The Association of Hospital and Administrative Pharmacists of Nigeria, AHAPN, on Friday raised a fresh alarm over the tragic death of Nkanu, the young son of celebrated writer Chimamanda Ngozi Adichie, describing the incident as “a grave patient-safety failure” that demands urgent national accountability.
In a press statement yesterday, AHAPN National Chairman, Pharm. Elechi Oyim, said emerging details surrounding the case point to a “serious deviation from internationally accepted standards of pediatric anesthesia and medication safety.”
According to him, reports that propofol was administered continuously as a sedative to a child under three years old contradict established global guidelines.
“This practice is in direct conflict with international anesthesia and pediatric safety standards, which clearly warn against prolonged propofol infusion in young children due to the risk of Propofol Infusion Syndrome (PRIS), a complication associated with high morbidity and mortality,” Oyim said.
He noted that PRIS is linked to severe metabolic acidosis, muscle breakdown, cardiac failure, and sudden death, adding that global bodies such as the World Health Organization (WHO), the U.S. Food and Drug Administration (FDA), and leading British anesthesia institutions have repeatedly cautioned against such use in pediatric intensive care settings.
“The FDA expressly states that propofol is not approved for long-term sedation in pediatric intensive care units because of multiple fatalities associated with PRIS,” Oyim stressed.
Beyond the clinical implications, AHAPN said the case exposes deeper weaknesses in Nigeria’s healthcare governance structure.“From a clinical governance and patient-safety perspective, this incident represents a serious deviation from accepted international standards of care. Where safeguards are absent, individual clinical judgment becomes an institutional risk,” Oyim declared.
He argued that no clinician should act as prescriber, administrator, and sole monitor of high-risk medicines without independent professional review.
“This contravenes fundamental principles of good governance. Healthcare delivery, like justice, depends on checks and balances,” he said.
Oyim lamented what he described as the routine marginalisation of pharmacists in critical care decisions, warning that such exclusion creates dangerous vulnerabilities.
“The exclusion of pharmacists from the medication-decision continuum, particularly in anesthesia and pediatric care, constitutes a systemic governance failure, not a mere clinical oversight,” he said.
The AHAPN chairman explained that clinical pharmacists are trained to detect unsafe drug choices, monitor dosage and duration, and intervene early to prevent fatal outcomes.
“Medication safety is a shared responsibility. High-risk drugs like anesthetic agents must never be used without structured multidisciplinary oversight,” he added.
AHAPN called for a thorough, transparent, and independent investigation into Nkanu’s death, alongside urgent reforms to strengthen multidisciplinary medication governance in Nigerian hospitals.
“Paediatric patients are a legally and ethically protected population. They must never be exposed to avoidable pharmacological risk,” Oyim said.
He warned that failure to enforce international safety standards not only endangers lives but also increases institutional and legal liability.
Expressing sympathy to the bereaved family, Oyim said: “On behalf of AHAPN, I extend our deepest condolences to Chimamanda and her family. This is a deeply distressing loss that should never be repeated.”He concluded with a call for collective responsibility in healthcare delivery: “Healthcare must evolve from professional dominance to collaborative accountability. Anything less is not only a clinical failure, but an ethical breach and a governance lapse that places lives at unacceptable risk.”
