16-10-2026, 03:51 PM
1. Case Background
A consumer commission in Kolkata held a surgeon and Apollo Gleneagles Hospitals jointly liable for medical negligence and deficiency in service after a patient developed an infection following surgery for a high anal fistula. The patient, aged 53, underwent surgery on March 10, 2018, after consulting the surgeon on February 26, 2018. He was discharged the following day but later complained of severe pain and developed an infection and inflammation at the surgical site. He subsequently underwent another procedure at a different hospital on April 13, 2018.
2. What Were the Allegations?
The patient alleged that he had informed the surgeon about his regular medications, including Ecosprin 75, a blood thinner, and medicines for hypertension that he had been taking for nearly 10 years. However, he claimed that these medications were not properly documented in his medical records. He also alleged that his blood sugar levels were not checked before the surgery, which he believed contributed to the postoperative infection and the need for another procedure. The patient raised five allegations before the Commission, including issues relating to the continuation of Ecosprin, blood grouping, shaving of the surgical area, postoperative care and the failure to check blood glucose.
3. What Was the Doctor’s Defence?
The surgeon denied the allegations and maintained that the surgery had been performed satisfactorily. He argued that the subsequent inflammation was most likely a reaction to the seton material used during the procedure. He also stated that the patient had been reviewed on March 14 and April 5 and had been advised further treatment. Regarding blood glucose testing, the hospital argued that such testing was not required for relatively minor surgery unless the patient was already known to have diabetes. In contrast, the surgeon maintained that the blood sugar test had been conducted.
4. What Did the Commission Notice?
The Commission rejected several of the patient’s allegations but found that the failure to check blood glucose before surgery had been established. It highlighted a crucial contradiction: the hospital maintained that the test was unnecessary, whereas the surgeon claimed that it had been performed. More importantly, neither a report of the alleged test nor any mention of it in the discharge summary was produced. The Commission also considered the patient’s age, history of hypertension, long-term medication use and the nature of the procedure. Blood tests conducted before the second surgery showed fasting glucose of 132 mg/dL and post-meal glucose of 205 mg/dL, while subsequent records mentioned borderline type 2 diabetes and treatment for high blood sugar. The Commission concluded that the failure to check blood glucose fell below the standard expected of an ordinarily competent practitioner and that the undetected blood sugar problem contributed to the postoperative infection. However, it did not conclude that the second surgery was entirely attributable to this failure.
5. How Much Compensation Was Awarded?
The Commission directed the surgeon and Apollo Gleneagles Hospitals to jointly pay ₹3 lakh as compensation for medical negligence, deficiency in service, physical suffering, mental agony and harassment. An additional ₹20,000 was awarded towards litigation costs, taking the total to ₹3.2 lakh. The amount was directed to be paid within 45 days of the judgment. In case of non-compliance, the unpaid amount would attract interest at 9% per annum from the date of the judgment until payment. The Commission rejected the patient’s separate claims for ₹6 lakh towards alleged loss of wages and promotional opportunities and for additional treatment expenses, citing insufficient supporting evidence.
6. Lesson for Doctors
This case highlights an important medicolegal principle: a test that was allegedly performed but has no documented report may be difficult to defend in court. Doctors should assess patients appropriately before surgery, considering their age, comorbidities, medication history and the risks associated with the proposed procedure. Preoperative investigations should be ordered according to clinical indications and applicable protocols, and their results must be reviewed and documented. A patient’s regular medications, relevant medical history, preoperative assessment, investigations, operative notes and postoperative follow-up should all be recorded accurately. If a test is performed, its report should be traceable in the medical record; if it is not indicated, the clinical reasoning should be documented where appropriate. Hospitals must also ensure that medical records are complete, consistent and readily retrievable.
Remember: In medicolegal practice, good clinical care is essential, but proper documentation is what helps demonstrate that care was actually provided. A missing record can seriously weaken a doctor’s defence, particularly when the alleged omission concerns a clinically relevant preoperative assessment.
A consumer commission in Kolkata held a surgeon and Apollo Gleneagles Hospitals jointly liable for medical negligence and deficiency in service after a patient developed an infection following surgery for a high anal fistula. The patient, aged 53, underwent surgery on March 10, 2018, after consulting the surgeon on February 26, 2018. He was discharged the following day but later complained of severe pain and developed an infection and inflammation at the surgical site. He subsequently underwent another procedure at a different hospital on April 13, 2018.
2. What Were the Allegations?
The patient alleged that he had informed the surgeon about his regular medications, including Ecosprin 75, a blood thinner, and medicines for hypertension that he had been taking for nearly 10 years. However, he claimed that these medications were not properly documented in his medical records. He also alleged that his blood sugar levels were not checked before the surgery, which he believed contributed to the postoperative infection and the need for another procedure. The patient raised five allegations before the Commission, including issues relating to the continuation of Ecosprin, blood grouping, shaving of the surgical area, postoperative care and the failure to check blood glucose.
3. What Was the Doctor’s Defence?
The surgeon denied the allegations and maintained that the surgery had been performed satisfactorily. He argued that the subsequent inflammation was most likely a reaction to the seton material used during the procedure. He also stated that the patient had been reviewed on March 14 and April 5 and had been advised further treatment. Regarding blood glucose testing, the hospital argued that such testing was not required for relatively minor surgery unless the patient was already known to have diabetes. In contrast, the surgeon maintained that the blood sugar test had been conducted.
4. What Did the Commission Notice?
The Commission rejected several of the patient’s allegations but found that the failure to check blood glucose before surgery had been established. It highlighted a crucial contradiction: the hospital maintained that the test was unnecessary, whereas the surgeon claimed that it had been performed. More importantly, neither a report of the alleged test nor any mention of it in the discharge summary was produced. The Commission also considered the patient’s age, history of hypertension, long-term medication use and the nature of the procedure. Blood tests conducted before the second surgery showed fasting glucose of 132 mg/dL and post-meal glucose of 205 mg/dL, while subsequent records mentioned borderline type 2 diabetes and treatment for high blood sugar. The Commission concluded that the failure to check blood glucose fell below the standard expected of an ordinarily competent practitioner and that the undetected blood sugar problem contributed to the postoperative infection. However, it did not conclude that the second surgery was entirely attributable to this failure.
5. How Much Compensation Was Awarded?
The Commission directed the surgeon and Apollo Gleneagles Hospitals to jointly pay ₹3 lakh as compensation for medical negligence, deficiency in service, physical suffering, mental agony and harassment. An additional ₹20,000 was awarded towards litigation costs, taking the total to ₹3.2 lakh. The amount was directed to be paid within 45 days of the judgment. In case of non-compliance, the unpaid amount would attract interest at 9% per annum from the date of the judgment until payment. The Commission rejected the patient’s separate claims for ₹6 lakh towards alleged loss of wages and promotional opportunities and for additional treatment expenses, citing insufficient supporting evidence.
6. Lesson for Doctors
This case highlights an important medicolegal principle: a test that was allegedly performed but has no documented report may be difficult to defend in court. Doctors should assess patients appropriately before surgery, considering their age, comorbidities, medication history and the risks associated with the proposed procedure. Preoperative investigations should be ordered according to clinical indications and applicable protocols, and their results must be reviewed and documented. A patient’s regular medications, relevant medical history, preoperative assessment, investigations, operative notes and postoperative follow-up should all be recorded accurately. If a test is performed, its report should be traceable in the medical record; if it is not indicated, the clinical reasoning should be documented where appropriate. Hospitals must also ensure that medical records are complete, consistent and readily retrievable.
Remember: In medicolegal practice, good clinical care is essential, but proper documentation is what helps demonstrate that care was actually provided. A missing record can seriously weaken a doctor’s defence, particularly when the alleged omission concerns a clinically relevant preoperative assessment.