hospital (BSUTH) — was described as “a single very tiny piece of greyish biopsy tissue that could be insufficient for course of.” On the hospital, Serah instructed them she needed to know the kind of lump she had.
MISDIAGNOSIS, THEN INDUSTRIAL ACTION
The histopathology prognosis of the primary check was Atypical Epithelial Hyperplasia (an irregular development sample that’s related to a small enhance in breast most cancers danger), which has been proven to be pre-cancerous however is just not most cancers. The second prognosis was an Invasive Ductal Carcinoma which, based on the Johns Hopkins Medicine, represents 80 p.c of all breast most cancers diagnoses.
Simply as Serah was awaiting the results of the third check, the hospital went on an industrial strike in September 2017 and by the point the strike was referred to as off in January 2018, she had undergone 5 rounds of chemotherapy. Her physician, Dr. Stephen Atokolo, had urged her to do a mastectomy to rapidly cease the unfold of what may very well be most cancers. She did the surgical procedure. When the third check consequence was out, the histopathology prognosis was Fibroadenoma. Serah Yugh didn’t have most cancers.
THE LONG WAIT FOR IMMUNOHISTOCHEMISTRY TEST
This misdiagnosis was nevertheless not what bothered her. Serah wanted her immunohistochemistry check. The check was to be given earlier than radiotherapy because it decided the subsequent steps of remedy. This nevertheless didn’t occur and he or she began taking Tamoxifen.
Since 2017, she had been coming to BSUTH from Kaduna and Abuja, asking for her immunohistochemistry check from the Dean of the Faculty of Well being Sciences, Dr. Joseph Ngbea. The check consequence was to allow the physician at Nationwide Hospital to determine on the remedy to present her.
Dr. Ngbea instructed FIJ that he was not in control of Serah’s case. And whereas Serah had paid for the check to his secretary at his request, every time she went, she was instructed the outcomes had been coming. The final time she waited to see him at his workplace, she remembers, he shouted at her.
At a gathering with Dr. Raymond Vhriterhire, the previous Head of Division of Histopathology, and Dr. Joseph Ngbea — who was newly appointed as Commissioner for Well being, Benue State, Serah was provided a breast reconstruction and a job. She rejected each.
She was extra fascinated about figuring out the precise life-redefining error made by the medical doctors. She additionally needed to know why they’d not but given her the immunohistochemistry check. She had requested them how she would address the unintended effects of the chemotherapy, radiotherapy, and medicines she was taking. The provide got here throughout to her as a ploy to silence her from asking questions — questions she had been asking since September 2017 when a mastectomy was carried out on her.
A physician who requested to not be named defined to FIJ that in issues of misdiagnosis as relevant to medical doctors, negligence is decided by a few elements. A physician has an obligation to a affected person. Secondly, there’s a dereliction (when a health care provider intentionally fails to do what she or he is meant to do). Thirdly, there may be harm as a result of dereliction and that harm bears a direct hyperlink between the physician’s negligence and the consequence (the harm).
THE IMMUNOHISTOCHEMISTRY TEST IS VERY IMPORTANT!
After her chemotherapy, Serah returned to Kaduna. It’s right here that she discovered Kunak and Project PINK BLUE, two NGOs that gave her assist. Venture PINK BLUE, a corporation engaged in most cancers consciousness, paid for her radiotherapy. However previous to then, Serah needed to get an immunohistochemistry check that was imagined to additional pin down the prognosis of most cancers.
In line with an oncologist, Dr. Chinedu Arua, histology and immunohistochemistry checks are stipulations for sufferers searching for breast most cancers remedy.
“These issues have an implication when it comes to the medicine we’re going to use to deal with the affected person, and the result of the illness,” he mentioned.
“It additionally has medical implications. With out the checks, a health care provider received’t comply with deal with the affected person. What they’ll do is to take a second pattern from that tissue and get histology for that. This might assist the physician give the suitable medicine to the affected person and provides a focal of what can be the doubtless consequence of the illness. Is the affected person coping with a illness that’s curable or one which they’ll simply be managing? The immunohistochemistry check is essential! With out it, the affected person may be given a incorrect drug for a incorrect illness.”
It was when Serah went to Abuja that her oncologist identified the discrepancies within the outcomes she introduced. She didn’t know the check outcomes had been totally different and due to this fact signified one thing deeper she may need been lacking.
“All my plan was to complete chemotherapy and do radiotherapy so I might play my half and relaxation,” she instructed FIJ.
TURNING TO GOD
The Nationwide Hospital Abuja, the main most cancers centre in Nigeria, was the place Serah underwent radiotherapy for six months. It was after radiotherapy that she returned to BSUTH to get her tissue block so as to do the immunohistochemistry check that was requested by oncologists on the Nationwide Hospital, Abuja. She had paid for the check in 2017 on the behest of Dr. Ngbea simply after her mastectomy in September. However the check outcomes by no means got here.
“I shed weight when I’m harassed,” Serah says.
With every date she remembers, she presents a supporting piece of proof to assist her declare. At different moments when she remembers her travails, she smiles and shakes her head. In these darkish moments, she says, she turned to worshiping God. It was there she discovered power and solace. It was additionally in her relationship with God that she discovered the power to emulate the biblical Joseph and maintain chasing for her immunohistochemistry check with out giving up.
“I couldn’t do radiotherapy the actual time I used to be imagined to do as a result of I used to be psychologically down and my weight drastically got here down. They mentioned they needed to place me on mattress watch. I used to be consuming and sleeping, attempting to achieve weight.”
After her radiotherapy, her oncologist instructed her they wouldn’t proceed with out the immunohistochemistry check. Since fee in 2017, and till 2019 when she underwent radiotherapy, she acquired no check outcomes. She was with out cash and couldn’t go to Benue State to observe up on the check.
WHERE IS THE TISSUE BLOCK?
Dr. Ngbea’s secretary instructed her the tissue block had been despatched to Labnetwork, a pathology and medical laboratory in Abuja. This was a wild goose chase. They didn’t have her data. She referred to as Dr. Ngbea to tell him her tissue block had not been acquired. When it was finally despatched, the check wasn’t paid for.
Serah opted to do a tumour marker check as a second possibility. A tumour marker check seems for tumour markers within the blood or physique tissues. When Serah finally bought the immunohistochemistry check from Labnetwork, the prognosis learn: “Breast tissue – no residual malignant tumour is seen!”
Up till December 2019, two years since her mastectomy, Serah nonetheless believed she had most cancers. The medical doctors at Benue State College Educating Hospital didn’t attain out to her to tell her of any misdiagnosis.
Nonetheless, regardless of the prognosis from Labnetwork, Serah didn’t but perceive that the outcomes confirmed she didn’t have most cancers. In line with her oncologist, her tumour marker check confirmed that she was away from most cancers. However the specimen which confirmed invasive ductal carcinoma was not what was despatched to Labnetwork. What had occurred to that specimen? Had it been disposed? Or had the medical doctors at BSUTH already recognized a mistake had been made and had been overlaying it up? When Serah went again to get her tissue block she was instructed they might solely discover the primary and third tissue blocks. The second tissue block mentioned to include most cancers cells couldn’t be discovered.
FINDING OUT SHE NEVER HAD CANCER
On March 2020, Serah wrote a letter to the Chief Medical Director of Benue State College Educating Hospital demanding for her immunohistochemistry check, and her tissue block from the second check she did.
“I’ve made repeated verbal calls for for my tissue block to the Division of Histopathology, however nothing has been achieved,” she wrote. “I would like you to assist take the required motion to allow me to get the tissue block as a result of the subsequent line of my remedy and drugs depends upon it.”
When she acquired no response, Venture PINK BLUE wrote to the Chief Medical Director, Dr. Terlumun Swende, in Could 2020 to attraction for the tissue block. The hospital, by means of the Chief Medical Director, responded to Venture PINK BLUE on July 2020.
“I’m to tell you of our lack of ability to grant your request for the discharge of the tissue block in respect of above affected person,” the response learn. “The affected person could nevertheless want to strategy the present managing doctor, as requests of this nature usually emanate from the managing doctor.”
In August 2020, the Division of Histopathology of the Nationwide Hospital, Abuja despatched a request to the Chief Medical Director for the tissue block, which Benue State College Educating Hospital mentioned contained most cancers. No response was acquired.
Looking for her tissue block to be given to her turned a full-time occupation for Serah. When she was directed to the Head of Division, he wasn’t out there for greater than three days. She later realized he had gone out on an official task.
“They began setting assembly. Earlier than I knew what was occurring, the H.O.D (Dr. Raymond) referred to as my uncle telling him that it was an error. I instructed him, I’m the sufferer right here. If you had been telling me I had most cancers, did you name my uncle?” Serah instructed FIJ, virtually breaking down in tears.
“So why are you calling my uncle telling him that I don’t have most cancers. I’m the one with the issue don’t name my uncle. If I might deal with the information that I’ve most cancers, then I can deal with ‘I don’t have most cancers it was an error’. They mentioned they’ve a way of doing issues.”
It was within the assembly arrange between Dr. Raymond and Serah’s uncle that Serah bought to know she had been misdiagnosed and didn’t have most cancers. This revelation made her demand to see the Chief Medical Director.
“You got here to my division requesting for blocks for the check that you just needed to do, that you just did someday up to now… to boost your remedy, which was troublesome for us to truly obtain. I need to apologise on behalf of the division that we couldn’t do this. I’m very sorry that we couldn’t provide the blocks,” the H.O.D began by saying within the assembly.
It was within the assembly that Dr. Raymond revealed that specimens had been discarded in 2018 as a result of the lab was stuffed up. Serah’s specimen was additionally discarded. Having learn the three reviews, Dr. Raymond didn’t assume the check can be crucial.
“These three reviews, the one which was at variance was the second. After I checked out it, I now thought inside me, if we determine to do immunohistochemistry it may not yield a lot,” Dr. Raymond mentioned.
The surgeon relied on the prognosis of the pathologist. The second report, which confirmed that Serah had most cancers, had Dr. Ngbea because the advisor pathologist. FIJ bought a replica of the report and on it somebody signed for Dr. Ngbea. Once we reached out to Dr Ngbea, he claimed the resident physician accountable had left the hospital however that he had nothing to do with Serah’s case.
BREAKING THE NEWS TO SERAH
FIJ obtained an audio recording the place Dr Raymond and Dr Ngbea had a gathering with Serah. Dr Raymond mentioned within the recording: “It’s unlucky that within the technique of attempting to supply assist, generally error happen. What can we do to help her choose the items of her life collectively as a result of clearly she doesn’t have most cancers?”
He additional mentioned, “The prognosis of most cancers has disrupted her life for the previous three years. . . The excellent news is that every one these surgical procedures that she went by means of she survived it. None took her life. The query now could be what’s the method ahead? How can we get her to select items of her life. It may not utterly deliver again her pleasure however not less than a bit style.”
It was on this assembly that they provided Serah a breast reconstruction and a job as efforts to indicate that she is just not left to bear the burden alone. This nevertheless appeared to come back at a time when Serah’s struggling and burden had greater than weighed her down. On the assembly, Dr Raymond acknowledged a failure within the examine and stability system of the hospital and a failure of the system.
“I don’t know what’s going on. I’m simply in the midst of the whole lot occurring,” Serah mentioned, confused. “First I assumed it was immunohistochemistry consequence I used to be coming for. Then I found it was tissue block. Then the subsequent factor is that I by no means had most cancers.”
These conferences had been lengthy explanations into how errors had been made by medical doctors. Serah questioned what they might do concerning the unintended effects of chemotherapy, radiotherapy and Tamoxifen? She recalled how weak her bones had been and the way inconsistent her durations turned. She couldn’t stroll or journey for lengthy distances and lots of occasions needed to take care of complications. As we discuss, she tries to recollect among the questions I had simply requested her minutes earlier than. She tells FIJ she’s been coping with reminiscence loss.
On the assembly she requested that the Benue State College Educating Hospital write a letter to her physician on the Nationwide Hospital, Abuja, that they made an error and due to this fact she ought to cease remedy. No letter has been written. And whereas verbally the medical doctors have acknowledged they made an error, it’s not been documented formally.
“Once they instructed me I had most cancers it didn’t have an effect on me this a lot,” she mentioned. However it’s the battle of combating the error that has taken extra from me. After I give it some thought, consuming turns into an issue.”
Serah misplaced her relationship, and her dream to pursue a Ph.D.
“I don’t need others to fall sufferer as a result of I do know it won’t finish simply with me alone,” she mentioned, explaining why she’s been combating the misdiagnosis made on her. Though she fears for her life and the repercussion her talking up may deliver to her, she desires an official apology from the Benue State College Educating Hospital.
JUSTICE FOR SERAH
Runcie Chidiebe, the founding father of Venture PINK BLUE, instructed FIJ that getting justice for Serah is in three folds.
“Primary is the justice that must be pushed by the woman whose breast was lower off when there was no want for that. That’s justice for her as an individual,” he says.
“The second half is for girls throughout the nation who’ve been by means of this, to talk out. This needs to be a really sturdy message to each medical practitioner to be very aware of the licence they’ve bought.
“The third half is that if you concentrate on the influence of this, she is going to dwell the remainder of her life with one single breast when she by no means had most cancers. This can be a very sturdy reminder of what the system has subjected many to.”
Chidiebe lamented that there are thousands and thousands of people that will nonetheless get most cancers in Nigeria or elsewhere in Africa, however they need to search second opinion earlier than present process surgical procedure.
“You don’t simply get first opinion, then enable your breast to be lower off. A number of checks have to be achieved,” he warns.
On what Serah may need on the finish of all this, he defined that her most urgent targets should not pecuniary.
“If Serah had needed a job, she would have been working on the hospital way back. If she needed cash, she would have gotten the N10million that was promised her a number of months in the past,” he mentioned.
“However she instructed me way back she desperately desires this info to get out in order that different individuals identified with most cancers can keep away from the pitfall she’s into. And I feel that’s actually assured of her. She must be supported and guarded in any respect prices.”
Having labored within the area for seven years, this isn’t the primary case of misdiagnosis Chidiebe has seen.
“We’ve seen a lady who was identified triple unfavourable, however they’d given her another person’s consequence and mentioned she was hecto-positive,” he mentioned.
“They usually had been treating her with totally different most cancers chemotherapy, one which she didn’t want. It’s occurring in hospitals throughout this nation — due to negligence. ”
For that reason, Chidiebe desires these culpable within the misguided removing of Serah’s breast to be prosecuted in a courtroom of regulation.
“It’s so painful when individuals know the reality they usually’re hiding it from you, making you appear like a child,” he laments. “The individuals who made this error needs to be prosecuted!”
This story is unique to Foundation For Investigative Journalism