Updated: May 26, 2021 11:13:30 am
Even as Covid-19 cases touched a peak of over 18,000 daily new cases being reported, at least 592 ventilators provided to the state by the Central government though the PM Cares fund could not be used, as of last week, The Indian Express has learnt.
Additionally, the state has raised a staggering 571 complaints regarding these ventilators with Bharat Electricals Limited (BEL), as of May 16 — of which, only 180 were resolved.
The state has received 1,900 ventilators through PM Cares, of which 1,500 were made by BEL and 400 were provided by AgVa Healthcare. According to Health Minister Raghu Sharma, the state now has a total of 2,523 ventilators —including the 1,900 provided by BEL and AgVa. As per the state Covid portal, there are a total of 2,530 ICU beds with ventilators in Rajasthan, of which 2,314 were occupied and 216 were available as of Saturday; this figure includes ventilators in private hospitals.
According to sources, 592 PM Cares ventilators could not be utilised, as of May 13, due to various issues. As many as 366 machines reported issues such as pressure drop, compressor failure and sensor failure, among others. The remaining machines were awaiting installation, or had parts missing.
A major reason that emerged in non-utilisation of these ventilators was bottlenecks in resolution of issues. “BEL has handed over the maintenance of ventilators to TBS, who claim they have designated 11 engineers. However, we don’t even have the name and phone numbers of these engineers. Through medical colleges, we got to know that only 5 engineers have been working. However, even they are not experienced and are unable to resolve all the issues. So we need senior, experienced engineers,” Sharma told The Indian Express.
His officials say, “We don’t have access to their dashboard, so we don’t know how many complaints are being resolved each day.” According to sources, at least 727 of these ventilators were being used in various medical colleges across the state “despite challenges.
Apart from bottlenecks in resolution of issues, officials said a lack of trust in the machines was also an issue. “Suppose a doctor starts using these ventilators and he sees there are pressure problems, then the doctor develops a lack of confidence, and says ‘what’ll happen if pressure drops (and leads to an untoward incident)’. So they have become averse to using it. That is one of the main reasons that we have seen. We have been talking to doctors. They say ‘who will be responsible if something happens. We can’t afford (using a faulty ventilator)’,” a top official said.
“So there is a need for these ventilators to be seen by competent engineers, and they should be run by the engineering team in the presence of doctors, so whatever flaws are there can be rectified,” the official said.
The issue was first raised in a Covid review meeting chaired by Chief Minister Ashok Gehlot on April 5. In the meeting, Dr Lakhan Poswal, principal of Ravindra Nath Tagore Medical College, Udaipur, had said that the district had received 85 PM Cares ventilators but, “Our anaesthetists and intensive care doctors of medicine (department) don’t have confidence in PM Cares ventilators at all. The ventilators run for 1-2 hours and then they stop working. So, Udaipur had received 85 ventilators, and I spoke to principals of all medical colleges and the ‘CV 200’ and ‘AgVa’ ventilators of Indian Government are not effective.” Subsequently, similar problems with PM Cares ventilators were reported from other districts too.
Sharma said that since then, the Health Department officials have written to the Union government twice, first on April 6 and then again on April 23. Subsequently, Sharma says he wrote to the Union Health Minister Harsh Vardhan on May 8.
On May 13, taking to Twitter, Gehlot said that the Union government “had made 1900 ventilators available to the state from the PM Cares Fund. The government of India was responsible for the installation and maintenance of these ventilators. According to doctors, many of these ventilators have technical shortcomings due to which they can turn out to be dangerous for patients.
“Doctors said that there is a pressure drop problem in these ventilators. These ventilators shut down after continuously working for 1-2 hours. These also have problems of sudden decrease in PiO2, and failure of oxygen sensors and compressors,” Gehlot had said.
Two days later, on May 15, Prime Minister Narendra Modi “took serious note of some reports about ventilators lying unutilised in storage in some states and directed that an immediate audit of installation and operation of ventilators provided by the Central Government should be carried out. The Prime Minister added that refresher training for properly operating ventilators should be provided to healthcare workers if necessary.
Same day, Gehlot tweeted that the PM’s decision to direct an audit was “a step in the right direction” and said that “59,000 ventilators were purchased from ten companies of which many didn’t have any experience in manufacturing ventilators. Hence, defective ventilators were distributed to several states. Because of this, these ventilators were not used by doctors in most places at the cost of risking the patients’ lives.”
Sharma said that since then, Harsh Vardhan has written back to him “but our issues have still not been resolved.
“We are writing back to him. We are thankful for the ventilators and not indulging in politics. But the issues with the ventilators should be resolved,” he said.
BEL was yet to respond to a detailed questionnaire sent by The Indian Express. Earlier, it had told the newspaper that it “has supplied 1,500 CV 200 ventilators in different lots to Rajasthan and 1,455 of them have been installed and are functional. BEL has been attending to all the breakdown complaints and preventive maintenance is being carried out as per schedule.
“The initial supply of ventilators had basic functions required for Covid care and ICU requirements and did not have functions like invasive BiPAP / CPAP mode, which were subsequently developed and introduced in all the ventilators post installation through upgraded software,” it had said.
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