A day after a fire in the ICU and dialysis ward of the SUM Hospital in Bhubaneswar left 20 patients dead and another 105 injured, police arrested the hospital superintendent and three others, including its fire safety officer, on charges of culpable homicide not amounting to murder.
The fire services department filed an FIR against the hospital authorities for not adhering to its recommendations made during a fire safety audit in 2013 and police Tuesday evening arrested hospital superintendent Pushparaj Samantasinghar, its fire safety officer Santosh Das, electrical maintenance engineer Amulya Sahu and junior engineer Malaya Sahu.
WATCH VIDEO: Fire At Bhubaneswar Hospital Kills 19 Patients
The Indian Express has learnt that the hospital lost its accreditation with the National Accreditation Board for Hospitals & Healthcare Providers (NABH) two months ago. It was found lacking quality standards, including measures to deal with fire.
Dr K K Kalra, CEO of NABH, told The Indian Express Tuesday: “SUM Hospital lost its accreditation about two months back when the surveillance team found it to be wanting on several counts. NABH does not have specific standards for various units of the hospital but SUM was found to be lacking in overall compliance to our standards.”
Kalra refused to comment on specifics of the hospital report card that was discussed by the accreditation committee and did not pass muster.
NABH sources, however, said the inspection team found that the hospital had not renewed its fire no-objection certificate (NoC) after 2013 and fire drills showed that its staff had not been adequately trained.
The hospital first got NABH accreditation in June 2013 and this was the first cycle of inspection. NABH sources said the inspection report, which ran into ten chapters, reported serious deficiencies in almost every chapter pertaining to patient safety and “overall intent” of the hospital.
A hospital usually needs at least 70 per cent compliance of NABH standards for renewal of its accreditation. When the SUM Hospital report was discussed, the accreditation committee decided that the hospital could no longer carry the NABH tag, sources said.
Responding to queries from The Indian Express, Amit Banerjee, vice-chancellor of the Siksha O Anusandhan University, under which the medical college cum hospital operates, said the hospital did not have the NABH certificate.
Hospital officials said its NABH certificate ran out in August this year. Incidentally, several hoardings of the hospital announced it was NABH-accreditated.
The FIR, filed Tuesday by central range fire officer Brajendu Bhushan Das, stated: “Despite recommendations, an operational sprinkler system was not provided in the dialysis ward and ICU. The existing fire protection system available in the building like the fire hydrant system did not function during fire-fighting and there was no water source available. External fire escape staircase has not been provided which hindered evacuation and patients had to be evacuated through windows after breaking the glass panels.”
Another FIR was filed by the health department through the joint director of medical education and training against the hospital management for flouting safety guidelines, including lack of fire prevention system and patient evacuation management.
In Bhubaneswar, amid growing calls for the arrest of hospital owner Manoj Nayak, a computer engineer considered close to the ruling BJD, police said he too could be arrested during the course of investigation. “No one will be spared,” Deputy Commissioner of Police Satyabrata Bhoi said.
Nayak’s TV channel News 7 did not give extensive coverage Monday night to the incident though his Odia newspaper, Prameya, front-paged the story, calling it a horrible incident. Nayak was nowhere to be seen in the 1,000-bed hospital where a semblance of normalcy returned Tuesday.
B K Behera, Director General of Fire Services, who inspected the hospital Tuesday morning, said steps recommended by the fire services wing in 2013 were ignored by the hospital.
Officers of the fire service and police said a flame was first spotted near the dialysis ward, located on the first floor of the hospital, around 7.30 pm. Hospital staff tried to douse it with two extinguishers but gave up after 20 minutes and then called the fire service.
“The air-conditioning ducts turned the hospital into a death trap by helping the poisonous gas travel,” a hospital staff member said.
Hospital authorities claimed they sounded the Code Red and activated their emergency response teams. Amit Banerjee said: “It is incorrect to suggest that our emergency response failed. It was the sheer volume of the toxic fumes which took their toll.”
In New Delhi, an official of the NABH — currently, 424 hospitals are accredited under its hospital programme — said: “We look at the organisation from the aspect of patient safety which includes access, assessment and information, patient care and rights, management of medication and hospital infection control, and from the aspect of the institution under which head the inspection committee looks at quality improvement, management responsibility, human resource and facility management.”
Standard medical guidelines for setting up an ICU include adequate fire safety measures under the head of disaster preparedness. An ICU is required to have enough fire-fighting equipment and an emergency exit apart from the usual ICU entry/exit which too needs to be at a convenient location for easy transportation of critical patients.
Incidentally, though the NABH accreditation of SUM Hospital was not renewed, the Institute of Medical Sciences to which the hospital is attached, was allowed by the Medical Council of India (MCI) to increase its student intake for the MBBS programme from 100 to 150 seats for the 2016-17 academic year.
The IMS, according to the Medical Council of India website, is “recognised for 100 seats when degree granted on or after August, 2012. Permitted for renewal of permission for increase of seats from 100 to 150 u/s 10(A) for 2016-17. (Prev. under Utkal University i.e. before March 2014)”. This is the third batch of MBBS students to be admitted to the IMS.