TOI has learned that of the 232 ICU admissions at the BKC facility in the past three weeks, 86 patients have died, lending it a fatality rate of 37%. This is higher than that seen by some of BMC’s tertiary hospitals like KEM (34% in June) or Sion (26%) at the peak of the pandemic.
The jumbo care centres in the city have the best of medicines, the best of ventilators and other healthcare facilities. What they need more of is supervision so that there is greater accountability and that public confidence in going to such facilities in case of health issues continues to stay strong.
Civic officials said some very critical patients were referred to the facility, including from peripheral areas.
BMC gives medicines and pays pvt agencies Rs 6,000 per ICU bed
ICUs in three of the five jumbo facilities have been commissioned in the past one month, whereas a fourth 225-bed critical care facility built in the Nesco grounds, Goregaon, is nearing completion. While the BKC ICU has 108 functional ICU beds, Dahisar has 119 and the Dome in Worli has 28. The ICUs at Dahisar and Worli facilities, which too are run by private agency LifeLine Care, have registered a dozen deaths each out of 119 and 90 admissions respectively.
BMC’s additional municipal commissioner Suresh Kakani said the BMC has sought details of deaths from Cardiac Health Care agency that has won the bid to run the BKC facility and will shortly be managing the NESCO ICU. “We are doing an internal evaluation. BMC doctors are not directly involved in the treatment and are playing a supervisory role here,” Kakani said.
The BMC is paying a sum of Rs 6,000 per bed to private agencies running the ICUs who are provided medicines and life-saving equipment by the civic body. These agencies are only supposed to bring manpower consisting of doctors, nurses and ward boys.
A senior doctor in one of the centres said there have been worries about the quality of manpower and misuse of medicines and consumables. “These issues are expected in the initial stages of Private Public Partnerships and can be ironed out. The worrying part is that these ICU teams have been hurriedly put together, some without adequate training,” the doctor said.
To reduce the mortality numbers, Dr Muffazal Lakdawala who has been running the Covid facility in Worli Dome said they have formed a panel of specialists who are guiding the team from the private agency (Lifeline) on video calls. “Four to five experts—a diabetologist, nephrologist, cardiologist and neurologist—are all coming on phone calls to help them,” said the surgeon. “While deaths are a worry, it needs to be acknowledged that some of the most critical patients refused admission elsewhere are admitted here. Also, the patients are not dying immediately but after one or two weeks of treatment,” he said. During a pandemic, a death rate of up to 20% in ICUs is not considered unacceptably high, said officials. Many 80- and 90-year-olds have also walked out of these centres.
Dr Kishor Bisure, who is overall in-charge of the Dahisar facility, said many patients have given good reviews of the privately-run ICUs. “I have deputed a BMC anaesthesiologist to oversee ICU management. Our centre has one intensivist per shift and patients have told us that they are approached by a medical person at least four times in a day,” he said. Dr Neelam Andrade, dean of Nesco jumbo facility said one of the workable solutions could be monitoring of ICU management by BMC doctors and nurses for better outcomes.