The Kerala High Court has ordered a Special Investigation Team (SIT) probe by the State Crime Branch into the alleged medical negligence in the case of a 31-year-old software engineer who lost nine fingers following a fat-removal surgery at a private cosmetic clinic in Thiruvananthapuram in 2025.

The court directed that the SIT be constituted within two weeks and complete the investigation as expeditiously as possible, within six months of its formation.

Neethu, a native of Sreevaraham, Muttathara in Thiruvananthapuram, underwent the surgery at Cosmetiq Hospital in Arasummoodu on February 22, 2025. She alleged that complications following the procedure left her with more than 80% physical disability, including the amputation of nine fingers and damage to internal organs. She also said she lost her livelihood because she could no longer pursue her career in the IT sector.

The court noted that the clinic was classified as a day care centre when the surgery was performed. Under the Kerala Clinical Establishments Rules, 2023, such centres can undertake only procedures that allow patients to be discharged within 24 hours of admission.

Observing that liposuction and abdominoplasty were complex procedures requiring adequate facilities for post-operative care, the court said Neethu's contention that performing the surgery at a day care centre amounted to gross negligence was well-founded.

The court also pointed out that neither the district-level expert committee nor the state-level apex committee had adequately examined whether performing such a complex surgery at the facility violated medical protocols.

Complications after surgery
Neethu was discharged at around 9.30 am on February 23, the day after the surgery. According to her account before the court, she developed low blood pressure, vomiting, dizziness and abdominal pain within hours of returning home.

When her family contacted the hospital, its nursing staff allegedly said doctors were unavailable because it was a Sunday and advised her to return the following day. She was also advised to consume salted rice water and monitor her blood pressure, she claimed.

Neethu was taken back to the hospital on the morning of February 24. After finding that her blood pressure was abnormally low, the staff administered intravenous fluids and a blood transfusion. As her condition worsened, she was shifted to Ananthapuri Hospital in Thiruvananthapuram in an Innova car at around 8 pm, she said.

She suffered a cardiac arrest on reaching the hospital. Subsequent investigations reportedly revealed septic shock caused by a bacterial infection, followed by kidney failure.

Although treatment saved her life, the petitioner alleged that the high doses of medication administered to manage her dangerously low blood pressure resulted in severe complications, including digital gangrene that necessitated the amputation of nine fingers.

She further contended that the clinic lacked the basic infrastructure and equipment required for the procedure and did not even have an ambulance to transport her when her condition deteriorated.

Expert committees' findings
During the investigation, a medical expert committee constituted at the investigating officer's request said it could not reach a definitive conclusion on whether the hospital had committed criminal negligence.

The State Level Apex Committee subsequently concluded that Neethu had received adequate and reasonable medical care. However, the High Court noted that the committee had examined only the question of criminal negligence, leaving any civil liability to be determined by the competent authority.

The court also observed that the clinic's status as a day care centre limited the procedures it could undertake and the duration of patient care it could provide.

It said the failure to examine whether conducting the complex surgery at such a facility amounted to gross negligence was a significant omission in the earlier assessments.

The court further noted that the hospital had allegedly failed to advise Neethu to return for immediate admission after being informed of her post-operative complications.

Describing the alleged violation of medical protocols as a serious concern involving patient safety, the court said the investigating agency and expert committees had not given sufficient attention to these aspects while assessing the allegations. Considering these circumstances, the court ordered a Crime Branch investigation through an SIT.

Another surgery ahead, career uncertain
Neethu is now preparing for another major surgery scheduled for December. It was initially planned for March but was postponed on medical advice so she could regain her strength before undergoing the procedure.

“Doctors advised me to improve my health before the surgery, as it is a major procedure. So it was rescheduled for December,” she told Onmanorama.

She is also uncertain about her professional future, given the impact of her disabilities on her ability to work in the IT sector. “Typing is an important part of my job, and I am worried whether companies will be confident about entrusting me with responsibilities. Travelling could also be difficult,” she said.

Neethu said she had worked for eight years at Technopark in Thiruvananthapuram across multiple companies after completing her engineering degree.

“This is the only career I know. I am confused about whether I should switch careers and learn something new or wait. I will take any major decision after the upcoming surgery,” she said.

She added that the High Court's order had renewed her hope for a thorough investigation into the case.

Advocate T M Raman Kartha represented Neethu at the High Court.