Criminal negligence

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The fire incident at the SUM Hospital in Bhubaneswar on Monday is a grim reminder how a number of private hospitals in the country continue to ignore fire safety norms.
It needs to be investigated how a 1,000-bed hospital was allowed to function when it lost its accreditation with the National Accreditation Board for Hospitals & Healthcare Providers (NABH) in August. Records say that the hospital got its first NABH accreditation in 2013.
Two years down the line, it was sternly warned by the authorities about its falling standards. Incidentally, when the SUM hospital-cum-medical college was denied its accreditation certificate, it somehow managed to raise the number of student intake for its MBBS programme, from 100 to 150 for the academic session of 2016-2017. Clearly, the hospital management was allowed to flout crucial Government rules and regulations.
It looks like no lessons were learnt from the 2001 AMRI hospital fire tragedy in Kolkata that killed 90 patients. A retired judge of the Calcutta High Court, Tapan Mukherjee, who conducted a judicial probe into the AMRI hospital fire, had brought to light the fact that the centrally air-conditioned building did not have a vertical firestop which could have easily prevented smoke from the basement to reach the top floors of the building. Besides, smoke from the basement went to the other floors of the hospital through the AC-duct which led to the death of many patients due to heavy suffocation.
Justice Mukherjee’s recommendations also stated that the AC-ducts must have strong preventive mechanisms where the air circulation could stop once it detects smoke.
The horror that took place at the SUM hospital could have been avoided if the authorities had taken these recommendations seriously. The fire was first spotted in the dialysis ward, which then spread towards the intensive care unit (ICU) of the hospital. Like in the AMRI hospital fire tragedy, the AC-ducts at SUM turned to be death traps for patients, as poisonous gas spread across the building.
The NABH, which is a constituent board of the Quality Council of India, has the responsibility to ensure patient and institution standards.
This broadly includes access, assessment and information, patient care and rights, management of medication and hospital infection control for maintaining patient standards.
For streamlining the institutional standards, the NABH demands continuous quality improvement, responsibility of the management, facility management, safety and finally, management of the human resources of the hospital. The irony is that the SUM hospital was found to be inadequate in many of these aspects.
The fire safety measures in the ICU were not sufficient and when the emergency broke out, most patients suffered. It is recommended that, apart from the usual ICU entry/exit, such units must have enough fire-fighting equipment and an emergency exit.
Unfortunately, the SUM hospital lacked in many fronts. The State Government has taken the first few steps in fixing accountability. Some people have been arrested and others suspended. While the guilty must be punished, systemic changes too are needed to avoid another SUM-type tragedy.

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