Is State Govt Aware That COVID-19 Patients At Ahmedabad Civil Hospital Are Dying Because Of Lack Of Ventilators? Asks Gujarat HC [Read Order]

The Gujarat High Court on Friday observed that the condition prevailing in Ahmedabad Civil Hospital, which is dedicated for COVID-19 treatment, was pathetic.

"It is very distressing and painful to note that the condition prevailing, as on date, in the Civil Hospital, is pathetic", observed a division bench comprising Justices J B Pardiwala and Ilesh J Vora.

The Court asked if the Gujarat Government was aware that the lack of adequate number of ventilators was the cause of high mortality of patients there.

"Is the State Government aware of the hard fact that the patients at the Civil Hospital are dying because of lack of adequate number of ventilators? How does the State Government propose to tackle this problem of ventilators?", the bench asked. 

The Court lambasted the health department and asked if the Health Minister was aware of the affairs of the Civil Hospital.

"We wonder, how many times the Health Minster of the State has visited the Civil Hospital at Ahmedabad so as to keep a watch or take stock of what is going on at the Civil Hospital. Does the Health Minister of the State of Gujarat has any idea about the problems which the patients, doctors, nursing staff and other employees are facing as on date? How many times the Health Minister has interacted with the Medical Officers and other staff members in person so as to understand their difficulties and problems? We wonder whether the Chief Secretary of the Health Department has any idea as to what is going on in the Civil Hospital? We wonder how many times the Chief Secretary of the Health Department has paid visit to the Civil Hospital?"

The Court noted that out of total 625 deaths in Gujarat, 570 deaths have been recorded in the Ahmedabad City till 20th May 2020. Out of total 570 deaths, 351 deaths have been recorded in Ahmedabad Civil Hospital. The Civil Hospital contributes to 62% of the total deaths.  

The mortality rate in the Civil Hospital, which is run by the Gujarat Health Department,  is 13%. At the same time, the mortality rate of COVID-19 patients at SVP Hospital, run by Ahmedabad Municipal Corporation, is 7%, though patients brought to both hospitals are by and large from the same area. 

The Civil Hospital contributed to highest death in most of the week during the last eight weeks, the Court noted. 

"It is very distressing to note that most of the patients in the Civil Hospital are dying after four days or more of the treatment. This indicates complete lack of critical care", the Court said.

"We are very sorry to state that the Civil Hospital, Ahmedabad, as on date, appears to be in an extremely bad shape. Ordinarily, the citizens hailing from a poor strata of society are being treated at the Civil Hospital. This does not mean that human life is not to be protected. Human life is extremely precious and it should not be allowed to be lost at a place like the Civil Hospital at Ahmedabad", the Court observed.

The Court even went to the extent of calling it a "dungeon".

"As we said earlier that the Civil Hospital is meant to treat the patients. However, it appears that as on date, it is as good as dungeon. May be even worst than a dungeon.  Unfortunately, the poor and helpless patients have no option".

The Court listed the following factors as matters of concern :

• There is inadequate patient care in the Civil Hospital.
• Senior doctors do not visit the wards and throw the entire burden on the Resident doctors.In such circumstances, the decisions regarding treatment of critical patients get delayed and neglected in the Civil Hospital.
• The Senior doctors are unable to control the ward boys and the sanitation staff and therefore, the health and hygiene is not being maintained in the Civil Hospital.
• There is no single command and control structure in the Civil hospital.
• There are 1200 Resident doctors in the Civil hospital as against 425 in the S.V.P. Hospital, yet the critical care is insufficient.
• The patients history record is maintained manually in the Civil hospital. Therefore, change in the shift of doctors leads to discontinuity in the patient care.
• The situation has not yet improved in the Civil Hospital past last two months, despite senior IAS officers like Pankaj Kumar, Milind Torwane and Jayanti Ravi have been appointed for the management of the Civil Hospital, Ahmedabad.

The Court also recorded in the order the contents of an anonymous letter, stated to have been sent by a doctor of the hospital, which described the sorry state of affairs there.

The Court said that ordinarily it would not take cognizance of such anonymous letters. "However, the situation is so grave that we should not ignore the contents of the letter", it said.

The letter stated that the medical personnel are not given proper PPE kits and N-95 masks, and highlighted that doctors working there are not tested for COVID-19 or even isolated.

"If the condition remains same in CHA , doctors working here will be super spreaders of COVID­19", the letter had stated.

The Court asked the State Government to take the issue seriously, and passed the following directions.

1. The doctors, who are not performing in the Civil Hospital, should be immediately transferred to other districts. There are large number of senior and experienced Doctors who are ready and willing to render better services in the Civil Hospitals from the other districts.
2. The Class III & IV Union should be dealt with strictly.
3. The working conditions of the resident doctors should be improved.
4. The accountability of senior officers who have failed to improve the health care in the Civil Hospital leading to massive loss of human lives should be fixed at the earliest.
5. Number of ventilators and oxygen beds should be increased.
6. Punitive action should be taken against the Ward Boys who just leave the patients unattended (One oxygen support patient recently died on a toilet seat and the same was noticed after an hour simply because no ward boy followed him up.)

Lack of ventilators

It was brought to the Court's notice that the problem of lack of adequate number of ventilators at the Civil Hospital can be taken care of by shifting the patients to : (1) Institute of Kidney Diseases (2) U.N. Mehta Institute of Cardiology.

Taking note of that , the Court ordered that adequate steps shall now be taken to admit the patients at these two institutes so that in case of emergency.

The Court also constituted a committe of the following members to look into the issues plauging the COVID-19 hospitals in Ahmedabad

1. Dr. Ami Parikh, Head of the General Medicines, SVP Hospital, Ahmedabad.
2. Dr. Advait Thakore, Head of the Emergency Medicines at the SVP Hospital, Ahmedabad.
3. Dr. Bipin Amin, Professor (Medicines) at the Civil Hospital, Ahmedabad. 

"Maintenance and improvement of public health have to rank high as these are indispensable to the very physical existence of the community and on the betterment of these depends the building of the society which the Constitution makers envisaged..

Without a guarantee of health and well being most of these(constitutional) freedoms cannot be exercised fully. To make other rights meaningful and effective right to a healthy life is the basis underlying the constitutional guarantees", reminded the Court.

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Click here to download the Order (Paragraphs 48 to 50/pages 90-104 relevant with respect to this report)