A 32-year-old woman, Konika Rani Mondol, was admitted to Faridpur's Shamorita General Hospital on Jun 29 with labour pains.
That evening, she delivered a baby girl through a caesarean section performed under Dr Laxmi Rani Datt.
A day after the surgery, Konika's abdomen began to swell. Her relatives allege hospital staff paid no heed when they raised the issue.
She subsequently suffered a string of complications.
On Jul 7, doctors at Dhaka's Ibn Sina Hospital discovered gauze, a thin mesh-like cloth used during surgery, lodged inside her abdomen. She died on Aug 19.
Konika’s case is far from isolated. Incidents of gauze, mops or even surgical instruments being left inside patients' bodies and stitched shut regularly make headlines in Bangladesh.
On Apr 20, a woman named Habiba Jannat from Rangpur's Pirgonj Upazila raised a similar allegation.
"Gynaecologist Razia Begum Mukta operated on me at the city's Bandhan General Hospital on the 8th of March. I've suffered severe abdominal pain and complications ever since," she said.
On Aug 28 last year, Farida Yasmin, 40, underwent a caesarean section in Feni.
Her relatives allege the doctor mistakenly left gauze inside her abdomen before stitching her up.
The victim's brother filed a written complaint against the doctor with Feni's civil surgeon over the incident.
Two days after Konika's death, on Aug 21, Health Minister Sardar Md Sakhawat Husain said action would be taken against those responsible if the allegations were proven through investigation.
"No form of medical negligence will be tolerated. Strict action will be taken against those involved in medical negligence, in line with regulations."
Probe Finds Negligence
While visiting the victim's family to offer condolences and gather details, the health minister ordered the formation of an investigation committee.
A five-strong panel was subsequently set up to probe the maternal death.
Md Moktar Hossain Khan, family planning and health officer for Faridpur Sadar Upazila, was made the committee's chairman, with Sultana Begum, assistant professor at Faridpur General Hospital's gynaecology and obstetrics department, as member secretary.
Abdul Jalil, the senior consultant at Dhaka's Ibn Sina Hospital who performed Konika's second surgery, said: "Gauze and mops were found in her abdomen. We've shared the details with the investigation committee accordingly."
Asked about it, the hospital’s Director Md Parvez Kabir said: "The gauze left inside her abdomen caused septicaemia. The patient's body also showed resistance to all types of antibiotic sensitivity."
An official linked to the investigation committee said, "Gauze was found inside her abdomen, and some negligence on the doctors' part was established. We've made our recommendations accordingly."
Dr Moktar, head of the probe committee, said: "We submitted the investigation report to the civil surgeon's office on the 27th of August. I don't wish to comment further on this."
Asked about it, Faridpur Civil Surgeon Mahmudul Hasan said: "We've forwarded the investigation report to the ministry through the health directorate, after gathering detailed information for the report. The ministry will now take action on this."
Pravath Chandra Biswas, director general of the Directorate General of Health Services, said the agency had received the report and found medical negligence.
Action would be taken against the doctor under the relevant rules, he added.
Minister Sakhawat visited Konika’s home in Rajbari on Aug 21.
The Root of the Problem
Gauze and mops are typically used during surgery to stem bleeding and clean wounds.
According to several experts, such errors tend to occur when inexperienced or unqualified individuals perform surgery, leading to various internal complications.
Patients, however, can recover normally if the error is detected quickly and a fresh operation carried out.
Dr Khandaker Shehneela Tasmin (Sumi), unit head of the feto-maternal medicine department at Shaheed Suhrawardy Medical College Hospital, said: "I don't believe a qualified doctor would make such a mistake. But such errors can occur when inexperienced, unqualified individuals perform surgery in remote parts of the country."
Asked how many skilled personnel are needed for a caesarean, she said: "Five people are enough for a standard caesarean.
“That includes one experienced doctor with a relatively junior doctor alongside, a senior nurse, an assistant nurse and a technician."
She explained that heavy bleeding during an operation can require the use of a large number of gauze pieces and mops.
But every item used during surgery is counted, with the lead surgeon reminded by another member of the team if anything is overlooked.
Such systems may not always be properly maintained in remote areas, where operations may also be performed without adequate staff, she said.
Bilkis Mahmuda, senior consultant in the gynaecology department at Sir Salimullah Medical College and Alliance Hospital, said five to six trained staff members are needed during surgery.
“One of them arranges the trolley, where all instruments and gauze-mop counts are tracked.
"Before the surgery ends, a count must be completed of what's been used and what hasn't. These are also recorded on boards. So, such errors have little chance of occurring at a good hospital with competent doctors."
Asked what to do if gauze or a mop is mistakenly left behind, she said: "Anyone experiencing problems in the abdomen or surgical area should seek a doctor's advice immediately. An ultrasonography can reveal the internal condition.
“If something is found, a fresh operation should follow quickly. Delaying this can lead to various infections,” Dr Bilkis added.
