When a sponge or instrument is left inside a patient after surgery
A swab, a surgical mop, a pair of forceps or a length of gauze left inside the body when the wound is closed is one of the few medical injuries the law treats as nearly self-proving. The standard of care for a surgeon is the protective Bolam standard — the ordinary skill of an ordinarily competent practitioner — accepted for India in Indian Medical Association v V P Shantha and elaborated in Jacob Mathew v State of Punjab , and a mere error of judgment is not negligence. But a foreign body sealed inside a patient is different in kind. In Achutrao Haribhau Khodwa v State of Maharashtra , (1996) 2 SCC 634, a mop was left inside a woman's abdomen during an operation; peritonitis developed, a second surgery followed, and she did not survive. The Supreme Court fixed liability on the institution because no valid explanation was forthcoming for the swab having been left behind, and held the doctrine of res ipsa loquitur applicable to such a case. This guide sets out the standard of care, why a retained foreign body shifts the evidential burden, the hospital's vicarious liability, the consumer-commission route, and the criminal threshold.