MULTAN, Aug 29: The Punjab Healthcare Commission (PHC) has directed the authorities concerned to seal a private hospital and register a case against its administration and doctors.

The action has been recommended on the complaint of brother of a woman who died due to an anaesthesia overdose.

Ghulam Abbas Naqvi, a resident of New Multan, filed a complaint with the commission stating that his sister Ambreen Naqvi (26) went to Zamzam Hospital for consultation after suffering from abdominal pain on Jan 21, 2012.

The doctors suggested gallbladder surgery for the removal of stones and surgery was conducted on Feb 2.

The patient went into coma due to anaesthesia complication and was shifted to Nishtar Hospital where she expired after 40 days on March 14, 2012.

The complainant alleged that the patient was mishandled at the Zamzam Hospital which ultimately resulted into cardiac arrest followed by brain hypoxia.

The complainant requested the commission to investigate the matter, take action against the hospital and demanded Rs0.5 million compensation.

The commission summoned Dr Ishfaq Gujjar (surgeon and owner of the hospital), Dr Riaz Hashmi (anaesthetist), Dr Naghma Ishfaq (wife of Dr Gujjar) and Rashid Mehmood (dispenser) while a PHC team also visited the hospital.

“It transpired from the record that the elective surgery of the patient was planned at odd hours -- 12am -- at Zamzam Hospital. The patient developed cardio pulmonary arrest during the pre-medication for anaesthesia,” the commission report issued by the patient rights and complaints director on Aug 23 said.

It stated that according to the opinion of the expert the incidence of allergic/anaphylactic reaction to Nalbuphine and Maxolon cannot be ruled out and could be the cause of cardiac arrest in the said case, there may also be a possibility of wrong drug administration, for example, muscle relaxant as a part of pre-medication leading to respiratory arrest, there was delayed detection of cardiac arrest and standards / guidelines for Cardiopulmonary Resuscitation (CPR) were not followed.

“CPR was done but due to unavailability of ventilator and backup support of intensive care unit, the patient had to be shifted to Nishtar Hospital, which led to time loss,” it said.

The report said no autopsy was done so the cause of the death could not be ascertained while the record produced before the commission showed that all the three doctors are regular government employees, their jobs are residential and they leave their duty stations daily.

“The Chief Minister’s Inspection Team during its visit to the site found general outlook of the hospital pathetic, there were no proper arrangements for sterilisation and building was converted into hospital violating the commercialisation bylaws.”

It said that the conduct of surgery at odd hours under limited facilities led to irreversible brain damage from which the patient could not be revived.

As per the report, there are only two private rooms in addition to doctor’s office in Zamzam Hospital, operation theatre is established in a room adjacent to general ward/recovery (which is actually the lounge of the house), the building requires maintenance work and standard of cleanliness needs to be improved, no defibrillator was available, antidote to inject Kinz i.e injection Naloxone was also not available; however anaesthesia machine, standard instruments and sterilisation facilities were available while the anaesthetist admitted that they probably missed something in evaluating the patient.

“After thorough deliberations the commission decided that the hospital be closed down immediately as it does not have the adequate facilities to carry out surgical procedures and may only be re-opened after receiving clearance from PHC, a fine of Rs100,000 is imposed on the said healthcare facility under section 28 of PHC Act 2010, the Multan district police officer is also directed to initiate criminal proceedings against owner Dr Ishfaq Gujjar (surgeon THQ Dunyapur), Dr Naghma Ishfaq (gynaecologist THQ Dunyapur) besides Dr Riaz Hashmi (anaesthetist THQ Karor) as he failed to act with due diligence and care,” the report said.

It said the case of all three doctors be referred to health department for disciplinary action.