DR. NOBLE OGUGUO V. MEDICAL AND DENTAL PRACTITIONERS DISCIPLINARY TRIBUNAL (2019)

Background

Dr. Noble Oguguo, a registered medical practitioner working at Nomegal Generations Hospital, Lagos, was disciplined by the Medical and Dental Practitioners Disciplinary Tribunal for infamous conduct in a professional respect. The complaint arose from a medical certificate of cause of death, Exhibit NK2, dated 2 September 2002, which the appellant issued in respect of Alhassan Usman Opoke. The deceased had died on 16 August 2002 at Mile 4 Hospital, Abakaliki, Ebonyi State, where an earlier death certificate, Exhibit NK1, had been issued by the attending medical practitioner on 30 August 2002.

The appellant nevertheless issued a further certificate relating to the same death. The charge alleged that he issued Exhibit NK2 with an intention to mislead, despite being aware of the earlier certificate, and thereby conducted himself infamously in a professional respect contrary to rules 11 and 40 of the Rules of Professional Conduct for Medical and Dental Practitioners in Nigeria, punishable under section 16 of the Medical and Dental Practitioners Act, 1990. The Tribunal found him guilty and suspended him from practice for three months in its judgment delivered on 22 February 2007.

On appeal, Dr. Oguguo argued that the charge effectively disclosed allegations of forgery, conspiracy and obtaining by false pretences under the Criminal Code of Lagos State. He contended that the Tribunal lacked jurisdiction to try such criminal offences. He further argued that the Tribunal abandoned the particulars of the charge and relied unfairly on the words “aware or informed” contained in the certificate. He also maintained that the certificate was valid, was based on the World Health Organization form, and was authorised by section 22 of the Births, Death and Burial Law of Lagos State.

Issues

1. Whether the charge disclosed forgery, conspiracy or obtaining by false pretences so as to place the matter outside the competence of the Tribunal.
2. Whether the Tribunal abandoned the particulars of the charge and thereby violated the appellant’s right to fair hearing.
3. Whether the Tribunal’s findings concerning Exhibit NK2 were justified having regard to the document, the WHO format and the surrounding evidence.

Ratio Decidendi

The Court of Appeal held that the charge was one of professional misconduct, not a charge of forgery, conspiracy or obtaining by false pretences. Its substance was that the appellant, knowing that an earlier death certificate had been issued by the medical practitioner who attended the deceased at the place of death, issued another certificate with an intention to mislead. Since none of the ingredients or particulars of the Criminal Code offences were stated in the charge, the Tribunal retained jurisdiction to determine the professional disciplinary complaint.

The court explained that “misconduct” means unacceptable behaviour, particularly by a professional person. “Infamous conduct in a professional respect” means serious professional misconduct, and it may arise from numerous circumstances which cannot be exhaustively listed in a professional code. The proper question is whether the conduct falls below the standard expected of practitioners of good repute and integrity and breaches the code regulating the profession.

The court further held that rules 11 and 40 required medical practitioners to conduct their practice with proper decorum and to ensure that certificates, reports and similar professional documents did not contain information that they knew or ought to know was untrue, misleading or otherwise improper. A practitioner issuing a certificate relating to death must exercise appropriate care, verify the information included and clearly distinguish between personal knowledge and information received from another person.

Court Findings

The court rejected the appellant’s reliance on Lagos State legislation. It held that the Medical and Dental Practitioners Act and the Rules made under it are federal legislation specifically enacted to regulate medical and dental practice and professional conduct throughout Nigeria. They therefore take precedence over state legislation dealing with the same subject matter. Where a conflict exists, the federal enactment prevails; even where the provisions are merely similar, the federal legislation has priority for regulating the professional issue in question.

Regarding Exhibit NK2, the Tribunal had identified significant defects. The document was not simply a photocopy of the WHO-approved form but a retyped document from which the instructions for completion had been omitted. In particular, the form retained the alternative expression “as I am aware or informed” without indicating whether the cause of death was based on the appellant’s personal knowledge or information from a third party. The Tribunal considered that omission capable of creating ambiguity and misleading persons relying on the certificate.

The Court of Appeal found that this reasoning remained connected to the particulars of the charge. The appellant had been present throughout the proceedings, was represented by counsel, gave evidence, called a witness and cross-examined the prosecution witnesses. He also had the opportunity to address the Tribunal. Accordingly, the constitutional right to fair hearing was not violated. Fair hearing requires a reasonable opportunity to know the case, present a defence and have the material aspects of that defence considered; it does not prevent a tribunal from evaluating documentary evidence and drawing conclusions from it.

Conclusion

The appeal was dismissed for lack of merit. The Court of Appeal affirmed the decision of the Medical and Dental Practitioners Disciplinary Tribunal suspending Dr. Noble Oguguo for three months. The parties were ordered to bear the costs of prosecuting the appeal.

Significance

The decision confirms the distinction between professional disciplinary proceedings and criminal prosecution. A professional tribunal may determine whether a practitioner’s conduct violates professional ethics without trying the practitioner for a separate criminal offence. It also demonstrates that the validity of a medical certificate depends not merely on the practitioner’s ability to state a cause of death, but on strict compliance with professional standards governing accuracy, verification and clarity. Medical practitioners must not issue certificates containing ambiguous alternatives or information that may mislead, especially where another competent certificate has already been issued. Finally, the judgment reinforces the overriding effect of federal professional legislation over inconsistent or overlapping state laws concerning the regulation and discipline of medical practitioners.