US Defense Secretary Lloyd Austin suffered complications from prostate cancer surgery in December and was hospitalised for several days, sparking controversy after it emerged that President Joe Biden and other top officials were not notified for three days.

Austin, 70, underwent minimally invasive surgery on December 22, but developed complications on January 1, including a urinary tract infection and fluid collections impacting his small intestine. He was then admitted to Walter Reed National Military Medical Center and briefly transferred to the intensive care unit for further treatment. 

Despite his critical condition, the Pentagon failed to inform US President Joe Biden, who only found out about the diagnosis of prostate cancer on Tuesday, or other key officials about Austin's hospitalisation for several days. This delay raised concerns about national security and transparency within the Biden administration, as the defence secretary features just after the president in the hierarchy of the US armed forces.  

National Security Council spokesman John Kirby said, "Nobody at the White House knew that Secretary Austin had prostate cancer until this morning." 

"This is not the way it is supposed to go," Mr Kirby said.

Mr Austin faced criticism after it was learnt that senior Pentagon officials did not find out about the hospital visit for three days. However, he has apologised for not "ensuring the public was appropriately informed". 

The White House has also admitted the handling of the situation was “not optimal”, prompting Chief of Staff Jeff Zients to implement new notification procedures for Cabinet members in case of incapacitation. 

The Pentagon confirmed Mr Austin remained hospitalised on Tuesday. A spokesman did not provide an update for when he would be discharged. 

"Secretary Austin continues to recover well and remains in good spirits he's in contact with his senior staff and has full access to required secure communications capabilities and continues to monitor DoD his day-to-day operations worldwide," the spokesperson told reporters. 

Austin caused a stir when he allegedly failed to alert the White House and Pentagon to his hospital stay earlier this month. The Pentagon claimed the failure was a result of a key staff member suffering from flu. 

It has emerged that Biden did not plan to sack Austin over his failure to disclose he was hospitalised for days. The White House confirmed the development despite calls from Republicans for the removal of the Pentagon chief.

Doctors at Walter Reed National Military Medical Center, the US's top military hospital, provided the timeline of Lloyd Austin's hospitalisation and treatment for the first time.

• A check-up in December 2023 "identified prostate cancer which required treatment", Dr John Maddox at Dr Gregory Chestnut wrote.
• Austin was admitted to the hospital on December 22, 2023 for a "minimally invasive surgical procedure" to remove the cancer. He was under general anaesthesia during the procedure. 
• He returned to hospital on January 1, 2024 after experiencing "complications" from the procedure, and an evaluation revealed a urinary tract infection. He was transferred to the intensive care unit the next day for further treatment, including "abdominal fluid collections impairing the function of his small intestines". 
• Dr Maddox and Dr Chestnut said that during this January stay, Mr Austin "never lost consciousness and never underwent general anaesthesia".
• The doctors wrote that Mr Austin infection has cleared and "he continues to make progress and we anticipate a full recovery although this can be a slow process".