Bhubaneswar SUM Hospital fire: Management cannot pass the buck

At least 22 patients were killed and more than 20 injured in a fire that broke out at SUM Hospital in Bhubaneswar on Monday evening, in one of the worst such incidents involving a medical facility in Odisha.

According to the hospital authorites, the fire started around 7.30pm in the dialysis ward on the second floor. A short circuit could have sparked the blaze, which engulfed the entire floor within minutes, they said.

Several patients and their attendants were injured while trying to escape amid the chaos and smoke.

This is the second such incident in the state in six months. On May 31, a fire broke out at the state-run SCB medical college and hospital in Cuttack. More than 100 patients had a providential escape when the cardiology department got engulfed.

Odisha chief minister Naveen Patnaik described the incident as “very tragic”. He directed government hospitals to provide the necessary treatment to patients shifted from SUM Hospital and requested all private hospitals to extend treatment as well.

Meanwhile, the state has ordered a high-level probe by the Director, medical education and training, into the incident. In addition, a probe by the revenue divisional commissioner (RDC) has also been initiated.

SUM Hospital has announced Rs 5 lakh compensation for each victim and free treatment for all the injured, including those being treated in other hospitals.

Amit Banerjee, vice-chancellor of Siksha O Anusandhan (SOA) university, which runs the hospital, said the hospital would extend the fullest cooperation in the two inquiries ordered by the government.

Can the hospital give up responsibility?

The website of SUM Hospital displays lofty claims. It says: Institute of Medical Sciences and SUM Hospital, established in 2005, is a leading medical institute providing quality medical education and global standard healthcare services. SUM Hospital is an intrinsic part of the institute of medical sciences with a total number of 750 beds, 25 intensive care beds and 150 cabins. SUM Hospital offers therapeutic care with a focus on preventive care for a healthy society.

Despite claiming that it provides global standard healthcare services, it is strange that the hospital has washed its hands off the loss of lives due to negligence.

Dr Lingraj, patients relation officer, said nothing can be said as of now. "When the smoke started emerging, we shifted the patients to different wards and to nearby hospitals. There is no need to worry. We cannot say anything right now," he said. "There is no lapse on the part of the hospital. We did whatever we could. The doctors have also started treatment," he added.

Sum Hospital horror is a grim reminder of hospital administration's negligence and lack of safety measures. It has not even been five years since the AMRI Hospitals fire tragedy in Kolkata killed 90 patients.

Despite the worst hospital fire at AMRI Hospitals on December 9, 2011, it seems the hospital administration in India has not learnt a lesson. The deaths of patients in Kolkata and Bhubaneswar were not due to any natural disaster, but due to negligence on the part of the hospital management.

It is unfathomable that a fire could take place in a sensitive zone like the ICU, and even if it broke out due to a short-circuit (as has been claimed), why couldn’t it be doused at an initial stage?

In many cases, as in the case of AMRI Hospitals, hospital authorities have argued that the fire was an “accident” and not “intentional”, but it has been found in a large number of fire incidents, including the one in Kolkata, that lack of precautionary measures, improper safety devices and failure to deal with an emergency situation led to fire breakouts and deaths.

Some of the worst hospital tragedies in recent times include:

Aug 6, 2001: Moideen Badusha Asylum, Erwadi, Tamil Nadu, where 28 chained patients were charred to death.

Dec 9, 2011: AMRI Hospitals, Kolkata, in which 95 died due to asphyxiation.

Nov 7, 2013: Gokul Hospital in Mumbai; one doctor was killed due to asphyxiation.

May 31, 2016: SCB Medical College, Cuttack; 60 patients escaped unhurt.

Aug 27, 2016: Murshidabad Medical College, where three were killed and 50 injured in a stampede.

According to the National Building Code 2005, hospitals are classified as institutional buildings and therefore require fire-fighting equipment. It is mandatory that at all times, the area around a hospital building is kept clear for easy access of fire tenders. There are certain clauses that have to be strictly followed while constructing a hospital or sanatorium. These are often violated in India.

The National Association of Fire Officers has a detailed checklist that recommends hospitals and nursing homes to have active fire protection system, fire-fighting installation details, fire prevention and awareness measures and a building plan. Some measures that are mandatory are:

Preventive and protective measures

- Good housekeeping in all areas, especially stores and kitchen; electrical installations, transformer house and waste disposal areas etc. should be maintained.

- No smoking zone (while applicable in office, store, depot etc.) shall be enforced rigidly.

- All electrical installations shall be periodically checked and tested by competent electrical engineers, while all loose electrical wiring if any shall be replaced immediately.

- Appropriate MCB (miniature circuit breakers) shall be installed where necessary as perIndian Electrical Rules.

- All old electrical wiring shall be replaced.

- Arrangement should be made for proper checking, testing and maintenance of fire protection and detection system.

- Electrical safety audit should be carried out at regular intervals as per Indian Electrical Rules.

- Water reservoir exclusively for fire-fighting shall be made available as prescribed in National Building Code (NBC) Part IV.

- Replenishment of the reservoir may be incorporated with deep tubewell with auto facility.

- Sprinkler system to be provided for all floors and other places/areas.

- Fire fighting extinguisher should be provided within the building as per IS: 2190 and person having work station in that area should be trained to use the same if required in case of emergency.

Despite such stringent preventive and protective measures, fire tragedies in hospitals have become a recurring phenomenon. Some questions are pertinent to be asked.

Can the hospital authorities wash their hands off? Can the management pass the buck? Are these cases of negligence on the part of the hospital management? Was there a gap in the system? Did SUM Hospital fail to follow the mandatory norms and blatantly violated them, as was in the case of AMRI Hospital?

It’s high time the government took strict action to ensure no patients die in their sleep due to fire. It is only through the enforcement of absolute liability clause (also known as "no fault liability”, in which a person can be made liable even without fault) that hospitals can be held accountable for such tragedies.

Also read: Why public healthcare is making India eat from the floor