India performs millions of surgeries every year, ranging from simple procedures like cataract surgery to complicated surgeries like organ transplants. But there are many cases where Routine Surgeries Go Wrong, and this happens due to a combination of system failures, including overcrowded hospitals, inadequate infrastructure, poor communication within surgical teams, and a lack of standardised safety protocols. Other factors include high-pressure environments leading to human errors, such as wrong-site surgeries, leaving gauge or small surgical instruments in the body, and in some cases, performing unnecessary procedures.
Reasons
1 High Patient Load and Overburdened Healthcare System
India’s healthcare system faces immense pressure due to its large population:
- Government hospitals often handle a disproportionately high number of patients.
- Surgeon and medical staff may perform multiple surgeries back-to-back with minimal rest.
- Time constraints can lead to rushed pre-operative assessments or post-operative care.
Impact: fatigue and time pressure increase the risk of human error, even in standard procedures.
2 Variability in Healthcare Infrastructure
There is a wide gap between urban and rural healthcare facilities.
- Tier 1 cities may have advanced equipment and highly trained specialists.
- Smaller towns and rural hospitals may lack essential surgical infrastructure.
- Inconsistent availability of ICU support, sterilisation systems, or monitoring equipment.
Impact: Even routine surgeries can become risky if proper facilities are unavailable.
3 Shortage of Skilled Personnel
India faces a shortage of trained healthcare professionals relative to its population.
- Limited number of anesthesiologists, nurses, and technicians.
- In some setups, undertrained or inexperienced staff assist in surgeries.
- Skill levels can vary widely across institutions.
Impact: Surgical success depends on a team; weaknesses in any link can affect outcomes.
4 Inadequate Pre-operative Evaluation
Routine surgeries are sometimes perceived as ‘low-risk’, which can lead to complacency.
- Incomplete patient history (e.g., undiagnosed diabetes, hypertension)
- Lack of proper diagnostic tests due to cost or time constraints.
- Poor communication between the patient and the doctor.
Impact: Hidden medical conditions can lead to complications during or after surgery.
5 Infection Control Challenge
Hospital-acquired infections remain a concern in some facilities
- Overcrowding can compromise hygiene standards.
- Inadequate sterilisation of instruments in certain setups.
- Antibiotic resistance is rising in India
Impact: Post-surgical infections can turn minor procedures into life-threatening situations.
6 Communication Gaps
Effective communication is critical in surgical care.
- Language barrier between patients and doctors.
- Poor coordination among surgical teams.
- Inadequate explanation of risks and post-operative instructions.
Impact: Miscommunication can lead to errors.
7 Commercial Pressures in Private Healthcare
The private sector plays a major role in India’s healthcare system.
- Financial incentives may sometimes lead to unnecessary surgeries.
- Cost-cutting measures in smaller private hospitals.
- Pressure to increase patient turnover.
Impact: Compromises in quality and judgment can increase the risk of complications.
8 Lack of Standardisation and Protocol Adherence
While protocol exist, adherence is not always uniform
- WHO surgical safety checklist is not consistently followed everywhere.
- Variation in clinical protocols across hospitals.
- Limited auditing and accountability in some institutions.
Impact: Skipping basic safety steps can result in avoidable errors.
9 Patient-Related Factors
Not all complications are due to medical negligence
- Patients may delay seeking treatment until the condition worsens.
- Poor compliance with pre-and post-operative instructions.
- Lifestyle diseases like diabetes and obesity increase surgical risk.
Impact: Even a routine surgery becomes complex if the patient’s health is compromised.
10 Legal and Reporting Issues
India’s medico-legal environment also plays a role
- Underreporting of surgical errors due to fear of litigation.
- Lack of transparent data on complications.
- Defensive medicine practices in some cases.
Impact: Without proper reporting, systemic issues remain unaddressed.
11 Training and Education Gaps
Although India produces many doctors, the training quality can vary.
- Limited exposure to advanced surgical techniques in some institutions.
- Inconsistent mentorship during residency.
- Rapid technological advancements are outpacing training in some areas.
Impact: Inexperience or outdated practices can affect surgical outcomes.
Steps Being Taken to Improve Safety
India is actively working to address these challenges.
- Ayushman Bharat- improving access and infrastructure.
- National Medical Commission (NMC) – reforms in medical education.
- Accreditation systems like NABH promote standardisation.
- Increasing adoption of minimally invasive and robotic surgeries.
- Growing emphasis on patients’ safety protocols.
In the end, routine surgeries going wrong in India are rarely due to single mistake. Instead, they reflect a complex interplay of systemic strain, infrastructure gaps, human factors, and patient conditions. While the situation is improving with policy reforms and technological advancements, ensuring consistent quality across the country remains a key challenge.
Strengthening healthcare systems, enforcing strict protocols, improving training, and fostering transparency are essential steps toward minimising surgical complications and building public trust.
Anil Malik
Mumbai, India
18th March 2026