KARACHI, July 4: The preliminary report of an inquiry into the alleged ineptness of medical staff at a PECHS healthcare facility says that the resuscitation of an engineering university student could not be conducted in a timely manner as the private hospital did not have an instantaneous supply of oxygen and two of the relevant medicines.

The student has been in a coma for the last three weeks due to the alleged administration of “the wrong injection” after undergoing “minor surgery”.

The inquiry is being conducted by senior doctors and government health officials.

According to the inquiry officers, the severe repercussions of the incorrect administration of ‘Aquran’ to the 20-year-old student, Raheel Naeem, son of Abdul Naeem, could have been averted if the doctors attending to patients on emergency calls were provided with the required life-support facilities and emergency medicines on demand.

A doctor started resuscitation when the patient had completely collapsed (cyanosed with no cardiac sound) but that too without an oxygen cylinder, ambo bag, injections like Atropine, Solucartef and adrenaline, the officials found.

The oxygen and medicines in question were not available on the floor where Mr Naeem was being treated. Later, the oxygen was collected from the emergency department and medicines from a sub-store located on some other floor, but by that time it was too late to slow the process of muscle paralysis and brain hypoxia, the inquiry doctors have noted, according to a source privy to the fact-finding exercise.

As the Sindh government currently has no legislation under which to take direct action against the doctors or the private medical establishment involved, the Sindh health secretary had the inquiry committee constituted to probe the matter. It is headed by Special Health Secretary Dr Abdul Majid (chairman), and comprises EDO Health Dr A.D. Sajnani (member/convener) and THO Jamshed Town Dr Malika Jaffery (member). The patient, Raheel Naeem, was admitted to a trauma centre located in PECHS on June 10, with no co-morbids, and was operated on by an ENT specialist for an SMR problem on June 12.

Referring to post surgery developments, the doctors in their report said that the patient was stable at the time of shifting to the room and injections such as Augumentin, Transimine, Toradol and Indent were procured from the sub-store.

The person in charge of the sub-store, not a qualified pharmacist, handed over the medicines, including the injection Aquran, instead of Transimine, in a plastic bag.

The inquiry report states that the unfortunate incident took place due to the negligence of three people: the person in charge of the sub-store, a staff nurse and a midwife.

The hospital had also been held responsible for employing unsuitable people in their medical store, and also for failing to ensure the availability of an oxygen cylinder and required medicines on the same floor.

Government’s hands are tied

A detailed report, including recommendations, will be submitted shortly, but according to sources in the health department there is almost no chance of any drastic or direct action against the management of the private hospital concerned.

It is up to the patient’s family members and Pakistan Steel, the company for which Abdul Naeem works and which provides health cover to his family, to go to the police and lodge a case of criminal negligence, as there is no regulatory law that authorises the health department to initiate any drastic action against the private hospital on its own, said the source.An official of the department said that people’s concerns were growing over the quality of service and the practices of private sector hospitals in the city and some other parts of the province, as there are no legal provisions for regulating healthcare institutions and make them answerable for any negligence or unethical practices.

In recent months, the federal and provincial health ministers have repeatedly underlined the need for regulating the business of private hospitals, clinics and diagnostic centres, pledging that the government will enact a set of laws exclusively for the purpose very soon. Their efforts came amid growing public concern that no concept of patients’ rights exists in the country.

However, no one in power seemed interested in providing relief to the public, said a source, adding that the maximum the health department could propose to the Pakistan Medical and Dental Council (PMDC) or the Pakistan Nursing Council (PNC) after receiving the inquiry report would be suspension of the registration of the doctors or nursing staff concerned, as the case may be.

Negligence resulting in a patient’s death, unjustifiably high cost of treatment, excessive hospital charges or unnecessary removal of a patient’s organ(s) are all tantamount to criminal acts and such complaints against hospitals’ managements or medical and other staff are reported very often.

However, the health department does not have the authority to lodge a case with police, said a senior health official, requesting anonymity.

Hospitals sometimes enter into negotiations with the aggrieved party in cases of alleged malpractice, with offers made for compensation to be paid in various ways. In the absence of any regulatory system, the official added, this seems to be the most that could come from the inquiry report.

It was further learnt that an ordinance for accreditation and regulation of private hospitals was drafted by the health department, vetted by the law department and finally endorsed by the chief minister about three years ago, but its promulgation is still hindered by influential owners of hospitals and diagnostic centres.

Mr Naeem is currently admitted to a different hospital, where he has been taken off the ventilator. His doctors say that his condition is “relatively good”.
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