PM vows zero mercy over deadly PIMS fire

Prime Minister Shehbaz Sharif has ordered immediate action against eight officials named in the preliminary inquiry into the Pakistan Institute of Medical Sciences (PIMS) neonatal ward fire that claimed the lives of 14 newborns.

The decision was taken during a meeting chaired by the prime minister, where officials presented the inquiry committee’s interim findings along with CCTV footage reconstructing the incident.

The prime minister approved the suspension of the officials and directed that departmental proceedings be initiated. He also ordered criminal action against anyone found guilty of criminal negligence, stressing that no one responsible for the tragedy should receive preferential treatment.

Those named in the inquiry include PIMS Executive Director Prof Dr Imran Sikandar, Joint Executive Directors Dr Mutahir Shah and Dr Owais Ali Shah, neonatal department head Prof Dr Sadia Riaz, senior registrar Dr Naghma, Dr Nousheela Amjad, PIMS Assistant Director Security Mohammad Usman and Capital Development Authority Emergency Services Director General Dr Abdul Rehman.

Action has also been ordered against the private security company working at the hospital and officials associated with it.

Shehbaz said the loss of innocent newborns had left the entire nation grieving and expressed solidarity with the families who lost their children.

He directed authorities to ensure exemplary punishment wherever negligence is established, saying accountability was necessary to prevent similar incidents in the future.

Nurse honoured for bravery

The prime minister also approved the Sitara-e-Khidmat for nurse Razia Noreen, who entered the burning neonatal ward and rescued a newborn.

She will receive a cash reward of Rs10 million for her courage, according to the Prime Minister’s Office.

CCTV footage reviewed during the inquiry showed Noreen entering the nursery as the situation rapidly deteriorated. She emerged moments later carrying a baby and subsequently attempted to return to the ward.

The prime minister praised her courage and dedication, saying her actions represented an extraordinary commitment to her duty.

Meanwhile, a nurse and female security guard who were present in the ward have been directed to remain off duty and have been placed on special duty pending further investigation.

Dr Mohammad Salman, CEO of the National Institutes of Health, has been appointed acting executive director of PIMS. The prime minister also ordered the immediate appointment of replacements for officials removed from their positions.

He directed the relevant ministry to make the inquiry committee’s interim report publicly available.

Fire source still under investigation

The inquiry has not yet determined the exact cause of the fire.

The interim report said different accounts had suggested an air conditioner, incubator, warmer or an electrical problem as possible sources. However, investigators said no particular appliance or electrical component could yet be declared responsible.

Records from the Islamabad Electric Supply Company reportedly showed no fault or tripping on the external power feeder when the fire occurred. Investigators are therefore examining PIMS’s internal electrical network, including wiring, sockets, plugs and connected equipment.

Although maintenance documents showed that several incubators had recently undergone servicing, the committee said this did not conclusively establish the electrical safety of the equipment or its associated circuits.

The committee stressed that identifying the initial source of ignition was only one part of the investigation. It said equal attention must be given to the safety failures that allowed a relatively contained fire to become a mass-casualty incident.

CCTV shows rapid deterioration

The inquiry committee used CCTV recordings to reconstruct the sequence of events, describing the footage as the most reliable available account.

At approximately 6:38am, charge nurse Nasreen was seen leaving the nursery and seeking assistance. Roughly 20 seconds later, she and security guard Maria entered the nursery, where signs of flames were visible.

Nurse Razia entered at around 6:38:56am and returned approximately eight seconds later carrying a newborn. She then attempted to go back inside.

Dr Abdul Rehman was seen emerging shortly afterwards. Within seconds, smoke had significantly reduced visibility on the relevant cameras.

The committee concluded that conditions inside the nursery deteriorated extremely rapidly, with the situation becoming catastrophic within about two minutes.

Major safety weaknesses identified

The interim report highlighted serious shortcomings in PIMS’s fire preparedness.

Although the hospital had 13 standard operating procedures, investigators found only limited references to fire and emergency situations. The hospital could not provide evidence of a dedicated and regularly practised fire and evacuation procedure specifically designed for the neonatal nursery.

The committee said there was no sufficiently detailed procedure covering essential actions such as fire detection, alarm activation, emergency notification, incident command, extinguisher use, isolation of oxygen and electricity, opening emergency exits and evacuating newborns who could not move independently.

The report noted that PIMS’s Security Department SOP, issued in May 2023, did recognise fire safety as an institutional responsibility. It required the security department to maintain fire exits, ensure firefighting equipment remained functional and arrange appropriate staff training.

The hospital had also nominated personnel for specialised fire-safety training before the incident. However, the inquiry questioned whether these administrative measures had translated into effective preparedness at the neonatal ward.

Emergency exits under scrutiny

The Capital Emergency Services separately assessed the hospital’s fire and life-safety arrangements and found them inadequate.

According to the findings, some emergency exits and escape routes were locked or obstructed. Firefighters reportedly had to force open certain doors and access points during their response.

The committee described the reported deficiencies as serious but said it was still determining the precise condition and status of each door before assigning responsibility.

Investigators also examined a corridor door near the nursery that appeared closed at first and was opened at around 6:39:45am.

The report cautioned that controlled access to a neonatal unit could have legitimate security reasons. Therefore, a locked door alone would not establish negligence. Investigators would need to determine whether it was an emergency exit, whether it could be opened immediately and whether its condition delayed rescue or evacuation.

Hospital-wide safety audit ordered

The inquiry committee recommended immediate safety measures rather than waiting for its final report.

It called for a comprehensive fire, life-safety and electrical audit of PIMS, preferably by independent technical experts. High-risk areas, including the neonatal nursery, intensive care units and operating theatres, should be given priority.

The committee recommended testing smoke and heat detectors, alarms, extinguishers, hydrants, emergency lighting, electrical protection systems and all designated fire exits.

Any emergency exit found locked, obstructed or unusable should be made operational immediately.

It also called for technical checks of incubators, warmers, air-conditioning systems, IVAC equipment, sockets, plugs, distribution boards, circuit breakers and earthing systems.

Where automatic fire detection or protection systems are inadequate, temporary fire-watch arrangements should be introduced.

The committee further recommended practical fire and neonatal evacuation drills involving medical, nursing, security and engineering personnel.

A clear emergency command and communication system should also be established. Any fire detection should immediately trigger an internal alarm, mobilise designated responders and alert emergency services, including Rescue 1122.