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Serious lapses in ambulance service, bed availability in Pune hospitals, patients say

Hindustan Times, Pune | ByNadeem Inamdar and Steffy Thevar
Jul 08, 2020 04:52 PM IST

Two more incidents of hospitals denying service to needy patients have come to light during the past two days, bringing into focus the shortage of beds in the city as the Covid tally surges ahead

A day after a 68-year-old diabetic patient living in Wadgaonsheri succumbed to a heart attack as his relatives failed to first get an ambulance and then, ICU beds in various hospitals, another incident of a 62-year-old Covid patient succumbing to the contagion due to non-availability of a vacant bed has come to light.

Besides these two cases, two more incidents of hospitals denying service to needy patients have come to light during the past two days, bringing into focus the shortage of beds in the city as the Covid tally surges ahead.

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In the 62-year-old woman’s case, she was initially asked by the administration since no bed was available for admission, she can stay at her house in Gujar-Nimbalkarwadi on the outskirts of Pune.

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However, on Monday, her condition worsened as she gasped for breath amid non-availability of a ventilator in the hospital situated in neighbourhood complicated the situation, said her kin.

Vyankoji Khope, sarpanch of Gujar Nimbalkarwadi said, “The health department has not provided adequate facilities to us to fight Covid-19. The health department officials have still not visited our villages despite there being 10 positive patients. The villagers have to spend from their pockets, pay extra charges for vehicles and other facilities to save their lives. We are ready to give our halls for free for establishing Covid quarantine facility in the village.”

After the incident, district health officer Dr Bhagwan Pawar promised an inquiry saying negligence will not be tolerated at any cost.

“Special checking squads will be formed to check the spread of Covid-19 in Haveli area and all the grievances of the residents would be addressed,” said Pawar.

In the 68-year-old Wadgaonsheri resident’s case, the deceased and the relatives had to go looking for a vacant ICU bed for two-and-a-half hours on Sunday, before the patient got a bed in the casualty of Sassoon Hospital, which also did not have a vacant ICU bed. Although the patient was suspected to be a Covid-19 person, he was never tested for the same.

Anant Dudhane, brother of the deceased who was present with the patient said, “After rushing my brother to two hospitals early hours on July 5 and then inquiring for a vacant ICU bed in multiple other hospitals, we did not get any response. We first went to Ruby Hall Clinic, then to Inlaks and Budhrani hospital and faced a similar situation. On the way, we also made calls to Jehangir, KEM and Deenanath Mangeshkar hospital over the phone but we got to know that there are no vacant ICU beds. Finally at 5.20am, we admitted him at Sassoon hospital where he suffered a severe heart attack and breathed his last at 6am. Even at Sassoon, he was taken to the casualty ward and not the critical care centre as they too did not have any beds.”

The patient also did not get a cardiac ambulance on time which would have helped save the golden hours, said Anant. “We had to take my brother in our own car as we did not get an ambulance. We were denied an ambulance at Ruby Hall and then when we called the government service at 108 they said they will call back but they never did. Although my brother had Covid-19 symptoms he was not tested for the same. Had those hospitals provided critical care at the right time, my brother would have survived.”

The hospital in its clarification has stated that they did not have any vacant beds to accommodate the patient and so they stabilised the patient by improving the oxygen saturation, following which they were advised to take the patient for isolation ICU care.

Dr Sanjay Pathare, medical director of Ruby Hall Clinic, said, “We had a patient named Tanaji Dudane who complained of breathlessness, fever with chills and was a Covid-19 suspect. His SPO2 or oxygen saturation was 80 per cent we gave him oxygen support on venture mask started with 5ltr. When the saturation reached 93 per cent saturation we asked them to take him to a hospital with a vacant ICU facility. We did offer them an ambulance but they denied it and took the patient in their own vehicle. With the current divisional commissioner’s dashboard, anyone can check for a vacancy on real-time bases so there is nothing to hide. We are having 130 plus patients admitted at any point in time.”

Dr Dnyaneshwar Shelke, chief operating officer at BVG India for the Maharashtra emergency medical services (MEMS) which run the 108 ambulance service stated that they did get two calls with regards to this patient. He said, “We got a call from Ruby hall clinic but we do not provide ambulance services to private hospitals. The next call we got was from Sassoon but by the time the ambulance was dispatched, the relatives said that they do not require it anymore. Before we dispatch any ambulance we need to check the medico-legal part of it and the scope of the patient so we need to talk to the medical officer, nurse or the treating doctor.”

He further added that every hospital needs to stabilise a person before sending them to a different hospital even if they do not have a vacant ICU bed. “The ambulance is not above hospital it is just transit care. Usually, the response time for urban areas is 20 minutes and for rural areas, it is 30 mins. We are integrating private ambulances too to increase our strength. Out of the current 937 ambulances we have, 440 are dedicated to Covid-19 and we cannot transfer a non-covid patient in that ambulance.”

Pune district collector Naval Kishore Ram said, “We have formed a special committee to look into the complaints of overcharging, denial of the hospital facility and overcharging by ambulances. We have the power to impound ambulances and book them for denying service to the needy patients both COVID and regular patients.”

As of Monday evening, only two hospitals showed vacant ICU beds with ventilators in PMC areas and only four hospitals showed vacant ICU beds without ventilators

Difficulty in getting admitted

A senior citizen from Kothrud had to face the worst ordeal of her life as several prominent hospitals denied her admission on the ground that whether her Covid-19 test was undertaken and the results had come. Her doctors advised treatment in a multi-speciality hospital as she was having breathing issues. Those patients who have Covid like symptoms and whose tests have not been done find great difficulty in getting admitted in prominent hospitals across the city, her family members said.

Death at Sassoon

A diabetic died of a heart attack at Sassoon Hospital after he was denied a bed by hospitals in the city. The deceased developed severe breathing issues at around 3 am on Monday night, but despite requests for admission by relatives, a bed was denied to him. He was rushed to Sassoon hospital where he suffered a heart attack and died. His relatives alleged that the private hospitals were flatly denying hospital beds without any fear of action.

Problems in rural areas

No dedicated quarantine centres

Delay in testing

For 10 villages, one Covid centre

Dedicated fleet of ambulances is required which is currently missing

Dedicated team of medical professionals including doctors and paramedical staff

Complaints of overcharging by private vehicles

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