A hysterectomy performed for persistent menstrual bleeding spiralled into years of medical complications after a ureter injury sustained during surgery allegedly went unrecognised and untreated for critical days.

The patient underwent hysterectomy at a reputed nursing home after complaints of heavy and irregular bleeding. According to the complaint, severe complications began almost immediately after surgery. There was continuous soakage from the wound site, abdominal pain, unstable vital signs, persistent leakage of fluid, inability to tolerate food, and progressive deterioration in condition.

The family alleged that despite these warning signs, they were not informed that the ureter had been damaged during surgery. It was further alleged that timely corrective measures were not initiated, leading to prolonged urinary leakage, repeated hospitalisation, and multiple subsequent surgeries over the following months.

The defence did not deny the existence of ureteric injury.

Instead, the treating surgeon argued that ureter injury is a recognised complication of hysterectomy, particularly in patients with complex medical backgrounds. It was contended that specialists were consulted once complications emerged and that multiple reputed surgeons later participated in efforts to manage the leakage and repair the damage.

But the Commission drew a distinction between a recognised complication and negligent management of that complication.

Clinical records showed that signs of post-operative deterioration had appeared early. Blood pressure instability, soaked dressings, abdominal pain, persistent fluid leakage, bowel distension, tachycardia, and signs of sepsis had all emerged in the days following surgery.

Yet, according to the Commission, no timely urological evaluation or definitive diagnostic assessment was undertaken during this critical window.

The Court noted that intra-operative or early post-operative recognition of ureter injury is medically crucial because delayed diagnosis significantly worsens patient morbidity and often necessitates repeated reconstructive procedures.

That delay became central to the finding of negligence.

The Commission observed that while ureter injury may occur even in properly performed hysterectomies, surgeons are expected to maintain vigilance for such complications and promptly investigate suspicious post-operative symptoms through imaging and specialist consultation. In this case, CT imaging and urological intervention were initiated only after the patient’s condition had substantially deteriorated.

Another significant issue concerned informed consent.

The Commission found no material demonstrating that the specific risk of ureter injury had been discussed with the patient beforehand. It reiterated that informed consent is not limited to obtaining signatures on standard forms; it requires disclosure of material surgical risks that may reasonably influence patient decision-making.

Holding both the surgeon and hospital liable, the Commission awarded compensation exceeding ₹26 lakh.

The ruling underscores a defining principle in surgical negligence law: not every complication creates liability, but delayed recognition of a known complication may. In modern medico-legal scrutiny, the timeline between symptom and response can become as important as the surgery itself.

IML Insight

Ureter injury is a recognised complication of pelvic surgery, particularly hysterectomy. However, medico-legal exposure often arises less from the injury itself and more from delayed diagnosis and delayed escalation.

Persistent wound leakage, abdominal pain, tachycardia, sepsis, unexplained fluid collection, and urinary abnormalities after pelvic surgery demand early suspicion of ureteric involvement. Timely imaging and urological consultation are often decisive in reducing long-term morbidity.

The case also reinforces the growing legal importance of informed consent. Courts increasingly expect surgeons not only to document consent, but to demonstrate meaningful communication regarding serious procedural risks and foreseeable complications.

Source : Order pronounced by West Bengal State Consumer Disputes Redressal Commission on 6th May, 2026.