Hospitals do not usually lose on the surgery
Someone read five years of medical negligence judgments from the national consumer commission, start to finish. Just over half went against the doctor or the hospital. The most common reason was poor skill or care. The second most common reason was not the operation at all. It was the way it was written down.
The finding
The study is a five-year retrospective review of 253 medical negligence cases decided by the National Consumer Disputes Redressal Commission between 2015 and 2019, published in the Indian Journal of Medical Ethics. Negligence was upheld in 135 of them, which is 53 per cent.
Surgery led the list of specialties at 27 per cent of the cases where negligence was found, with obstetrics and gynaecology next at 21 per cent. That will not surprise anyone who operates.
The part worth stopping on is what actually went wrong in these cases. Poor skill or care came first, in 36 per cent of them. Poor medical records came second, in 22 per cent. Not a wrong drug. Not a missed diagnosis. The record.
The authors do not stop at pointing it out. They name three things that prevent these cases: skill, talking properly to the patient, and careful records. Two of those three are about writing things down.
A second study, of 89 cases decided by state commissions in north India, says much the same thing. General surgery was sued most often, in 16.5 per cent of cases. Privately owned hospitals were sued more than any other kind. Government hospitals, the authors write, were the safest of all.
A number you should stop believing
You have probably seen a figure like 65,000 medical negligence cases a year in India, or a 400 per cent rise in cases. I went looking for where those numbers come from. There is no source.
Someone filed an RTI with both the National Consumer Disputes Redressal Commission and the National Medical Commission, asking how many medical negligence cases there are in the country. Neither of them counts. The rise that gets quoted everywhere comes from companies selling indemnity insurance, and a big number helps them sell it.
So when someone forwards you a frightening number, ask where it came from. The solid numbers are more boring and more useful. Pending cases at the national commission went up from 78,797 at the end of 2022 to 82,496 in 2024. In 2025 the Supreme Court itself pointed to delays running into years, and noted that about half the state commissions had no president sitting.
That is the real risk for a hospital. Not that you will definitely be sued. It is that if you are, the case will sit on your desk for years. In one matter decided in September 2025, the patient had died in 2005. The final judgment came twenty years later.
What would have made the difference
- Write the time, not only the date. If the note says explained to attenders and there is no time on it, you cannot answer a family who says they were told at a different hour.
- Write down who was in the room. The complaint almost always comes from the relative who was not there. If you have the names of the people who were there, with their signatures, that argument ends in one line.
- Write what you said, not just that you said something. Two lines about this patient are worth more than a printed paragraph that is the same on every form.
It is the question I get asked most. The honest answer is that a form proves a signature, not a conversation. When the dispute comes, nobody argues about whether a form exists. They argue about what the family was told, when they were told, and who told them. A signature at the bottom of a printed page answers none of those three.
Think of the consent form as proof of one moment. The ward and ICU conversations are the rest of the story, and in most hospitals there is no proof of those at all.
Next month
Why a properly signed, printed consent form can still be thrown out. What the Supreme Court has asked for in a valid consent since 2008. And the mistake with a relative's signature that careful doctors still make.
Sources
- Medical negligence in cases decided by the NCDRC: a five-year retrospective review. Indian Journal of Medical Ethics. ijme.in
- Study of 89 state commission cases, northern India. Journal of Forensic Medicine and Toxicology. acspublisher.com
- No consolidated national count; RTI to NCDRC and NMC. Medical Journal of Dr. D.Y. Patil Vidyapeeth, 2024. journals.lww.com
- NCDRC pendency and the Supreme Court on consumer-forum delays, 2025. Moneylife. moneylife.in
- Deep Nursing Home v. Manmeet Singh Mattewal, Supreme Court, 9 September 2025. indialaw.in
Case Notes is written by Dr Ranadheer Raju C S, laparoscopic surgeon at Sri Sara Hospital, Tirupati. It is one doctor reading published judgments and standards, and writing them up for other doctors. It is not legal advice. If you have a case going on, talk to your own lawyer. If I have got something wrong, tell me and I will correct it here.
MedSaakshi makes consent and explanation records that are signed, timed, recorded and sealed. If that sounds useful, there is a demo at medsaakshi.com. If not, the note above is still yours to use.