Did a Fire in a Centrally Funded Hospital in Delhi Cause the Deaths of Three Patients?

On the night of 6 August, a fire broke out in the Viswanathan Chest Hospital—the hospital wing of Vallabhbhai Patel Chest Institute, a post-graduate medical institution maintained by Delhi University and funded entirely by the ministry of health and family welfare. At least three patients in the hospital's intensive care unit died that night. SHAHID TANTRAY
25 August, 2017

On the night of 6 August, a fire broke out in the Viswanathan Chest Hospital—the hospital wing of Vallabhbhai Patel Chest Institute, a post-graduate medical institution maintained by Delhi University and funded entirely by the ministry of health and family welfare. The hospital caters to patients with chest diseases, and its facilities include an intensive care unit with eight beds, which is situated on the first floor of the hospital. The fire broke out in a server room that was located on the ground floor, directly beneath the intensive care unit. Members of the hospital’s medical staff told me that the smoke had spread to the first floor and into the ICU, in which there were six patients undergoing treatment. At least three of them died that night.

According to the records of the Delhi Fire Service, it received an SOS call from the hospital at 1.48 am on 7 August. The record stated that fire engines from its Roop Nagar fire station, located around two kilometres from the hospital, were dispatched within two minutes. The firefighters left the hospital at 4.35 am, the records note. However, it also notes that there was “no casualty reported.”

The fire service’s records appeared to corroborate the account of a member of hospital’s non-medical staff. Nobody knew exactly when the fire broke out, but according to the staff member, smoke began emanating from the server room a little after 1 am. The server room is a part of the PACS Workstation room—the picture archiving and communication system, which houses the hospital’s medical imaging technology—and was locked at the time, the staffer said. After noticing the smoke, the staffer and a few members of the medical staff tried to break the door down. They were unsuccessful, the staff member told me. “The smoke was not reducing,” the staffer said. “The gallery below”—on the ground floor—“was covered in smoke.” “This is a hospital for respiratory diseases. The patients were facing a lot of difficulties when the smoke began to rise to the first floor,” the staff member added.

I spoke to several members of the hospital’s staff, including three members of the medical staff, two of whom were on duty that night. The medical staff spoke to me only on the condition of anonymity. The two members of the staff who were on duty told me that the level of smoke could have asphyxiated the patients. “There was smoke all around, nothing was visible,” the first member of the medical staff told me. The second member of the medical staff said that, judging by the amount of smoke, the fire may have started an hour before it was noticed. “Neither any fire alarm nor any fire sprinkler was set off,” the second medical staffer added. “There was also no water in the fire hose reel and the fire extinguishers were also not working.”

The third member of the medical staff I spoke to said she was the caretaker for one of the patients who died that night. I also spoke to the family members of the two other deceased patients, who were present when the fire broke out. Both families spoke of the amount of smoke in the hospital—they said it was causing itchiness in the eyes of the healthy occupants of the building. According to the hospital’s admission and discharge register, all three patients who died that night were supported by ventilators.

SAGAR FOR THE CARAVAN

The ICU’s death register, which I accessed, identified the three patients who died the night of the fire—a 60-year-old man named Ishwar Chand, a 36-year-old man named Omprakash, and an 85-year-old woman named Veena Jain. Ishwar and Omprakash’s family members told me that they do not believe their relatives died a natural death due to their respiratory diseases. According to the third member of the medical staff, Jain was a resident of an ashram and did not have any family, although the death register notes that her body was claimed by her daughter. “I took care of everything for her,” the third member of the medical staff said.

Ishwar Chand was admitted to the hospital on 1 August and diagnosed with pulmonary tuberculosis. His son, Rupesh Chand, who appeared to be in his 30s, told me that he was sitting in a waiting hall outside the ICU when the smoke began spreading. “I insisted that I wanted to see my father, but they [hospital staff] took us downstairs.”

Rupesh said he the hospital authorities informed him about his father’s death at around 1 am, and that the body was handed over to him after dawn in the morning of 7 August. The death register, however, listed Ishwar’s time of death as 1.50 am, and added that the body was handed over to the family at 3.45 am.

The hospital’s records note that Omprakash was diagnosed with “Post TB Fibrosis”—a medical condition in which a patient develops scarring in her lungs. According to these records, he was admitted on 4 August and died at 11.35 pm on 6 August. Kanchan, his wife, told me that Omprakash had been unwell since 2010 and always stayed at home. She told me that she is a domestic worker, and lives with a five-year-old daughter and one-year-old twin boys in Delhi’s Majnu Ka Tila locality. That night, Kanchan said, she was resting in a room on the ground floor and on a different side of the hospital than the ICU.

She recalled that a doctor informed her at around 11 pm that Omprakash’s “heartbeat has stopped.” However, she said that the fire broke out around the same time because the doors to the room in the hospital where she was resting were shut on account of the fire. “I wasn’t on that side [of the hospital],” she said, “but people were saying that a fire broke out somewhere.” “The guards had locked the door and the windows and we could not get out,” she continued. Kanchan added that she was only able to see Omprakash’s body at home the next morning. The death register notes that the body was handed over to Omprakash’s brother at 7.10 am.

The member of the medical staff who took care of Veena Jain told me that she wasn’t on duty the night of the fire but heard about it the next day. The medical staff member said that it was possible for the smoke to have caused patients to suffocate, before adding that it could be “extremely dangerous” for patients whose conditions were critical. The death register noted Jain’s time of death as 3.30 am.

SAGAR FOR THE CARAVAN

According to its website, every year since 2011, the Viswanathan Hospital has been treating over 60,000 patients in its out-patient department, around 4,000 patients in its general and emergency wards, and over 400 patients in its ICU. It also records its annual income for the year 2015–16 as Rs 50.3 crore and its expenditure as Rs 49.2 crore. However, my conversations with the staff also revealed the absence of any standard operations procedure in the hospital in the instance of a fire outbreak. The second member of the medical staff told me that the hospital has an oxygen plant located on the ground floor, which supplies oxygen to the ICU and emergency wards. “If the fire had spread, it might have exploded,” the member added. One of the staffers told me that the oxygen supply to the wards had not been cut off throughout the incident.

According to 2016 inspection report, Delhi Fire Service officials examined the building in January that year, and subsequently granted a fire-safety certificate on 9 February. The certificate observed that the “premise have deemed complied with the fire prevention and fire safety requirements” and that it was valid for “a period of three years.” It also noted that the hospital had 63 fire extinguishers installed against the requirement of 28, had two fire-hose reels on each floor, as well as automatic fire detection and alarming systems. The inspecting officers had also mentioned that “the fire protection systems provided in the building were test checked and found functional at the time of inspection.”

I spoke to Mohammed Yunus, a mechanical engineer and fire expert who has been running Expert Fire Engineers, a company that sells fire equipment to commercial buildings, for the past five years. Yunus told me that it was very likely that smoke filled the ICU through the shafts, or seeped in from under the door. “I don’t deny the possibility that patients in critical condition undergoing treatment in a room can die due to suffocation if a fire breaks out in a place which is exactly below that room,” he added.

According to two members of the medical staff, the hospital management tried to cover up the incident by ordering a renovation of the room the next morning. “The fire broke out at 2 am and by 9 am the next morning, the renovation had begun,” the second medical staffer said. “There was no written entry of the incident, no police investigation, no enquiry. Within two days, the server room was renovated.” When I visited the hospital on 21 August, I could not find any sign of the fire, though the server room’s door appeared freshly painted. However, the first member gave me photos from the day after the incident when the renovation was taking place—the photos showed the ceiling of a room that appeared to be partially covered in soot and was being repainted.

The hospital management neither confirmed nor denied the incident. On the day of my visit, I visited the offices of PR Santhanam, the joint registrar and the public information officer of the VPCI; and Arunabha Ray, who is presently the acting director of the institute. Santhanam’s personal assistant informed me that the joint registrar did not wish to speak to me. Ray’s personal secretary Radha Krishnan also declined to let me meet the acting director—Krishnan said the director was busy and that he would let me know about the appointment. Neither Krishnan nor Ray have contacted me since then.

When I later contacted Santhanam over the phone and asked him if he was aware of the fire, he replied, “What do you want?” I repeated my question and he said, “Nahi nahi, aap bataiye na kis liye puch rahen hain”—No no, you tell me why you are asking. Santhanam continued, “Fire toh chota-mota hota rehta hai”—small fires keep happening. “This is a big institution,” he said.

I repeated my question again: “But I’m asking you if you are aware of the fire incident that took place on the night of 6 August.” This time, Santhanam only responded with what sounded like a “hmm.” I began to ask him the deaths of the patients, but he stopped me as soon as I mentioned the word “allegation.” “Allegations will come,” he said. “We are in a democratic country, hundreds of allegations will come.” He then ended the conversation by telling me that I should write him an email with my questions if I wanted an “authentic reply.” I sent him an email with my queries, which was marked to the acting director as well. I am yet to receive a reply from either of them.

I attempted to speak to Manisha Verma, the media-communication officer of the health ministry, but she did not answer my call or respond to my text message. I wrote an email to Verma as well about the fire, and asked her if the ministry was aware of its occurence, or if it had ordered any enquiry. She, too, is yet to respond.

The family members of Chand and Omprakash, as well as the third member of the medical staff who took care of Jain, said that the hospital did not conduct a postmortem of the deceased patients. The ICU’s death register did not contain any record of a postmortem either. The death register comprises the details of a deceased patient’s name, registration number, age, date of admission, date and time of death, diagnosis, cause of death and the time of at which their body was handed over to the relatives. For every deceased patient, all the rows are filled. For instance, in the details of Pramila Devi, a 70-year-old patient who was admitted on 12 August and died the next day, the row next to “cause of death” notes that she died of a septic shock. When I accessed the death register, I noticed that for Chand, Omprakash, and Jain, the cause-of-death row was empty.