At Lok Nayak, medical doctors see virtually 600-700 sufferers a day in simply the emergency division. At GTB, this determine is 700-800.

No gear

One of the lads who died, a 47-year-old picked up in a sexual assault case from Northeast Delhi who jumped out of a PCR van, was taken to 4 hospitals on January 2 — together with GTB. He couldn’t be admitted there because the hospital’s CT scan machine was not purposeful.

An RTI filed by The Indian Express revealed that GTB hospital has only one CT scan machine that’s 10 years outdated and performs virtually 35-40 scans each day. This usually leads to the machine going out of order.

According to hospital sources, in 2022, the administration had despatched a proposal to the state well being division twice to amass new MRI and CT scan machines however claimed it didn’t get a response from the Delhi authorities.

As an interim measure, the hospital claimed it has signed

an MoU with IHBAS and Rajiv Gandhi Super Speciality Hospital beneath which it sends sufferers to the 2 hospitals for a CT scan or to avail of every other diagnostic facility.

In the second case too, the sufferer, a 46-year-old affected by continual liver illness, was in determined want of an higher GI endoscopy check — essential for any affected person with GI bleeding. He was admitted at GTB for six days earlier than medical doctors requested his household to go to GB Pant or Lok Nayak Hospital for the check.

Since GB Pant doesn’t present emergency providers within the gastroenterology division, he was shifted to Lok Nayak on January 5. There, his household was advised that the UGI endoscopy facility was not out there and he was ultimately refused admission.

The affected person’s brother alleged: “My brother died in a lift. I kept requesting the doctors to admit him but all they told me was that the UGI endoscopy machine is not available and no bed is there. No attempt was made to save him. In the end, we were asked to go without any proper referral.”

The hospital’s medical director, nevertheless, had earlier stated the affected person was introduced in a really vital situation. According to Lok Nayak MD Dr Suresh Kumar, the affected person’s solely choice was liver transplantation, which was not attainable at this stage. “Prognosis was explained to the family but he later passed away…,” Dr Kumar had stated.

After the primary demise, the state well being division arrange an inquiry committee and the GTB hospital’s medical director was requested to terminate the providers of a senior resident physician who was on responsibility when the affected person arrived.

The Federation of Resident Doctors’ Association (FORDA), nevertheless, has opposed the choice, calling it one other instance of scapegoatism. Dr Aviral Mathur, FORDA president, stated, “GTB hasn’t had a purposeful CT scan machine for greater than a month now. Why hasn’t this been swiftly addressed? Similarly, in different institutes, lack of infrastructure will get blamed on medical doctors usually. They are additionally working beneath the identical constraints and are administratively not accountable in any respect.

When requested for a response, a Delhi authorities spokesperson stated the Health Department is engaged on getting diagnostic check services in hospitals on a public-private partnership mannequin in order that the working situation of kit is ensured. “This will ensure tests are conducted even if Radiology vacancies are not filled by Hon’ble L-G. The Health Secretary has been asked to expedite this PPP model.”

Another problem: Emergency care

At Lok Nayak, the larger problem is emergency care as ICU and ventilator beds are

restricted. Sources stated out of many ventilator beds within the Emergency Medicine division, just a few are purposeful.

In the case of the molestation accused, police had stated he was taken to Lok Nayak from GTB the place he was turned away attributable to an absence of ICU ventilator beds.

When The Indian Express visited Lok Nayak’s Emergency Medicine division, two neurosurgery sufferers have been on ventilator beds whereas the remainder remained vacant with only one nursing officer. The identical ward admits Covid and dengue sufferers and H1N1 sufferers, medical doctors claimed.

A junior physician claimed, “Today, an H1N1 patient was shifted to the same ward that the neurosurgery patients were lying in. When the patient’s attendants raised concerns, nothing happened… they later left the hospital against medical advice.”

“In a tertiary care hospital like Lok Nayak, only one CMO is working in one shift with four junior residents. Patients are being forced to look after basic amenities like using the washroom as there are no nursing orderlies,” claimed a physician, including that consultants employed for the emergency medication division haven’t reported for responsibility.

“We have complained about this several times to the Medical Director but no action has been taken,” stated a junior resident physician on situation of anonymity.

At GTB, there is no such thing as a senior resident physician within the emergency division. “They come only when called. Otherwise, only junior residents and chief medical officers look after patients. A junior resident is still a student and learning. They can’t do much if a patient with an extreme injury or sickness comes to the hospital,” stated a chief medical officer at GTB Hospital.

Lok Nayak MD Kumar and the GTB Hospital PRO didn’t reply to questions in search of remark.

Referral coverage in limbo

After the incident the place the molestation accused affected person died, the chief medical officers of Lok Nayak took the initiative and began a WhatsApp group the place they move info to CMOs of different hospitals to refer sufferers. An official from Lok Nayak hospital stated the system, nevertheless, must be began from the federal government stage.

Doctors in control of the casualty and emergency departments of many hospitals additionally complained that sufferers usually die due to an absence of a referral system in place.

A senior physician from a Delhi government-run hospital, on situation of anonymity, stated a correct referral system with a dashboard is the necessity of the hour. “The dashboard can be used by chief medical officers deployed on emergency duty to see where beds are vacant and where a patient can be sent for immediate tests so we don’t end up losing lives we can easily save,” he added.

Several talks have been initiated to arrange such a referral mechanism but it surely by no means took off.

In October 2022, a gathering was held between medical administrators and superintendents of Delhi hospitals and the well being secretary of the state authorities to organize a referral system for emergency sufferers.

Sources at a Delhi authorities hospital stated that state and central government-run hospitals weren’t in a position to conclude how referrals could be handed and who would get extra referred sufferers. “It seems nobody wants to take the patient load that comes to Delhi which includes locals and patients from Western Uttar Pradesh, Haryana and Uttarakhand,” a supply stated.

In March 2023, the system made a recent headway with AIIMS Delhi asserting it could share its affected person load with two hospitals — MCD run-Charak Palika Hospital and Indira Gandhi Hospital in Dwarka —but it surely went into limbo. “GDMOs, nurses were given one-week training on how patients will be looked after in the trauma centre. However, despite a meeting with the Health Minister, no progress happened on that front,” an official added.

AIIMS Delhi and the Delhi authorities didn’t remark.