Karachi: A nine-month pregnant woman and her newborn died at the Jinnah Postgraduate Medical Centre (JPMC) Karachi after she was allegedly not provided timely transfer to the medical intensive care unit despite repeated requests and reports of vacant ICU beds, triggering an inquiry into a possible breakdown of emergency care.
Officials at JPMC Karachi said the woman, suffering from fulminant hepatic failure, had been shifted from Gynaecology Ward 9A to the Gastroenterology Ward on August 18 for specialised management, according to an official complaint submitted by the Department of Gastroenterology to the hospital’s executive director.
Referring to a formal complaint by the Gastroenterology department, they said the gastroenterology team was managing the patient’s liver failure but her advanced pregnancy and rapidly deteriorating condition required coordinated support from gynaecology, obstetrics and the medical ICU, particularly because she was close to delivery.
It said the department repeatedly contacted Gynaecology Ward 9A for a timely obstetric review, reassessment and assistance. However, the requested support and attendance were allegedly not arranged despite the patient’s critical condition.
The woman’s health continued to deteriorate and she went into labour while in the gastroenterology ward. She delivered a baby in the ward, placing both mother and child in a potentially unsafe situation as the facility was not designed or equipped to manage a high-risk delivery alongside a medical emergency, the complaint said.
JPMC officials said as per the complaint, multiple requests were also made to the medical ICU for assessment and transfer. The patient was not shifted to the ICU despite reports that ICU beds were available, according to the department’s complaint.
The absence of timely critical-care support further complicated the management of the patient, who subsequently deteriorated and died. Her newborn also could not survive.
The complaint further alleged that during the critical period, around 2am, senior doctors from Gynaecology Ward 9A did not provide the required cooperation despite the patient’s worsening condition and subsequent collapse. It also raised concerns about the conduct and communication of some members of the gynaecology team during the emergency.
The allegations in the departmental complaint are subject to an independent inquiry. However, the account has raised grave questions about why a critically ill pregnant woman could not receive coordinated obstetric and ICU care at one of Karachi’s largest public-sector teaching hospitals.
“The Department of Gastroenterology has requested an impartial investigation into the sequence of events, including the documented requests for assistance, ICU bed availability, timing of obstetric assessment, circumstances surrounding the delivery in the gastroenterology ward and the overall coordination between departments”, an official of the JPMC said.
The inquiry has also been asked to examine whether established protocols for escalation of care, interdepartmental communication and management of critically ill pregnant patients were followed.
Hospital administration has constituted an inquiry committee to establish the facts. Executive Deputy Director Dr Salman said a detailed investigation would be carried out and strict action would be taken against those found responsible for any lapse or negligence.
The case has exposed a serious patient-safety concern: a hospital’s departments may work separately, but a dying patient cannot be made to wait for coordination, approvals or a response between wards.
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