PIMS nursery fire caused by electrical fault, inquiry finds systemic institutional failures

A comprehensive inquiry into the deadly fire that swept through the Mother and Child Health (MCH) nursery at the Pakistan Institute

ISLAMABAD: A comprehensive inquiry into the deadly fire that swept through the Mother and Child Health (MCH) nursery at the Pakistan Institute of Medical Sciences (PIMS) on August 26 has identified an electrical fault involving an air-conditioning unit as the most probable source of the blaze, while concluding that the deaths of 14 newborns occurred amid serious systemic and institutional failures.

The inquiry was ordered by Prime Minister Muhammad Shehbaz Sharif following the tragedy, in which 14 of the 15 newborns in the nursery died while one survived. The committee, headed by former federal secretary Shahid Khan, examined CCTV footage, forensic material, maintenance and engineering records, medical documents, duty rosters, call records and statements from relevant personnel.

According to the inquiry findings, the National Forensic Agency’s technical assessment identified the electrical cable of AC Unit No. 2, located near AC Unit No. 1, as the most probable point of ignition. Investigators attributed the fire to a possible local electrical fault, unusual heating, overcurrent or a high-resistance connection that damaged cable insulation and ignited nearby combustible material.

The report ruled out arson and other possible sources, including an external electrical fault involving IESCO, an oxygen leak as the initial source and incubators or warmers.

CCTV records frontline staff response

The inquiry also examined the sequence of events through CCTV footage. The report recorded that the fire became visible at approximately 6:38pm and that dense smoke had substantially obstructed the camera view within about a minute.

The committee did not support a general allegation that frontline medical staff abandoned the newborns. It documented immediate rescue efforts by nursing, medical and security personnel, including actions by Charge Nurse Nasreen Akhtar, Security Guard Maria Saleem, Staff Nurse Razia Noreen and Dr Muhammad Abdul Rehman. Nurse Razia Noreen was credited with rescuing one newborn and attempting to re-enter the nursery.

Multiple safety gaps exposed

The committee concluded that the tragedy could not be attributed to a single safety lapse. Instead, it identified weaknesses across several layers of institutional preparedness.

The nursery was designed for 10 beds but was accommodating 15 critically ill newborns, many requiring oxygen and respiratory support. The inquiry also highlighted inadequate staffing, the absence of comprehensive newborn evacuation SOPs and drills, and insufficient fire detection, alarm and sprinkler arrangements.

The report further identified shortcomings in electrical safety inspections, including checks of cables, connections, insulation, earthing and protective systems. It also noted weaknesses in the hospital’s emergency command and coordination arrangements.

Another major concern was the delay in seeking external assistance. According to the inquiry, the fire emerged at around 6:38pm, while external assistance was notified at approximately 6:54pm, with dispatch following shortly afterward.

Earlier warnings

The inquiry also examined previous warnings and incidents at PIMS. It noted that fire-safety deficiencies had previously been highlighted through official correspondence and recommendations, while a fire at the Nursing Hostel in July 2026 had exposed additional weaknesses in emergency preparedness and safety arrangements.

Responsibility and recommendations

The committee described the failures as systemic and institutional. It recommended further investigation into possible culpable negligence concerning electrical installation and maintenance, emergency access, previous warnings and delays in seeking outside assistance.

At the same time, the report stated that frontline personnel whose rescue efforts were established should not be blamed merely because the outcome was catastrophic.

The committee recommended comprehensive fire and electrical safety audits, functioning detection and alarm systems, improved firefighting arrangements, dedicated newborn evacuation SOPs, regular emergency drills, stronger administrative oversight and independent verification of safety compliance.

The findings have also prompted further scrutiny from parliamentary authorities, with the National Assembly’s health committee seeking additional records concerning the fire’s cause, safety systems, staffing, equipment and emergency preparedness.