SHORTAGE: It is the shortage of trolleys and loose oxygen cylinders supplied by Scoop Oxygen Ltd, the solo agent given the contract, that has been responsible for the 300 deaths between April 30 and May 12, 2021

By Rajan Narayan

The Goa Bench of the Bombay High Court has strongly censured the State government, accusing it of taking away the Right to Life guaranteed by Article 21 of the Constitution. The matter came up on Wednesday, May 12, and the Goa Bench rejected excuses offered by the government explaining the shortfall in supply of oxygen. It directed the government to take immediate steps to ensure adequate supply of oxygen to prevent any more deaths. Dean Dr Shivanand Bandekar of the GMC admitted that there have been around 300 deaths between April 30 and May 12 and these were due to the drop in the pressure of tubed oxygen supply and shortage of oxygen cylinders.

The Goa Bench of the Bombay High Court has strongly censured the State government, accusing it of taking away the Right to Life guaranteed by Article 21 of the Constitution. The matter came up on Wednesday, May 12, and the Goa Bench rejected excuses offered by the government explaining the shortfall in supply of oxygen. It directed the government to take immediate steps to ensure adequate supply of oxygen to prevent any more deaths. Dean Dr Shivanand Bandekar of the GMC admitted that there have been around 300 deaths between April 30 and May 12 and these were due to the drop in the pressure of tubed oxygen supply and shortage of oxygen cylinders.

THE Goa Bench of the Bombay High Court comprising Justice Mahesh Sonak and Justice Nitin W Sambra, in their verdict on May 12, 2021, has held the Goa State government guilty of depriving the residents of the state of Right to Life guaranteed by Article 21 of the Constitution. Under the circumstance, the justices said, “There is therefore, a corresponding duty cast on the state to ensure that this life is not extinguished on account of the inability on the part of the State to supply oxygen to these unfortunate victims of the pandemic. This duty can neither be avoided by pleading helplessness nor by putting forth logistical difficulties in sourcing and supplying oxygen. The State officials repeatedly assured us that there was sufficient oxygen available but the problem was mainly of logistics of the supply chain….in any case we feel such logistic problems must be got over at the earliest, so that this tragedy of victims gasping for breath in the presence of their near and dear once and in several cases even dying for want of necessary oxygen supply, is arrested at the earliest. Therefore, the State will have to and is hereby directed to take all necessary steps to ensure that such logistical difficulties are overcome at the earliest and there are no casualties for want of supply of oxygen to the pandemic victims.”
In the affidavit filed by the GMC Dean Dr Shivanand Bandekar, the deficit in oxygen supply is clearly dramatized. Dr Bandekar has provided details of the gap between demand and supply on May 9/10/11, 2021. During which period it was admitted that a number of lives were lost not because of the covid infection but due to fall in the pressure of oxygen in the primary covid centre in the State, that is the Goa Medical College and hospital.
The situation is compounded by the fact that though GMC has only 750 beds, as on Wednesday 950 patients were admitted, many of whom in critical condition. The excess patients had to be accommodated on stretchers and even on the floor.
Dr Bandekar in his affidavit filed on May 12, 2021 told the High Court that there was a severe deficit of oxygen on all the three days concerned, namely May 9/10/11. The projected requirement of oxygen supplied through trolleys which contain 48 cylinders each were 50/58/60 respectively. As against this on the May 9 no trolleys were supplied; on May 10 only six trollies were provided which increased marginally to nine trolleys on May 11.
The projected requirement of cylinders to supplement the supply from the main oxygen tank at the GMC was 350 cylinders, each of 1.5 cubic meters and 750 cylinders of seven cubic meters per day on all three days. The actual supply of 1.5 cubic meters cylinders were 210 on the May 9, 287 on May 10 and 282 on May 11. The deficit was 140 cylinders on Sunday, May 9, and 70 cylinders on May 10 and May 11 with respect to seven cubic metre cylinders against the requirement of 750 cubic metre cylinders per day; for each of the three days the supply was only 771, 370 and 441 cylinders, respectively.
The deficit in metric tonnes was 3.6 MT equivalent to 500 cylinders of 7 cubic meters on Sunday May 9, 5MT equivalent to 700 cylinders on May 10 and 6.5 MT equivalent to 900 cylinder of 7 cum.
In his affidavit the Dean admitted that the reduced oxygen saturation lasted for a significant duration causing tissue hypoxia and irreversible tissue damage. This become worse if the covid patients has other problems such as a history of cardiac attack and diabetics and even old age. The death following even a small interruption in the oxygen supply or a fall in pressure is immediate. There have been cases where death has come after some period of time. The dean stressed that adequate and uninterrupted supply of oxygen is a vital importance in managing covid-19 pneumonia. The dean admitted that the GMC has faced many interruption in the supply of central oxygen on a daily basis leading to near critical fall in the oxygen saturation of patients in large numbers in the intensive care units. The supply of cylinder oxygen that was being used for mild stroke moderate patients was also deficient and erratic according to the dean, leading to the needy patients not getting it continuously.
To dramatized this point the dean has pointed out that on the April 30 when there were 533 patients, the supply of oxygen from the central tank was 160 and 231 patients were on cylinder. This was against the requirement of 577 cylinders. This lead to 17 deaths due to shortage of oxygen. On the May 1, when the number of patients increased to 591 the supply from the central tank remained at 160 cubic meters but the shortage of oxygen cylinders rose to 400. There were only 241 cylinder supplied against the requirement of 602 leading to 29 deaths. On the May 2 the shortage of cylinders increased to 90 leading to 31 deaths. The maximum number of deaths was on the May 5 when there were 754 patients. The supply of cylinders was only 370 as against the requirements of 925, which lead to 42 deaths. In the period April 30 2021, and May 8 2021, the number of deaths attributed by the dean to drop in pressure or shortage of cylinders were as high as 279. This is almost half of the total causality attributed to covid-19 in this period. The number of death rose to 45 on May 11 2021, when the supply of cylinders was only 330 as against the requirement of 825.
GMC’s dean in his affidavit has stated that though there was no problem with the availability and supply of liquid medical oxygen which is stored in the tank of 20,000 litres at the newly commissioned super speciality block, the liquid medical oxygen cannot be used in the main GMC building which relies entirely on the supply of oxygen through cylinders which are brought on trolleys and loose cylinders. The dean told the Court that loose cylinders have a capacity of only 1.5 and 7 cubic meters. He pointed out that there has been a problem with the supply of the trolleys which can carry 28 cylinders each – the result has been instances of a dropping of pressure in oxygen supply to patients, resulting in death.
It is clear from the affidavit filed by various officials including Dean Shivanand Bandekar that the GMC requires at least 500 jumbo cylinders of oxygen by 10pm, another 250 jumbo cylinders by 6am and so on. That is if they are to realistically tide over the crisis in the GMC; they would need a thousand jumbo cylinders every day. Various officials also pointed out that they would require at least 72 trolleys of oxygen, if patients admitted to GMC have to be effectively treated without risk of dying for want of oxygen supply.
Scoop Oxygen Ltd which has the contract for the supply of oxygen had promised the supply of an additional 55 trolleys of oxygen and 600 jumbo cylinders. The State has also asked for an increase in Central assistance with respect to allocation of oxygen.
Meanwhile an intervention application has been filed on charges of murder against Health Minister Vishwajit Rane and other officials for failure to ensure adequate supply of oxygen, even though they were aware that the shortage was leading to deaths every day between 2am and 6am. The situation has worsened with the State government stipulating that the oxygen cylinders cannot be refilled without a prescription from a government doctor.
Despite the warning of the HC bench there were 40 more death on May 13 between 2am to 6am. This time around the government sought to blame the drivers of Scoop. The government Advocate claim that the present Scoop drivers were not expert and could not place the trolly in the position to fill the tank at the GMC. They also promised to install a tank for storage at GMC to be completed for May 17. In the interim to Dura mega cylinders would be set up on Thursday itself. The court has warned that if there are any more deaths it will have a hearing on Saturday May 15 to decide on further action. wre