PM vows no mercy for 'negligent' PIMS officials

The prime minister directed that those found responsible for criminal negligence be prosecuted without discrimination and said they did not deserve any concession.

Among the eight people identified by the committee are PIMS Executive Director Prof Dr Imran Sikandar, Joint Executive Directors Dr Mutahir Shah and Chaudhry Dr Owais Ali Shah, head of the neonatal department 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.

The prime minister also approved action against the security company deployed at the hospital and its officials. He directed that those responsible be brought to justice, stressing that exemplary punishment would be ensured so that no mother would again lose her child due to anyone's criminal negligence.

"The death of innocent children is a tragic incident over which the entire nation is grieving," the prime minister said, adding that he and the entire nation stood with the bereaved parents.

The prime minister approved the conferment of the Sitara-e-Khidmat and a cash reward of Rs10 million for nurse Raziya Noreen, who risked her life to save a newborn during the fire at the hospital.

He paid tribute to Noreen for demonstrating an exceptional sense of responsibility by rushing through the fire and rescuing a baby moments before the nursery was engulfed by the blaze. "Nurse Raziya Noreen has demonstrated an exceptional example of responsibility and bravery," the prime minister said.

He said the entire nation, including himself, was proud of Noreen for putting her own life at risk to save the life of the child. "People who demonstrate such dedication to their duty cannot be praised enough," Shehbaz said.

He also ordered that a nurse and a female guard present in the ward be made officers on special duty (OSD) and directed further investigation into their roles.

The prime minister directed Dr Mohammad Salman, CEO of the National Institutes of Health (NIH), to be appointed acting executive director of PIMS.He further ordered the immediate and simultaneous appointment of new officials in place of those removed from their posts. The prime minister also directed that the interim report of the inquiry committee be made public immediately.

The report,, would be uploaded on the Ministry of National Health's website shortly. Rs1m for the nursePM Shehbaz also approved the Sitara-i-Khidmat award and a Rs1 million cash reward for nurse Razia Noreen, who "saved a child without regard for her own life", the PMO said.

Report. The interim report presented to the prime minister said the precise source of ignition had not yet been "conclusively established".

It noted that questions requiring forensic, technical or documentary examination - including the exact ignition source, the contribution of specific deficiencies to the incident and the final determination of individual responsibility - had been left for the committee's comprehensive report.

"The committee considers it important that uncertainty regarding the first spark should not prevent examination of the protective systems that should have prevented an initial fire from becoming a mass fatality event. The cause of ignition and the causes of the consequences are related but analytically distinct.

"The report also reconstructed the incident using CCTV footage, which it described as providing "the most objective reconstruction" of what happened., the first visible sign of an emergency appeared at around 6:38:15am, when charge nurse Nasreen hurriedly emerged from the nursery and sought assistance.

About 20 seconds later, she and security guard Maria entered the nursery, with reflections of flames visible. Staff nurse Razia entered the nursery at around 6:38:56am and emerged eight seconds later carrying a baby, thereby rescuing the child.

She then attempted to re-enter the nursery shortly afterwards. Dr Abdul Rehman emerged at around 6:39:12am, while Camera 16 was largely obscured by smoke by about 6:39:15am. The adjoining corridor door visible on Camera 12 was opened at around 6:39:45am, and that camera was also obscured by smoke by about 6:40:08am.

The report said the footage established that conditions inside the nursery deteriorated "catastrophically" within approximately two minutes. The footage of the incident was also shown to the premier and other meeting attendees.

The interim report of the inquiry committee said various accounts had attributed the fire to an air conditioner, an incubator or warmer, or an electrical short circuit or overloaded plug., Iesco records showed no contemporaneous fault or tripping on the external feeder, shifting the focus of the electrical-causation inquiry to Pims's internal electrical distribution system, including sockets, plugs, wiring and connected equipment.

The report noted that preventive maintenance records showed several incubators had recently been serviced and returned to working condition. However, it said these records did not conclusively establish the electrical safety of the equipment, plug, socket or associated circuit.

"Accordingly, an internal electrical/equipment-related origin remains plausible, but it would be premature to identify any particular appliance or component as the established cause," the report said. Charge nurse Nasreen and security guard Maria have been directed to remain off duty and not perform any duties until further orders.

A decision on whether to proceed against them will be taken after the inquiry committee submits its final report, added the interim report. The initial findings showed that Pims had no detailed standard operating procedures (SOPs) or training for dealing with fires or other emergency situations.

Of the hospital's 13 SOPs, references to fire or emergency situations were found in only two subsections, the meeting was told.

The interim report of the inquiry committee said the record showed that rescue and evacuation efforts had been made, but did not establish that there was an approved, communicated, trained and rehearsed fire and evacuation SOP specifically for the neonatal nursery.

It noted that while Pims had SOPs covering various clinical and administrative functions, no comparably detailed procedure had been produced for fire detection, alarm activation, external notification, incident command, extinguisher use, oxygen or electrical isolation, unlocking emergency exits, evacuation priorities or the safe relocation of non-ambulatory newborns.

The report, however, pointed out that Pims' Security Department SOP, dated May 27, 2023, expressly recognised fire safety as an institutional responsibility.

It required the security department to ensure fire safety for the protection of infrastructure, equipment, patients, visitors and staff, while assigning the assistant director security responsibility for ensuring the availability of fire exits, the functionality of firefighting equipment and the training of relevant personnel.

Pims had also nominated personnel for specialised fire-safety training before the incident, the report said, adding that the key question was therefore not whether fire risks had been recognised administratively, but whether the assigned responsibilities and available training had translated into actual preparedness at the neonatal nursery.

The report said the Capital Emergency Services (CES) had separately found fire and life-safety arrangements to be inadequate and compromised. It said emergency exits and escape routes were locked or obstructed, security personnel hindered aspects of the initial response and crowd management was inadequate., firefighters had to forcibly open locked fire-exit doors and other access points.

The committee described these as serious prima facie deficiencies but said it was still verifying the status and location of each relevant door before assigning responsibility. It also said the corridor door adjoining the nursery, visible on CCTV, required separate consideration.

The door was initially closed but was opened at around 6:39:45am, after rescue activity had already begun through another access point. The report cautioned that controlled access to a neonatal unit had a legitimate security purpose and that a locked or controlled door could not, by itself, be treated as evidence of negligence.

The key questions, it said, were whether the door was a designated or required emergency exit, whether it could be opened immediately in an emergency and whether its condition had materially delayed evacuation or rescue. The inquiry committee said certain safety measures could not be deferred until submission of its comprehensive report.

It recommended that Pims immediately conduct a hospital-wide fire, life-safety and electrical audit through competent and preferably independent technical experts, beginning with the NICU/neonatal nursery, intensive care units, operating theatres and other high-risk areas., smoke and heat detection systems, alarms, fire extinguishers, hydrants, emergency lighting, electrical protection systems and all designated fire exits should be physically inspected, tested and documented.

Any mandatory emergency exit found locked, obstructed or incapable of being opened immediately in an emergency should be rectified without delay. At the same time, legitimate controlled access to sensitive neonatal areas should be maintained through fire-safe arrangements.

The committee further recommended an urgent technical inspection of all incubators, warmers, air-conditioning and IVAC installations, sockets, plugs, distribution boards, circuit breakers, earthing and other safety-critical electrical systems in high-risk clinical areas.

It said Pims should introduce temporary fire-watch arrangements wherever automatic detection or protection systems were deficient and conduct practical fire and neonatal evacuation drills involving doctors, nurses, security and engineering staff. The report also called for an immediate, clear and tested emergency notification and incident-command protocol.

Under the proposed system, detection of a fire should trigger a simultaneous internal alarm, mobilisation of designated responders and direct notification of CES/Rescue 1122, without relying on informal communication through multiple administrative layers. The officer responsible for each step should be identified by designation and the process tested periodically, it said.