LAHORE: The Punjab health secretary has constituted a team to probe into alleged reuse of disposable material and procurement of ‘substandard medical devices’ used on cardiac patients by the Punjab Institute of Cardiology (PIC).

The issue surfaced when a team of the health department headed by Data Ganj Bakhsh Town drug inspector conducted a raid on the complaint of the PIC additional medical superintendent (AMS) and seized substandard equipment and disposable material.

The institute has been under scrutiny for different scams in the past, including use of substandard medical devices (stents), adulterated drugs and alleged embezzlement in the procurement process.

Talking about the fresh episode, an official said a couple of days back the AMS (Pharmacy) complained to the drug controller office about alleged reuse of newly-procured disposable tubes at the PIC.

He said the PIC had recently signed an agreement with another company M/s Universal Enterprisers for the purchase of 600 small and adult oxygenators with tubes, a device that removes carbon dioxide and adds oxygen to the blood during critical surgeries, through an institutional tendering process.

Health secy forms five-member panel to investigate issue

Medical experts say the oxygenators are used in every cardiac procedure.

The official, seeking anonymity, said the PIC administration initially tried to cover up the matter when complaints of reuse of the disposable tubes surfaced, and acted only when the health authorities got wind of it.

Sensing seriousness of the issue, the PIC formed a five-member committee to probe into the matter at the institutional level. It was headed by Professor of Cardiology Dr Ahmad Shahbaz.

The committee comprised Assistant Professor Dr Syed Imranul Hassan, AMS (admin) Dr Sagheer Ahmad Baloch, In Charge Emergency Dr Amir Rafique and pharmacist Sidra Sarwar.

However, dissatisfied with the action initiated by the PIC to probe the matter, the health secretary constituted a separate high-powered five-member inquiry panel to investigate the issue.

Headed by the additional secretary (procurement), the panel comprised professor of cardiac surgery Dr Tayyab Pasha, two deputy secretaries of procurement and establishment and a contract manager of the health department.

“According to the terms of references (TORs), the committee shall probe the reuse of oxygenators in PIC,” reads the notification (a copy is also available with Dawn).

It further stated that the committee shall determine in clear terms the violations made and fix responsibility, if any and would examine the procurement practices and the practices in place for safe storage and use of cardiac consumables (i.e oxygenators). It was given a 15-day deadline to submit a report.

The official said that two alleged violations surfaced in the matter – the procurement of oxygenators on higher rates and the purchase of the tubes in violation of the tender requirements.

According to the tender documents, the central purchase committee of the health department had already rejected purchase of the same medical devices on the pretext of “higher rates” quoted by some firms during the central procurement process.

The matter of higher rates was also mentioned in the minutes of the meeting of the central purchase committee of the Punjab Specialised Healthcare Department on Dec 1, 2022.

According to the documents, the committee had reviewed the procurement of several items for many state-run institutes, including the PIC, and rejected the offers of two firms for the purchase of oxygenators. A firm, M/s Medtronic, had quoted the rate of $444 per unit (oxygenator with tube) while M/s Vertex quoted the lowest rate of $414 per unit.

“The remaining items whose rates are not recommended/approved by the committee and against which no bid is received or no bidder is declared responsive, will be procured by the respective institutes through their own institutional tenders, observing due formalities,” reads the meeting document.

Interestingly, the official said, in the institutional tender, the PIC Lahore made procurement of the above-mentioned items on almost the same rates of Rs90,000 per unit, earlier rejected by the central purchase committee of the health department.

Secondly, he said, the institute was bound to purchase oxygenators with tubes (Terumo Japan) which was mentioned on the purchase order (a copy available with Dawn), but it was not done.

According to the purchase order, the procurement cost of 600 items totaled up to Rs54 million.

However, the PIC purchased the tubes from M/s Universal Enterprisers which were not compatible with those (tubes) mentioned in the tender.

The issue surfaced in the PIC when it was pointed out by some officials concerned that the tubes purchased by the PIC were China made and not FDA proved.

They further showed serious concerns that the tubes were allegedly reused on the cardiac patients during procedures, prompting the drug controller department to conduct raid.

When contacted, PIC Medical Superintendent Dr Mohammad Tehseen said the matter had been inquired at the level of the institute by a five-member inquiry team.

He rejected the allegations of reusing the disposable tubes saying that the committee has expressed its satisfaction over their use.

“No adverse reaction noted after the use of these tubes in operation theatre,” the MS claimed.

He said the staff nurse concerned and end user opened package of the tubes and showed their satisfaction.

“Since their use, one month has elapsed and no adverse events reported by end user and cardiac surgeon related to the tubes,” Dr Tehseen said.

About the purchase of the items mentioned-above on the rates rejected by the central purchase committee of the health department, the MS expressed his ignorance in this respect.

Published in Dawn, January 20th, 2023