Kannur: A 54-year-old homemaker died while undergoing heart surgery at Kannur Government Medical College Hospital, Pariyaram, on Tuesday night, with her husband alleging that doctors failed to inform him when complications developed during the procedure and kept the family in the dark for hours.

He filed a complaint of medical negligence with Pariyaram Police, who have instead registered a case of unnatural death. The hospital has conducted a preliminary inquiry and constituted a four-member team to examine the circumstances surrounding the death.

Fathima, a native of Vallithode in Ayyankunnu near Iritty, died at around 11.15 pm on Tuesday while undergoing surgery for a heart condition.

According to her husband Kunhu Muhammed (56), a trader, the family had been told that she would undergo a minimally invasive keyhole procedure and that it was not expected to be a major operation. He alleged that the family was not informed for several hours that the surgery had become complicated or that doctors had switched to a much more extensive procedure.

Kunhu Muhammed said Fathima was taken into the operation theatre around 8.30 am. According to him, the family was repeatedly told by nurses that there was no problem when they enquired about the prolonged surgery.

He said that around 9.30 pm, while he was outside the hospital having tea, he received a call asking him to return to the operation theatre. A doctor then told him that Fathima was in a critical condition and that a bypass procedure had been performed, he alleged. “I asked why they had not informed me earlier if a bypass was required. I was there, and they could have called me,” he said.

Kunhu alleged that the hospital kept the family in the dark about the complications during the surgery. "If a bypass surgery was required, I would not have said no. But I suspect my wife might have died during the keyhole surgery itself and they hid it from me," he told Onmanorama.

He also alleged that the doctor who performed the surgery was not the doctor who had previously treated Fathima. According to him, Fathima had been under the care of other doctors for several months before the surgery was scheduled.

Superintendent Dr Madavan K T told Onmanorama that a preliminary inquiry concluded that the doctors erred in not communicating the complications to the family. "If that would constitute medical negligence, the larger inquiry team will look into it," he said.

The patient had a condition in which the aortic valve, which controls the flow of blood from the heart into the aorta, had become severely narrowed.

Initially, the hospital scheduled a keyhole surgery to replace the aortic valve. The process would last for around four hours. After the surgery began, the doctor discovered an aortic dissection, said Dr Madavan. "The complication meant that replacing the valve alone was not sufficient," he said. Doctors had to switch to a major open-heart operation, replace the valve and repair the damaged section of the aorta using a graft.

The surgery began around 9.30 am and continued until about 7 pm. Doctors also performed two coronary bypass grafts after the patient's heart did not regain sufficient strength, the superintendent said.

According to Dr Madavan, the aortic dissection was detected only after the surgery had begun. Another cardiothoracic surgeon was called in, and the surgical team proceeded with the additional procedure.

“There does not appear to have been any major fault in the surgery. In fact, the surgery was done well. There was no shortage of staff either,” Dr Madavan said.

However, he acknowledged a failure in communication with the family. “The major issue here is communication. Communication is also part of the system. It was lacking,” he said.

The doctors were occupied with managing the complications as they arose and failed to keep the patient's relatives informed, he said. “The patient's relatives also have to be kept informed. That part was missed,” he said. “I would not call it negligence at this stage. Let the next inquiry committee decide that,” he said.

The external team comprises three professors from Kozhikode Medical College and a doctor from Kasaragod Medical College. The team is expected to examine the circumstances surrounding the death, including the treatment provided and the communication with the family.

The post-mortem has been conducted, while the case sheet and post-mortem report are with the police, the superintendent said.

Kunhu said he would be writing a letter to the Health Minister, too, seeking a detailed investigation. “We want justice. More importantly, we do not want this to happen to anyone else,” he said.