KARACHI: The fallout from the death of a critically ill patient transferred from the Jinnah Postgraduate Medical Centre (JPMC) to the National Institute of Cardiovascular Diseases (NICVD) has taken a new turn, with a senior emergency medicine physician at JPMC asking to be relieved of her duties in the department.
Dr Sanobar Sikandar, FCPS (Emergency Medicine), Assistant Professor of Emergency Medicine and supervisor of the Postgraduate Emergency Medicine Training Program at JPMC, submitted a written request to the hospital's executive director on August 3, 2026, seeking relief from her duties in the Accident & Emergency Department.
Her request does not identify a specific individual as responsible for the circumstances surrounding the patient's death. Instead, it describes a broader deterioration in the working environment and raises concerns about how departmental matters have been handled.
The development comes days after a 65-year-old patient died following transfer from JPMC to NICVD on July 28, an incident that had already prompted questions over emergency referral procedures and the responsibilities of staff involved in the transfer.
Senior emergency physician cites professional disrespect
In her letter, Dr Sanobar said she had experienced a persistent lack of professional respect and recognition in her capacity as a faculty member and senior consultant.
She said this had affected her ability to perform her academic, clinical and supervisory responsibilities effectively, despite her commitment to patient care, postgraduate training and departmental development.
She requested relief after concluding that she was no longer able to continue performing her responsibilities effectively under the prevailing circumstances.
The timing of the request is significant because Dr Sanobar holds a teaching and supervisory role within the Emergency Department in addition to her clinical responsibilities.
'Unhealthy working environment' cited as another reason
Dr Sanobar also described the prevailing atmosphere within the Emergency Department as increasingly affected by what she termed unhealthy departmental politics.
According to her letter, the environment had become unsuitable for professional practice, teaching and teamwork.
She further cited the involvement of media-related matters in departmental affairs, saying this had contributed to an increasingly difficult working environment and made it harder for her to discharge her responsibilities effectively.
These concerns come against the backdrop of heightened attention surrounding the July 28 patient death, which has already placed JPMC's emergency referral practices under scrutiny.
Letter raises concern over treatment by junior doctor
Perhaps the most pointed concern in Dr Sanobar's request relates to an incident involving a junior resident.
She said she had been subjected to what she described as unprofessional and disrespectful conduct by a junior resident in the presence of the departmental administration.
According to her account, the incident was not appropriately addressed and she did not receive what she considered adequate measures to uphold the dignity of her position as a faculty member and senior consultant.
Dr Sanobar said the episode had significantly affected her confidence in the institution's ability to maintain a respectful and professional working environment.
Her letter therefore points to concerns extending beyond the patient-death controversy itself, raising questions about the internal environment in which emergency physicians and trainees are expected to work.
Earlier inquiry had focused on the night-shift transfer
The development follows an earlier report by Medical News Pakistan on July 30 concerning the death of the 65-year-old patient after transfer from JPMC to NICVD.
According to the internal memorandum cited in that report, the Emergency Department supervisor had sought an explanation from night-shift in-charge Dr Waqas over the circumstances surrounding the patient's transfer.
The memorandum alleged that established referral procedures had not been followed, including advance communication with the receiving hospital and completion of required referral documentation.
NICVD subsequently stated that the patient had arrived in an extremely critical condition and that its emergency team immediately initiated resuscitation efforts. The institute also said it had received no prior notification or formal coordination from JPMC before the patient's arrival.
Dr Waqas, responding to those allegations, said the emergency department was simultaneously dealing with a serious road traffic accident and that Rescue 1122 personnel transferred the patient before the referral documentation could be completed.
He also said similar situations had occurred previously at the hospital.
At the time of the earlier report, no final inquiry finding had established responsibility for the patient's death.
YDA warns of impact on emergency medicine training
The latest development has prompted concern from the Young Doctors Association (YDA) Sindh).
YDA Sindh Chairman Dr Mahboob Noonari said Dr Sanobar is the only FCPS assistant professor in emergency medicine at Jinnah Hospital, and highlighted her role in the FCPS program and supervision of postgraduate trainees.
Dr Noonari warned that her departure could have implications for postgraduate emergency medicine training and potentially affect the continuity of the FCPS program.
He called on the hospital administration to resolve the matter and investigate the circumstances surrounding the patient's death.
The YDA chairman also alleged that a senior doctor was being pressured in connection with the incident and called for the role of night-shift in-charge Dr Waqas to be examined.
He demanded that Dr Waqas be asked to explain his role in the incident and that appropriate action be taken if negligence is established.
These remain allegations and demands by the doctors' body, and responsibility for the patient's death has not been formally determined through a final inquiry.
JPMC administration says it does not want to lose Dr Sanobar
JPMC Joint Executive Director Dr Suleman said the administration considers Dr Sanobar a valuable member of the institution and does not want to lose her services.
He said her contribution to the hospital and her role in training FCPS doctors were highly valued.
According to Dr Suleman, the administration would provide her with all possible support and work to address the concerns raised in her request.
He said the matter would be resolved soon.
A wider question now hangs over the controversy
The latest development has added a new layer to a case that initially centered on patient transfer and referral protocols.
What began with questions over whether a critically ill patient was appropriately coordinated and transferred between two major public-sector hospitals has now expanded into concerns about the working environment, professional conduct and the institutional handling of the aftermath.
Dr Sanobar's request is particularly significant because she has not simply cited workload or personal reasons for seeking relief. Her letter describes a combination of professional disrespect, departmental politics, media-related pressures and unresolved conduct issues that she says have made it increasingly difficult to perform her clinical, academic and supervisory duties.
At the same time, the earlier record shows that questions surrounding the patient's transfer had already led to an explanation being sought from the night-shift in-charge.
The contrast leaves an important institutional question: as scrutiny continues over the circumstances of the patient's death, are the concerns of the physicians responsible for maintaining emergency care and postgraduate training being addressed with the same urgency?
For now, the hospital says it wants to retain Dr Sanobar and address her concerns, while the YDA is pressing for further scrutiny of the July 28 incident.
No final inquiry report establishing responsibility for the patient's death has been made public.
The case therefore remains unresolved on two fronts: what happened during the patient's transfer, and what prompted a senior emergency medicine faculty member to conclude that she could no longer effectively perform her duties in the department.
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