Doctor & hospital had indemnity cover of 5 lakhs each but court awards 50 lakhs as compensation - Need for contemplation regarding amount of insurance cover

January 04, 2024

Doctors / hospitals must have indemnity cover of a reasonable amount taking into account the fact that the amount of compensation granted by courts to patients in cases of medical negligence is increasing with every passing day.

The definition of such a ‘reasonable amount’ could depend upon doctors’ / hospitals’ area of expertise / specialty.

Irrefutable Facts

The patient was under ANC care of the gynaecologist. On the due date, the patient got admitted and delivered a healthy child through C-section which was performed by the principal gynaecologist, assisted by another gynaecologist.

Post-surgery the patient suffered from abdominal pain and consulted the second gynaecologist, but did not get relief. After repeated visits to the hospital, the patient consulted another hospital after about 4 months, where investigations revealed a foreign body (cotton sponge / mop) in her abdomen, which was surgically removed.

Colostomy was performed, the same was closed after 2 years and the patient recovered.

The patient sued hospital and both gynaecologists, alleging that she had to undergo three surgeries due to their negligence in leaving the bundle of cotton inside her abdomen during C-section. 

Doctor’s Plea

The second gynaecologist stated that patient consulted the her just before the date of admission and that she was not under regular ANC. It was further stated that post-surgery, the patient was duly treated for her abdominal pain and was referred further to a super-specialist.

The hospital pointed out that the patient had undergone two LSCS in the span of one year at two different hospitals. Hence It was not possible to ascertain in which of the two operations the mop / sponge was left inside the abdomen.

Court’s Observations

The court observed that admittedly the patient had undergone two LSCS in a span of one year, and if it is presumed as stated in defence, that the mop was left during the first LSCS, then either the second gynaecologist could not detect it or she detected and left it unattended during second LSCS. Both were instances of negligence, held the court.

The court further observed that the patient had not complained of abdominal pain after the first LSCS, but after the second LSCS she “continuously suffered from pain and visited various doctors”. This was a clear indication that the mop was left during second surgery and not the first one.

The hospital and second gynaecologist were held negligent and ordered to pay fifty lakh rupees compensation to the patient, whereas they had professional indemnity cover to the extent of 5 lakhs each.

Prevention Is Better Than Cure

Editors comment:

Doctors in India are confused about how the extent of their indemnity cover – how much is really enough?

This case is an excellent illustration of the pitfalls of having low indemnity cover - the gynaecologist and hospital were held negligent for leaving a mop post-LSCS.

The court awarded a compensation of 50 lakhs jointly whereas both had indemnity cover of 5 lakhs each. The insurance company obviously paid up the amount that was assured but the rest had to come from the pockets of gynaecologist and hospital.

In this era where high compensation is being awarded in cases of medical negligence, higher insurance cover is advisable for both surgical and non-surgical specialities.


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Source : Sabiha Hamid v/s Dr. M. Khan Hospital