Medical Negligence in FESS (Functional Endoscopic Sinus Surgery)

Functional Endoscopic Sinus Surgery (FESS) is a surgical procedure for treating chronic sinusitis and other nasal conditions. In many instances of post surgical complications give rise to litigation owing on account of medical negligence. Though it is common practice and considered safe, but requires adherence to protocols and medical ethics to avoid unwarranted medico-legal complications that can arise:

1. Lack of proof of valid informed consent : Failure to communicate the possible outcomes of FESS surgery and post surgical complications, like fluid leakage, fracture of bone, injury to nerves that may even lead to blindness are often the main concerns of the affected patients that often holds attending surgeon guilty in the court of law.
2. Failure to meet standards of care: While ascertaining the onus, it is evaluated whether the surgeon has taken care of standard of practice prevalent in FESS. For this, Bolam principle is applied that there was deficiency of service and that resulted in the injury to the plaintiff causing irreparable loss.
3. Injury to Surrounding Structures: FESS involves working anatomical structures with thin bony walls surrounding the orbit, optic nerve, and internal carotid artery. Accidental injury to these structures can lead to serious complications like blindness, or even death. Such situation can result in medical negligence cases if not done with due care.

Therefore, practicing surgeons should keep all communications documented and proper case sheet shall be prepared. The patient should be well informed and valid consent should be taken for the surgical procedure.