Persistent bleeding after surgery, referral to higher centre: Hyderabad hospital, surgeon slapped Rs 10.9 lakh for medical negligence

Hyderabad: The District Consumer Disputes Redressal Commission-1, Hyderabad, recently held a private hospital and one of its surgeons guilty of negligence during the treatment of a patient, who developed complications after undergoing surgery at the facility.

In its order, the Commission directed the hospital and the surgeon to pay Rs 10.88 lakh towards medical expenses, compensation, and litigation costs.

Case Background:

The history of the case goes back to 2025, when the patient developed a small lymph node on his left leg and consulted his family doctor, who suggested certain investigations such as USG Abdomen/Pelvis, USG Spectrum and accordingly the complainant got the said investigations done. Along with the reports, the patient consulted the treating doctor at the treating hospital and was advised to undergo emergency admission for a 1-hour minor surgery, stating that he would be discharged the next day.

Since the patient was diabetic, the surgery was conducted after stabilising the clinical/vital parameters and the patient was shifted to the general ward post-operation. Allegedly, his attendants observed heavy bleeding at the surgery site and informed the doctor, who said that bleeding is common post-surgery for two days.

However, the bleeding did not stop even after three days, and the doctor advised a second surgery to stop the bleeding. During and after the second surgery, heavy bleeding also occurred. For this, 12 units of plasma and 12 units of 'O' positive blood transfusion were administered to the complainant. Following this, the doctor suggested a third surgery and moving the patient to a better hospital, stating that the hospital did not have Vascular Vein treatment. Meanwhile, police intervention allowed the patient to stay in the hospital for the night and also for billing-related issues.

After discharge from the hospital, the patient was moved to another hospital, where another doctor and his team operated on him to stop the bleeding, and later, the patient was discharged with a prescription for medicines for postoperative care and healing.

Filing the consumer complaint, the patient claimed that the first doctor in the first hospital conducted two surgeries negligently, resulting in non-stop heavy bleeding, necessitating being rushed to another hospital, where the emergency condition of the bleeding was addressed by Vascular surgery.

Further, the complainant claimed that he incurred additional medical expenses for the inevitable third surgery in the second hospital for the repair of the damage caused due to the negligence and deficiency of service on the part of the first doctor and hospital. It was further submitted that he was unable to attend to his work in his restaurant, which was his livelihood, because of enormous pain and prolonged suffering due to the negligent treatment.

On the other hand, the treating hospital and doctor denied the allegations and contended that the patient was provided with the treatment as per established standard practice and procedure, and there was no shortcoming, negligence or deficiency in their services. They submitted that the patient was in severe pain due to a large, delayed abscess in the left upper medial aspect of his left thigh.

Providing details of the treatment procedure, they submitted that no third surgery was advised and the patient was only advised to consult a vascular surgeon as a precautionary and specialised opinion. It was also submitted that the second surgery was not due to uncontrolled bleeding, but the procedure was planned for re-exploration and debridement, which is a standard procedure in such infections.

Meanwhile, the second hospital submitted that the complainant was admitted to the Emergency Room with complaints of heavy bleeding from the left groin and therefore an emergency left thigh exploration + left GSV Vein ligation + primary repair of left femoral vein was conducted under general anaesthesia.

It was also submitted that the complainant underwent 3 units of PRBC (Blood) transfusion during his stay in the hospital, and he was on ventilator support post-surgery and was weaned off and extubated on postoperative day-1. Daily dressing, antibiotic IV, PPI and other supportive care were provided, and ultimately he was discharged in a stable condition with post-operative medication, dressing and follow-up.

Observations by Consumer Court:

The consumer court took note of all the details; while referring to the Discharge Summary of the first hospital, the Commission noted that the document mentioned, "….. As patient ooze was persistent, in spite of all conventional measures, he is being transferred to higher centre for further management."

However, in the 'Operation Findings' in the Discharge Summary, it was mentioned that no major vascular bleed, diffuse ooze from wound edger controlled and Hemostasis achieved, which is contradictory to the statement reiterated in the Discharge summary, noted the Commission.

The Consumer Court also noted the handwritten referral letter stating that post-operatively, the patient developed continuous oozing from surgical site on POD-2 which was not controlled with a tight dressing.

"Post procedure CECT abdomen showed multiple enlarged nodes in bilateral common ileal region…left inguinal lymphadenopathy (enlarged lymph nodes) (ventral and horizontal region). No evidence of arterial extravasation (which means no leakage of blood or fluids from an artery into the surrounding tissues)," it observed.

The very next day, the patinet was admitted to the second hospital with bleeding from left groin and was diagnosed with 'Left Thigh Hematoma with Active Bleeding".

Referring to this, the Commission noted, "The fact that that there is persistent bleeding when the complainant was discharged from O.P.No.1 Hospital and referred to Higher centre for further management, implies that the complainant was discharged under unresolved clinical conditions with persistent bleeding (as categorically stated by O.P.No.2 in the Discharge Summary and the referral letter filed) and hence cannot be said that Hemostasis was achieved and the same is contradictory to the findings of O.P.No.2 of persistent bleeding as mentioned in the Discharge Summary."

"It is abundantly clear from Approximate Report-Refer to Higher Centre and the hand written referral letter dt.20/1/2025, referring and transferring, the patient/complainant herein to a higher center explicitly demonstrates that O.P.No.1 & O.P.No.2 lacked the facility and capability, skill, or equipment to fix the damage they caused during the initial procedures done on 15/1/2025 and 18/1/2025," it further observed.

Apart from this, the Commission also noted that in their written version, the hospital and doctor submitted that they suggested for third surgery by a Vascular Surgeon, for which the complainant declined. This was again contradicted by their own statement in their evidence affidavit that they never suggested a 3rd surgery but advised a consultation with a vascular surgeon.

"At the cost of repetition, it is abundantly clear from Approximate Report-Refer to Higher Centre and the hand written referral letter, that the complainant was being discharged and referred/transferred to Higher Centre for further management as there is persistent oozing in spite of all conventional measures to stop bleeding," the Commission noted at this outset.

The consumer court observed that it was evident from the Discharge Summary of the second hospital that the patient was admitted with complaints of bleeding from the left groin associated with pain and swelling and it was diagnosed as "Left thigh hematoma with active bleeding'. The complainant underwent 'left thigh exploration + GSV ligation+ Femoral Vein- Primary repair in the hospital, "implying that repair was done to the femoral vein which was damaged during or post procedure of Incision and Drainage of left inguinal lymph node abscess done by O.P.No.2 in O.P.No.1 Hospital on 15/1/2025 and 18/2/2025," noted the Commission.

Secondly, the Commission observed that the Discharge Summary of the second hospital mentioned that GSV Ligation was done. At this outset, the Commission said, "As per the medical literature, GSV Great Saphenous Vein is a major superficial vein in the groin and ligating (tying off) this vein indicates it was damaged during the earlier surgery done in O.P.No.1 Hospital resulting in persistent oozing/active bleeding after POD-1 & 2 on 15/1/2025 and 18/1/2025, necessitating further management in a Higher Centre. From the above facts and evidence on record, it leads to the irresistible conclusion that the complainant was transferred with a referral by O.P.No.1 & 2 to the O.P.No.3 Hospital due to persistent bleeding caused due to damage to the femoral vein and Great Saphenous vein during the earlier surgical procedures on 15/1/2025 or 18/1/2025 or post surgical complication which could not be fixed by O.P.No.1 & 2 for reasons best known and the said damage was repaired/rectified by the Vascular Surgeon in O.P.No.3 Hospital GSV LIGATION + FEMORAL VEIN -PRIMARY REPAIR UNDER GA."

"To put it in a nut shell the surgical findings from O.P.No.3 hospital—specifically the ligation of the Great Saphenous Vein (GSV) and the primary repair of the femoral vein— provide unequivocal evidence of the damage that could have occurred during the initial incisional drainage and the re-exploration procedure done on 15/1/2025 and 18/1/2025 by O.P.No.2 in O.P.No.1 Hospital and O.No.1 & 2 failed to fix / repair the said damage resulting in persistent bleeding, as they admittedly referred and transferred the patient-complainant to a higher centre for further management. The above facts and evidence on record negligence and deficiency of service on the part of O.P.No.1 & 2 in the treatment provided to the complainant from 15/1/2025 to 20/12025. Hence, this point is answered in favour of the complainant," it further noted.

Accordingly, holding the first treating hospital and doctor, the Commission observed,

"In view of the above findings, this Commission is of the considered opinion that the complainant is entitled for the medical expenses incurred for the treatment and blood transfusion undergone by the complainant in O.P.No.1 & 2 Hospital ( the medical bills along with payment receipts filed) and the additional medical expenses and surgical procedure and blood transfusion undergone in O.P.No.3 Hospital ( Medical bills and payment receipts filed) for rectification of the damage caused by O.P.1 & 2 and the Opposite Parties No.1 & 2 are jointly and severally liable to pay the same along with reasonable compensation for the prolonged suffering and pain, mental agony and financial loss of the complainant and his family. There is no allegation and no relief sought against O.P.No.3 and is arrayed as a formal party in the complaint."

It ordered the hospital and doctor to pay Rs 10.88 lakh to the complainant for negligence and deficiency in service. The Commission mentioned in the order, "In the result, the complaint is allowed in part, holding the Opposite Parties No.1 & 2 jointly and severally liable for negligence and deficiency in the treatment and services provided to the complainant and O.P.No.1 & 2 are directed i) To pay Rs.8,38,532/- (Rupees Eight Lakhs Thirty Eight Thousand Five Hundred and Thirty Two Only) for the medical expenses and hospitalization incurred by the complainant for the treatment and blood transfusion undergone in O.P.No.1 Hospital & the third surgical procedure done in O.P.No.3 Hospital; ii) To pay Rs.2,00,000/- (Rupees Two Lakhs Only) compensation for the pain and prolonged hospitalization and mental agony and financial loss suffered by the complainant due to the negligence and deficiency of service on the part of O.P.No.1 & 2, iii) To pay Rs.50,000/- (Rupees Fifty Thousand Only) towards costs of litigation."

To view the order, click on the link below:

https://medicaldialogues.in/pdf_upload/2026/06/27/hyderabad-hospital-medical-negligence-356450.pdf

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