A day after 38 patients were moved from Apex hospital, Mulund, during the power outage that hit Mumbai, a second Covid-19 patient from the hospital, Virendra Singh (54), died on Tuesday morning in Fortis hospital where he had been shifted.
Singh was in the intensive care unit but stable at Apex when the hospital’s generator caught fire forcing the management to shift all patients to eight hospitals in Mumbai and Thane on Monday evening.
Singh died of a cardiac arrest and multi-organ failure. Surendra Singh, his son, said Apex hospital did not inform them about the transfer until late night. “I know that my father was medically stable until yesterday. After the unexpected transfer, his condition suddenly became critical and he required ventilator support. The doctor in Fortis told us his pulse and oxygen level were low when he was brought,” Surendra said.
Singh’s death on Tuesday morning came 12 hours after he was shifted to Fortis. According to Apex, Singh had been on Bilevel Positive Airway Pressure (biPap) support at Apex. According to Fortis, when he arrived he had no breathing support. A hospital spokesperson said he was disoriented, restrained, had abnormal breathing and hypoxic and had to be intubated on ventilator support.
The BMC has formed a committee to inquire into the incident and to inspect whether transfer procedure had any lapses that may have led to two deaths. The four-member committee has to submit its report in a week.
On Monday night, another patient, Pandurang Kulkarni (82,) had died while being transferred from Apex to Fortis.
According to Madhukala Patkar, from Apex hospital’s administration, Singh was on biPap support but stable. He was admitted in Apex on October 5. “Yes he was stable. We transferred all serious patients in cardiac ambulances with oxygen support. He was on oxygen throughout. Maybe the panic of transfer had a psychological impact,” she said.
The Mulund-based hospital was running on generator since 10 am on Monday when electricity supply went out due to a massive grid failure. A staffer was deputed to make frequent trips to buy diesel. The hospital management said they were informed by the BMC that electricity would be restored by 4 pm but it only got restored at 7.30 pm. By 5.15 pm, the overheated generator was emitting smoke.
It caught fire at 5.30 pm. “We immediately called fire brigade, police. When the fire could not be easily doused, we started calling other hospitals and took a call to transfer 38 of our patients,” Patkar said. She maintained that oxygen supply to patients was never interrupted.
Vivek Singh, from hospital administration, said the process of shifting patients to eight other hospitals began from 6.45 pm. All 46 staffers were called on duty. There were 10 critical patients on ventilator support, three others were on high flow nasal cannula, and 10 on normal oxygen support. A local social worker arranged for 15 cardiac ambulances. By 7.45 pm the process of transfer was over.
But Surendra, a Mulund east resident, said his father’s admission details were missing for three hours in the chaos. “We asked Apex hospital and they said they are trying to ascertain his whereabouts,” he said. “We went to five hospitals to look for my father.” Surendra finally received a call at 11.30 pm from Apex hospital that his father was in Fortis hospital. “Nobody in our family is able to talk about this. Our experience was horrible. There should be an inquiry whether my father’s oxygen supply was stopped,” he said.
The family had not been able to make a video call for three days before his death. Singh had to be restrained to his bed as he often tried to escape and demanded to be sent home.
Madhumati Gawde (60) also remains critical in Fortis hospital. “We got a call very late that she was transferred. Since then we waited for 18 hours to get an update on her health,” said son-in-law Amit Aparaj. Gawde has diabetes and was on ventilator support when the fire broke.
While the fire did not reach the hospital building, lack of power supply forced the hospital to move everyone out. An ICU doctor accompanied Gawde in the ambulance to Fortis hospital. Her family was informed at 10.30 pm. “Fortis hospital has charged Rs 85,000 for a night’s treatment. We don’t have money to pay. Who will pay for her treatment in such a big hospital,” Amit asked. In Singh’s case too, Fortis hospital issued a bill of Rs 1.60 lakh for 12 hours of treatment.
Vivek Singh, from Apex hospital, said they are having discussions with local BMC ward office and Fortis hospital on billing issues. Other hospitals where patients were taken are Manisha hospital, Platinum, Aastha, Seven Hills Velam hospital and BMC jumbo centres.
In a statement Fortis hospital said, “A group of 28 patients in varied stages of criticality were rushed to Fortis Hospital, Mulund. Some patients were in need of oxygen, some were relatively stable and some needed critical care intervention. Despite the lack of medical records and no clarity on the patient’s Covid-19 status, the team at Fortis Hospital, Mulund, swung into action and took charge,” it said.
Dr Rahul Pandit, intensivist in Fortis hospital, said all 11 patients were put on ventilator when they were brought. “One patient (Pandurang Kulkarni) was declared dead. The second patient (Singh) died early morning. Both were critical when brought. We are following protocol for Covid-19 to treat them,” he said.
BMC officials said there was also a communication gap between Apex and Fortis hospital. While 28 patients were sent, eventually 11 were admitted and rest were referred to nearby hospitals.
On Tuesday, Apex hospital began calling each patient’s kin to check if they wanted to return to hospital. By evening four patients were re-admitted. Gawde’s family said after the incident they wanted to shift her to Panvel but in her condition, they could not risk another transfer. The hospital management said they are trying their best to settle bill issues with all eight private hospitals where they transferred 38 patients.
Tushar Garg (35), who was taken to Platinum hospital from Apex on Monday, said the whole transfer was chaotic. “There is no clarity. I have recovered and I just want a discharge today. But there is confusion over the bill. The treatment experience has been exhausting,” he said.
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