Corporate Governance and Ethics: AMRI hospital fire outbreak

Submitted for: Corporate Governance and Ethics

Submitted By: Submitted to: Dr. Sameera A. Raees

Smriti Gupta 1220

Vaishali Baser 1228
Divija Marwaha 1187
Sanjyot Chitre 1181
Anuj Chaturvedi 1171
Introduction

AMRI Hospitals Ltd is the premier private healthcare provider of Eastern India, with three super
specialty hospitals at Dhakuria, Mukundapur, and Salt Lake, in Kolkata, a state-of-the-art
daycare centre on Southern Avenue in Kolkata, and another super specialty hospital at
Bhubaneswar, Odisha. The Group takes care of around 3.5 lakh patients annually, conducting
more than 15,000 successful surgeries, with a roster of more than 5,000 healthcare professionals.
An impressive roster of more than 600 doctors and a well-trained force of nursing staff work
tirelessly across more than 1,000 beds across its four hospitals, backed by advanced technologies
and latest equipment to treat people and save lives. With major changes and developments on its
plate, the AMRI Group is headed towards a path of steady growth. AMRI Hospitals is all set to
add around 700 beds in the near future.

AMRI Hospitals brings to the table a class of its own, making the healthcare group a major
player in keeping Eastern India ahead of the curve. The Group treats more than 3.5 lakh people
every year and conducts around 15,000 surgeries annually, providing value-for-money services,
backed by advanced equipment and latest technologies. The hallmark of AMRI Hospitals is a
committed team of doctors and caregivers, who take up the challenge of treating the most
complicated cases, besides stepping up to handle Emergency and Critical Care with dedication,
expertise and compassion. Over the last three decades, the healthcare Group has made immense
contributions to the lives of people, not just from Kolkata and the rest of Eastern India, but also
from other parts of South Asia and the world.

SWOT Analysis

Strength
 AMRI hospital is a private hospital
with several specializations such as
dentistry, dermatology, diabetology,
IVF centre, urology and many more.
 Gives back to the community in the
Weakness
 Patients/ customers feel unsatisfied
with their medical services at times.
 Sometimes patients/ customers are
unsatisfied with the overall experience
at the hospital
 form of training programs and check-
up camps
Opportunity
 The hospital still can make reforms
and change their image in the eyes of
the public
Threat
 Given the history (the discussed case
is the 2nd fire outbreak in 3 years), the
hospital faces serious threats of shut
down

Hospital’s corporate governance and business ethics practices

AMRI supports and respects the patient’s right to impartial access to services and treatment that
are offered at the hospital and that are consistent with relevant laws and regulations and
medically indicated, regardless of race, sex, creed, nationality, religion, disability, age , diagnosis
or source of payment.

 Patients at higher than normal risk will be identified. Children under 18 years of age,
geriatric patients with mental or physical disability, mentally unsound patients, comatose patients
etc. who are identified as vulnerable patients will be given additional care.

 Receive life-saving treatment without delay regardless of his/her economic status or

source of payment. Should it not be an emergency and the hospital cannot accommodate him/her,
he/she has the right of safe transfer to a facility that agrees to receive and treat him/her.

 Right to receive considerate and respectful care, provided in a safe environment, free
from all forms of abuse or harassment

 Right to choose his/her own consulting physician.

 Easy access to the in charge doctor/sister and has a right to get detailed explanation about
the medical problem, diagnosis and prognosis in the language the patient/relative understands.
 Receive appropriate assessment and effective management of pain pertinent to his/her
medical condition

 Get timely medication and the consultant/primary physician should visit him regularly as
per the scheduled time.

 Patient has a right to receive adequate information related to their medical treatment,
investigations, and procedures to be carried out.

Right to Information
Patients are kept informed about:

 Medical Counseling by the Consultant about the deceased per se.

 The cost of treatment through proper financial counseling. The patient has a right to
examine and receive an explanation of his/her interim and final bill regardless of the source of
payment.

 The physician who is treating him/her.

 Plan of care and diagnosis and disease condition.

 Medication and safe medication usage.

 Outcomes of care including unanticipated outcomes of care and complications.

 The risks of discontinuing treatment when patients decide to discontinue care.

 Expected date of discharge and discharge instructions.

 Their rights and responsibilities in the hospital.

 Right to be informed beforehand about occurrence of any unpredictable life threatening

event or untoward situation.
  Right to know which hospital rules and policies apply to his/her conduct while a patient.

 Right to adequate information related to any procedures/ anesthesia; its risks, benefits,
alternatives and potential complications. After adequate information is received, the patient/legal
authorized representative gives an informed consent.

Freedom from Abuse and Physical Assault

 Be free from mental, physical, sexual, and verbal abuse, neglect, and exploitation from
staff, visitors, students, volunteers, other patients or family members.

 Special measures will be adopted to ensure safety and security of vulnerable patients such
as the elderly and young patients.

Confidentiality

 Confidentiality will be honored within the limits of the law. This includes the patient's
location, identity, and medical records and applies to the sharing of information with outside
sources.

 The patient himself has access to information contained in his/her medical files and can
ask for copies of the same by applying to the Medical Superintendent.

Privacy

 Personal, visual and auditory privacy will be honored to the extent reasonable.
Examination of all female patients by a male doctor or nurse can only be conducted in the presence
of another female attendant. This is applicable in any area of the hospital (Diagnostic services area,
outpatient consultation, ambulatory, casualty area, operation theatres, intensive care units, inpatient
areas).

 All physical examination will take place with adequate precautions to maintain the
dignity and privacy of the patient. All sensitive information is shared with patient and/or family
members inside the discussion room, to ensure auditory privacy.
 Psychosocial, Cultural, and Spiritual Values

 Patients have all the rights to express spiritual and cultural beliefs provided they do not
interfere with others or hospital operations. These psychological, cultural and spiritual values will
be considered in the care of the patient.

 Our hospital will also provide access and facilitation of services of the religious nature
for the patient, should he/she want it.

Unethical Issues happened in the hospital

Incident

AMRI hospital is a private hospital located in a densely populated are in South Kolkata. On
December 9, 2011, a massive fire broke out in the building in the early hours of morning. It was
first noticed by residents around 3:30 in the morning. However, the fire control room was
informed about the fire at 4:10 a.m.

Immediate response teams arrived at the site within 20 minutes.

Although the fire broke out in the basement of the hospital and could have been contained in the
area itself, the poisonous smoke was sucked by the air conditioning ducts that carried it to the
rooms and the corridors of the seven floor centrally air-conditioned hospital.

Entire hospital building was filled with thick pile of smoke causing tremendous suffocation for
all the indoor patients. Ninety people choked to death, many of them are in their sleep or were
not in condition to escape. These included people from different states and countries.

Cause

Despite warnings from the fire services department, government of West Bengal about the
inappropriate and dangerous use of the hospital basement, it continued to use the for storing
empty and filled up LPG cylinders, torn mattresses, wooden boxes storehouse instead for parking
cars.
Response and impact

Locals who had noticed the fire along with relatives of patients who were waiting outside tried to
help the patients who were trapped inside till the fire department response team arrived.

However, the security staff of the hospital stopped them from entering the hospital and the staff
tried to douse the fire with their own insufficient available equipment.

After the rescue operation by the fire department, it was also found that none of the smoke
alarms were activated even when the smoke started billowing out of the basement. It seemed that
they had been switched off because they would go off even at the slightest smoke at disturb the
patients. It was also found that the sprinklers, gas jets and other water releasing equipment that
are meant to fight fire, were defunct and none of them went off to prevent the fire. It was also
suspected that the basement was being used as a smokers’ corner by keeping the fire alarms in
switch off mode.

Although the reason for the fire outbreak is still unknown, it was suspected that a short circuit
was most likely the cause. The fire would have been at a much smaller scale and remained
confined to the basement if the combustible items like the empty and filled up LPG cylinders,
PVC pipes, rejected mattresses and wooden boxes had not been in the basement.

The impact would have been less if the centrally air-conditioned hospital had windows. As a
result, smoke could have ventilated outside the building. A critical component like mechanical
ventilation of centrally air-conditioned buildings was missing in the hospital building. The fire
brigade later broke open the glass facade to help the gas escape, but it was too late.

Action by administration

Govt. of West Bengal suspended the license of the AMRI hospital with immediate effect.

A judicial probe-was ordered for the entire catastrophe.

The Department of Health & Family Welfare, Govt. of West Bengal directed the hospital
authority to close the hospital and transfer the patients to another hospital.
A 15-member special investigation team was set-up under the leadership of Assistant
Commissioner, to investigate the case. On the basis of the preliminary inspection and report by
the fire department, the police arrested six directors of the hospital under four non-bailable
sections of the Indian Penal Code, namely, sections 304 - culpable homicide not amounting to
murder, 308 -attempt to commit culpable homicide, 285 - negligent conduct with respect to
combustible materials and 34 - common interests.

Other issues with respect to Corporate Governance and Ethics (Headlines)

 After 3 patient’s deaths: Kin accuses 3 private hospitals of negligence (one of which was
AMRI Hospital)

 After 3 patient’s deaths: Kin accuses 3 private hospitals of negligence (one of which was
AMRI Hospital) (2019)

 Corpse gets treatment in AMRI ICU! - kept a dead person in the ICU for many days to
charge an exorbitant ‘treatment’ cost (2019)

 AMRI horror: Kin say victim went in with stomach ache, returned dead (2018)

 AMRI Hospital, 3 doctors told to pay Rs. 5.96 Cr. for negligence (2016)

 Kolkata's AMRI Hospital to pay record Rs 11.41 crore compensation to NRI doctor
whose wife died after medical negligence (1999)

Learning Outcomes
Through this project, we learnt a lot of things such as:
  Application of Corporate Governance and Ethics practices – we learnt how
various organizations have to follow certain policies, procedures and
principles in order to function properly in the business environment
 SWOT Analysis: We came to know various Strengths, Weaknesses,
Opportunities and Threats face by the hospital and how it deals with them
efficiently.
 Knowledge Generation: For making this project we did a detailed case study
on the fire incident that took place in 2011. In process we came across
different viewpoints of different people. It added to our knowledge. We
understood the causes behind the fire, the rules which were broken, and the
gruesome consequences of the fire.
 Handling of the problems: We found out the results of not following the
Corporate Governance and ethical polies. Such as – Compensation paid to
the victims and the orders given by the court.
References and Bibliography

https://www.amrihospitals.in/?q=patient-care-services&nid=221

https://www.amrihospitals.in/academics

https://www.amrihospitals.in/community

https://www.amrihospitals.in/about-amri

https://www.ndtv.com/india-news/kolkata-89-killed-in-amri-hospital-fire-six-board-members-
arrested-566913

https://indiankanoon.org/search/?formInput=amri+hospital+fire

https://www.asklaila.com/reviews/Kolkata/salt-lake-city/amri-hospital/0JaLfNas/

https://www.slideshare.net/AlokKumar65/amri-fire
https://www.dailypioneer.com/2016/state-editions/corpse-gets-treatment-in-amri-icu.html