Missing womb: How fibroid surgery turned awry for Lagos couple

…She gave me approval, says doctor

In what appears to be a deeply unsettling case, Mrs Suzan Okeafor has accused Lagos-based doctor, Joseph Ayelaje, of performing a hysterectomy (womb removal surgery) without her consent. The mother of two claims she had only consented to a fibroid removal but was horrified to learn weeks later that her womb had been taken out. This claim has been denied by the gynaecologist, GODFREY GEORGE writes

For Mrs Suzan Okeafor, 44, life has not been the same since March 29, 2024, when she went under the knife.

What was supposed to be a straightforward myomectomy—an operation to remove fibroids—ended with her womb being taken out “without her consent.”

The doctor involved, the Managing Director of Holyfill Hospital in Ikorodu, Lagos, Joseph Ayelaja, however, claimed that she gave her consent.

Our correspondent learnt that the gynaecologist has since reached out to several bodies, including the Lagos State Chapter of the Nigeria Medical Association, to broker peace.

Now, Suzan, a mother of two daughters, grapples with anxiety, panic attacks, and the haunting reality that her chance to bear another child has been taken from her forever.

A simple consultation

It all began in February when she and her family registered with Holyfill Hospital.

Ayelaja was recommended by her health maintenance organisation, Marina Medical Services Limited, as someone capable of performing the fibroid surgery she urgently needed.

The procedure, known as a myomectomy, was supposed to help her find relief from pain, heavy bleeding, and other symptoms caused by the fibroids, which had already caused one miscarriage and hindered further pregnancies.

“When I met with the doctor,” she recalls, “he suggested a hysterectomy.” A hysterectomy involves the removal of the womb, permanently ending a woman’s ability to conceive.

But according to Suzan, she was clear about her wishes.

“I told him that was not an option for me. I wanted the myomectomy done as soon as possible to avoid another heavy menstrual flow.”

The woman said she declined having a hysterectomy and opted for the less invasive myomectomy, which would remove the fibroids while leaving her womb intact.

Her health maintenance organisation approved the request promptly, she told Saturday PUNCH.

The surgery was initially scheduled for March 30 but was moved to March 29 due to scheduling conflicts on the doctor’s end.

On that day, the highly apprehensive woman arrived at the hospital with her husband, both confident that she would leave the operating theatre with restored health and her family’s dreams intact.

A successful surgery?

Suzan said she asked the hospital staff if her husband could be present during the surgery, but her request was turned down.

After the procedure, when the effect of the anaesthesia had worn off, there was no indication that anything had gone wrong.

For the duration of her recovery at the hospital, she said she repeatedly asked to see the fibroid that was removed. But, according to her, each time, she was given vague responses and saw nothing.

Two months passed, and yet, something felt wrong – she had not had her menstrual cycle since the surgery.

On a follow-up visit to the hospital, her world was upended by a shocking revelation.

“That was when the doctor bluntly told me the most horrible news ever—that he took out my womb,” she recounted, her voice tinged with disbelief.

“I was in shock. I quickly ran to the nearest lab to do a pelvic scan, and that was where I confirmed the horrible truth that he really did take out my womb.”

Her devastation was immediate and profound. This wasn’t what she had agreed to, she stated.

The realisation that her reproductive future had been altered without her consent shook her to the core.

She described the weight of the discovery, her voice heavy with pain and disbelief. She said, “We wanted another child, a male. We have two girls already. The fibroid was the only obstacle to me conceiving naturally.”

Determined to find answers, Suzan and her husband took the matter to their HMO, seeking clarity on how such a grave error could have occurred.

Our correspondent, who saw the email thread, saw that the HMO approved a fibroid removal surgery and not a hysterectomy.

In one of the emails, which our correspondent obtained, the officer in charge of the HMO told the doctor to produce the signed papers, but the document tendered showed no evidence that the couple requested for removal of the womb.

Ayelaje in the email thread stressed that the couple requested a hysterectomy, a statement Suzan categorically denied.

She said, “I never suggested or agreed to such a procedure.”

Realising that their pleas were being ignored, the family reported the case to the local police station in Owutu, Ikorodu.

Our correspondent, who spoke to the Investigating Police Officer in charge of the case, Adekunle Alasopupo, confirmed that the matter was reported. The policeman, however, asked this reporter to visit the station with Suzan to ‘confirm’ the case.

He also claimed to have transferred the case to the State Criminal Investigation Department, Panti, Lagos; a claim which our reporter cannot validate as of the time of filing this report.

Suzan said she reported the case to the Owutu Police Station on May 18 and investigations began.

A police officer who works at the Owutu Police Station but did not want to be named because he was not authorised to speak on the matter confirmed Suzan’s claims.

The officer also noted that the matter was transferred to theSCID Panti, Lagos.

Our correspondent reached out to the state Police Public Relations Officer, SP Benjamin Hundeyin, to validate this assertion. The PPRO promised to reach out to the Divisional Police Officer of the station to find out the status of the case. He had yet to do that as of the time of filing this report. Multiple follow-up messages and calls were sent on Friday before press time, but they were not responded to as well.

In a WhatsApp conversation with Suzan on June 14, of which a screenshot was obtained by our correspondent, Ayelaje stated that he was doing the family a favour which they would be grateful for.

He allegedly wrote, “Good morning, Suzan. Perhaps the challenge is miscommunication. Yes, preparation is good anyway, and the procedure benefits you more than an ordinary fibroid removal.

“I thought you fully understood me during the consultation and explanation. I am sorry for the gap in communication. Before God and man, at age 44, having completed your family, it is the best procedure for you.

“In the next 10, 20, or 30 years, you will appreciate what I did. Then, you will be praying for me in your heart. If you had been at the Cancer Centre, where patients come in different forms, you would be praising God for me.

“Suzan, all we did was to help you. Now, you are free from bleeding. Your health is perfect and free from pain, bleeding, and the risk of cervical cancer. Twenty to thirty years from now, that is when you will truly appreciate what I did for you. It was to help you have a better life. Now, the truth is miscommunication.”

However, the doctor’s explanations did little to soothe the pain of what the woman had lost.

She lamented that the consequence of his actions was a life-altering blow, not a medical favour.

In another WhatsApp conversation between Dr Ayelaje and Suzan, the doctor allegedly wrote, “After the procedure, you were under the effects of anaesthesia. I did not know you were not shown (the tissue removed from you). And when I came for review, you did not ask me. I attend a lot of cases.”

Suzan allegedly noted, “I asked you (for the removed tissue) but you told me they (nurses) would show it to me. They never did.”

In his response, he allegedly stated, “No problem. We started as friends. Please, let’s leave in peace. Sorry about that. God controls the affairs of men. Please, help me plead with your husband, biko (please). I did not meant (sic) to hut (sic) you in any form.”

Silence and stonewalling

As word of the incident spread, the Nigerian Medical Association stepped in to facilitate a resolution. Suzan said the chairman, Lagos State Chapter of the NMA, Dr Saheed Babajide, was brought in to mediate.

She claimed that he assured the family that justice would be pursued, requesting a list of their demands.

The Okeafors submitted three demands – a written and truthful report of the surgery; an undertaking that the doctor would take responsibility for any health complications arising from the unauthorised hysterectomy; and compensation of N35m for damages.

But instead of swift action, they were met with stalling, the family said.

The NMA’s initial promise of assistance turned into pleas for leniency toward Ayelaje.

“The NMA stopped us from taking further actions against the doctor but has done nothing to meet any of our demands,” Suzan said.

In a rather shocking twist, strangers began to arrive at her husband’s workplace, pleading on behalf of the doctor, whom they claimed was devastated by the prospect of disciplinary action.

The family said they felt increasingly isolated, as though the system meant to protect them was instead mobilising to shield the doctor.

“The NMA doesn’t want him to lose his license; they don’t want his office sealed,” Suzan said.

Mental, emotional toll

For the patient, the psychological impact has been as devastating as the physical loss.

She said, “I suffer from panic attacks and struggle with depression and anxiety. My husband got me into therapy.”

Her voice faltered as she described the daily struggle of accepting her new reality. She cherished her two daughters, yet the longing for the son she might never have only deepened her anguish.

The aftermath of the surgery has seeped into every aspect of her life. She constantly relives the decision on the operating table, a moment she said cannot be undone.

Resolution begins

In a quiet, dimly lit corner of Buka’s Hut in Alagomeji, Yaba, Lagos, Suzan and her husband, George, accompanied by their legal advisor and a close relative, faced a group of medical professionals, all convened to negotiate the unthinkable. Across the table sat the doctor who had performed the surgery, alongside members of the NMA – the chairperson, the treasurer (also a pathologist), and the head of the private hospitals committee.

This was the first of several tense gatherings aimed at resolution, held in locations ranging from restaurants to church meeting rooms, but no contract was ever signed or written agreement signed, leaving only words and tentative gestures to attempt closure.

For Suzan, these negotiations were a stab at closure she once hoped would bring justice.

“Initially when this happened, I wanted justice,” she said. “I wanted him jailed and his licence revoked. I wanted him to hurt like he had made me hurt.”

Her husband, however, fearing for her mental health, saw another path in the negotiated terms of the NMA.

In support of his wife’s well-being, he encouraged her to follow this path, even as he advocated her demands, lowering their initial financial request from N150m to N50m, then further to N35m.

But the negotiations stalled, halting at N20m with little word from the NMA.

Meanwhile, the couple’s demand for a written undertaking from Ayelaje—a formal admission that he would bear responsibility for any future medical complications—was dropped.

As Suzan described it, they felt “led along,” but no conclusive action materialised.

She was left without the closure she had hoped for, even as her health declined amid anxiety and panic attacks.

Responding on Thursday morning via a text message, Dr Babajide, Chairman of the NMA in Lagos, said the association’s lawyer was handling the matter and seeking an amicable settlement, a claim Suzan dismissed.

He wrote, “Good morning, Sir. I wasn’t involved directly. NMA Lagos State is involved in the case in order to settle the issue amicably between Mrs Susan and Dr Joseph.

“Meetings were held which involved the lawyer of Mrs Susan and NMA Lagos State lawyer. The lawyer of Susan and the lawyer of NMA Lagos State are handling it as at now to resolve the issue amicably.

“Dr Saheed Babajide Kehinde, Chairman NMA Lagos State.

“You can call me for more information. You should also discuss with the 2 lawyers and the 2 parties involved for balanced information. Thanks, Sir.”

Susan, responding to Babajide’s claim of amicable resolution, noted that the association had not reached out to her since September, which led her to approach the press for help.

Lady lying, she gave express approval – NMA lawyer

The counsel to the NMA Lagos chapter, Mr Bayo Omotubora, speaking to our correspondent in a phone call on Thursday afternoon, said, “It is true I am the solicitor to the Nigerian Medical Association, Lagos State branch.

“The doctor in question, Dr Joseph Ayelaje, is a member of that association. So, whenever there is an issue that has to do with law and police, such matters are referred to my office for advisory services.

“The NMA referred the matter, and the doctor also came to my office to let me know what transpired between him and his patient, Madam Suzan Okeafor. The woman had a fibroid and it was causing ceaseless blood flow, and there were times she wouldn’t be able to go out. She’d be bleeding continuously for some days.

“She went to Dr Ayelaje to seek medical advice, and the doctor advised her of two medical options. The first option was the complete removal of the fibroid, and the womb would be closed back, but there was a possibility of recurrence and cervical cancer developing thereafter.

“The second was to remove the womb completely, that is if she would not need to have another child. And she told the doctor that her last child was 10 years old and they were no longer interested in childbearing. The doctor then requested to see the husband to be sure they were on the same page on the matter. The husband visited the hospital and they agreed.

“The husband even signed the consent form for the operation to be carried out, and it is in our custody. He signed for her the day the surgery took place. It was not only the wife; the husband was there, too.

“Now, fibroid is always in the womb, and if a fibroid has been removed with the womb and everything went well, why go home and show up thereafter to say that you didn’t see your menses? How can you see menses when the womb is no more there?”

Claims

“That was how the family started making a claim of N500m and that the doctor must pay them N500m. The doctor said he didn’t do anything wrong because they consented to whatever was performed on his wife. The doctor said he would not give them a dime.

“At that point, the doctor took the matter to the association and brought me into the picture. So, this idea of NMA trying to cover up the case is not correct.

“The idea of NMA trying to cover up the case cannot come in because the association has affiliate bodies. It is the affiliate body that Ayelaje belongs to in Ikorodu there (sic) were the ones who brought the case to NMA Lagos State branch. Lagos State NMA got involved in the matter. It has always been the woman’s lawyer that has been writing and demanding compensation.

“This story of negotiation… This is because Ayelaje has always insisted that he did not do anything wrong. He has no money to give. So, when they are now saying there was a negotiation that was deadlocked, maybe, it is on their own (sic) side. This is because I have never heard of any negotiation.

“What the doctor told me was that he did not have a dime to pay them because they consented to the operation and it was carried out. As for NMA covering up, I am sorry o. If they had the plan to cover up, would they have brought their members to my office?”

When our correspondent stated that he had recordings of Ayelaje and him (lawyer) speaking to the Okereafors and their lawyer, stating something entirely contradictory, he said, “You said you have me on record speaking to their lawyer? My brother, I have just told you the official position here.

“So, if anybody has recorded and told you anything, the doctor has never told me that there was a negotiation with anybody. The lawyer you speak of is the one who wrote a letter to me.

“I have his letter here where he was demanding money. They even just brought this lawyer into the picture because the woman had a lawyer before and they debriefed him and hired this new one.

“The lawyer called me and he sent me an email asking for N50 million or something. Sho! What is the meaning of ‘a recording’. I have just told you the official position, Journalist.”

Our correspondent contacted the new counsel to the Okeafors, Mr Ben Ijewere, he availed the email he sent to the NMA counsel on October 7, 2024.

The email read, “Good morning, Counsel. Thank you for our discussions over the phone in the last couple of weeks. My client’s proposal is as follows:

“1. A full and final settlement of N35 million.

“2. An undertaking from Dr Joseph that he will be fully responsible for any subsequent health issues tat may arise from the unauthorised removal of her womb surgery he carried out on her.

“Kind regards, “Ben Ijewere, Esq “Counsel to Mrs Otibho Okeafor.”

HMO’s confirmation

The HMO involved said Suzan’s initial request for fibroid removal was approved under a myomectomy code, a procedure clearly specified as distinct from a hysterectomy. The HMO confirmed that it did not sanction a womb removal and was unaware of the procedure.

Saturday PUNCH also confirmed in the email thread among George, Suzan’s husband, and the HMO, there was no mention of approval for a hysterectomy.

Our correspondent also obtained another set of voice recordings in which Ayelaje’s lawyer, purportedly speaking to a relative of the Okeafors, stated that he was disappointed in Ayelaje’s conduct in the matter.

He said, “We are still pleading with you people concerning the doctor (Ayelaje). I spoke to him yesterday. This is because if someone comes to you for a fibroid operation, the basis upon which they approach your office is for fibroid removal. For whatever reason, even if you are going to operate on the womb, it must be with the patient’s consent and a concurrent agreement with both the husband and the wife.

“If he claims to have discussed it with the wife, he should also have discussed it with the husband. It is a very unfortunate situation. I asked him, how can you go to the extent of removing someone’s womb without consulting both the wife and her husband?

“He told me that he did not discuss it with the wife in all fairness. That was the lady’s pain. That was why she was crying like that. The doctor was lying to her face. Since he alleged that the wife gave consent, now her marriage is shaking. That was the lady’s pain. He kept saying that she already had two children and she should manage it like that.”

‘It was a miscommunication’

 Ayelaje, in a phone call to one of the Okeafor’s family members, allegedly admitted to having carried out the procedure without express approval.

He said, “Help me pacify her. I have been calling the husband, but he is not responding. If the mistake had come from me, we wouldn’t be having this problem. If I had discussed it with him, we wouldn’t have had all these problems. This thing would not have happened. It was an oversight.

“She will benefit from it. All I did was for her benefit. She is no longer  menstruating. She will be strong. The only challenge that she would have is the additional children that she said she wants.

“She will no longer carry any unnecessary burden in her body. She will not have any problem. That was why we advised that. It is just to help them. That part is taken away, so no disease would kill her. But we still should have let them know. It is for her own good. I should have carried her along.

“The husband and I are birthday mates. There is a way God does His thing to connect people, but it is not supposed to be in this kind of case. I really appreciate your calmness. I appreciate your maturity and the way you handled the whole matter.”

Ayelaje declines response

 When Saturday PUNCH reached out to Ayelaje, he refused to comment on the matter, saying it was against the code of ethics of the medical profession.

“I am a doctor, please. I don’t have the privilege to divulge patient information to a third party. The profession does not allow that. I can’t divulge that information. It is still confidential information. I cannot say anything about that to you, please,” he insisted.

When told that his reaction was important as the matter was meant for publication, he remained defiant.

“I still maintain my stand that this is a professional issue. She came to me and I attended to her, and what she demanded was what I did for her. I don’t have any time to share that with anybody, whether press or what have you. Thank you.”

Before our correspondent could ask further questions, the doctor disconnected the line and failed to respond to subsequent calls.

Consent form doctored, says husband

Meanwhile, George, speaking to the consent form stating that he ‘consented’ to the surgery, noted, “This is not what I filled. It has been doctored. It was blank when the nurse passed it to me to complete my name and address. He inserted the word ‘hysterectomy’ when he was asked by the HMO to provide the consent form [that I signed]. It wasn’t there when I filled that form. The doctor inserted that. I am telling you nothing but the truth.”

NMA chair’s further reaction

 Before press, Babajide, the chairman of the Lagos State chapter of the NMA noted, responding to further enquiries by Saturday PUNCH on the allegations of stalling made by the Okeafors noted in a text message on Friday that the two parties were still ‘negotiating’.

He said, “Thanks sir. I have called your number but you didn’t pick my calls. As I told you, NMA Lagos State and the Okeafor family agreed that we should allow the lawyer of NMA Lagos State and lawyer of Okeafors to meet and discuss on the issue.

“NMA Lagos State lawyer was initially engaging first lawyer of Okereafors. She informed NMA Lagos State that she had discontinued the service of her first lawyer. She then introduced another lawyer, who is now engaging NMA Lagos State lawyer.

“The stage of negotiation as at now is at level of the two lawyers. They are yet to communicate to NMA Lagos State what they agreed upon. The messages she has been sending to me, I send them to NMA Lagos State lawyer.”

He reached out again to Saturday PUNCH, in another WhatsApp message, saying, “NMA Lagos State read about a case between Mrs Okereafor and Dr Adelaje on a public media. NMA Lagos State felt that the issue can be resolved between the two parties. Meetings held at different locations between the parties and NMA Lagos State.

“It was agreed at the last meeting that the lawyer of the two parties should discuss and engage. During the process of discussions between the two lawyers, Mrs Okereafor informed me that she had disengaged her first lawyer that another lawyer will be discussing with NMA Lagos State lawyer.

“The second lawyer of Mrs Okereafor has been discussing with NMA Lagos State lawyer. I always sent messages from Mrs Okereafor to NMA Lagos State lawyer. NMA Lagos State is still waiting for the conclusion of discussions between the two lawyers. They are yet to communicate their conclusion to the association.”

Informed consent needed for all surgeries – Experts

In Nigeria, the Code of Medical Ethics and the National Health Act require informed consent from a patient before any surgical intervention, particularly sensitive ones like a hysterectomy. The law emphasises that doctors must clearly explain the risks, benefits, and alternatives, ensuring the patient (and sometimes family members) understand the procedure fully.

A medical researcher, Mable Ijeoma-Ezeuko, in her article, “Nigerian laws on informed consent before a surgical procedure” published in the Medico-Legal Journal on October 7, 2019, stated that in cases where such consent is not acquired or where medical procedures are conducted without proper authorisation, the Medical and Dental Council of Nigeria may impose disciplinary actions, including suspension or revocation of the medical practitioner’s licence.

Furthermore, she noted that criminal charges can be pursued if the patient’s bodily autonomy is violated

“In Nigeria, informed consent from the patient herself is legally required for any surgical procedure, including hysterectomy. This is in line with the National Health Act and the Code of Medical Ethics, which prioritise the autonomy and informed consent of the patient undergoing the procedure.

“The law does not mandate consent from the spouse (in this case, the husband) as a legal requirement for the surgery to proceed, as only the patient can authorise medical interventions on their body unless they are incapacitated or otherwise unable to consent,” she stressed.

However, in certain cultural contexts or depending on hospital policy, some practitioners may seek to involve family members in the decision-making process for major surgeries.

This is not a legal requirement but rather a discretionary practice that some doctors may follow, especially in cases where they feel family involvement is beneficial for patient understanding and support.

Meanwhile, a recipient of the Maternal and Child Health Leadership Laboratory Award and graduate student at the Harvard T. H. Chan School of Public Health, Dr Olaniran Olabiyi, noted in an emailed response to our correspondent’s enquiry that the legal implication of unauthorised hysterectomies in Nigeria can be narrowed down to an infringement of rights to privacy as enshrined in Chapter 4, section 37 of the 1999 constitution of the Federal Republic of Nigeria and Article 12 of the Universal Declaration of Human Rights.

He said, “Performing a hysterectomy without a patient’s explicit consent is legally and ethically problematic, exerting enormous consequences under medical law. Informed consent is crucial, and any procedure conducted beyond a patient’s acknowledgement—like an unapproved hysterectomy in the course of myomectomy— supports legal concerns.

“The Medical and Dental Practitioners Act (Cap M8 LFN 2004) and the Code of Medical Ethics authorise doctors to confirm that patients are fully conscious of and admitted to any treatment. Nigerian case law highlights that performing a procedure without a patient’s consent constitutes a violation of the body’s autonomy and potentiates a criminal act.”

Citing the case of Okekearu V. Danjuma Tanko [2002]; 15 NWLR (Pt.791) 657 underlines that no consent in medical procedures could lead to claims of battery and assault.

This precedent recommends that unapproved surgeries like nonconsenting hysterectomy violate a patient’s rights, which exposes practitioners to criminal and civil liability.

Furthermore, the medical doctor noted that Section 34(1)(a) of the Nigerian Constitution protects an individual’s right to bodily integrity and dignity.

“Contravening this constitutional right by performing a hysterectomy with no consent could have grave repercussions legally for the involved medical professional. Getting consent from a spouse is another issue in the Nigerian context, with cultural expectations that may affect medical decisions.

“Nonetheless, Nigerian law does not support spousal consent as a substitute for patient consent. The Ojo v. Gharoro & Ors (2006) case established that the right to make informed decisions and patients’ autonomy regarding their medical treatment is paramount. This case demonstrates that only the patient’s consent is legally binding, regardless of cultural practices,” he added.

However, there is an exception to this precedence that supports spousal consent when the patient is unconscious, especially in emergency cases that involve life and death, he noted.