ISLAMABAD: A preliminary report prepared by the administration of the Pakistan Institute of Medical Sciences (PIMS) has pointed to a ruptured oxygen-related device attached to an incubator as the source of the fire that killed 15 newborn babies in the hospital’s neonatal nursery.
According to the initial findings, a nebulizer used to monitor oxygen levels near an incubator burst, causing oxygen to ignite and the fire to spread rapidly through the nursery.
The report said the fire initially remained small but quickly intensified, generating smoke that entered the infants’ respiratory systems through the oxygen pipes. The newborns died from a combination of oxygen disruption and burn injuries, according to the preliminary findings.
The account marks a major development in the investigation because it differs from several explanations given in the immediate aftermath of Wednesday morning’s tragedy, when an air-conditioning compressor explosion and an electrical short circuit were among the suspected causes.
The latest report also places the focus directly on equipment used in the care of critically ill newborns, raising questions about the condition, installation, maintenance and safety of oxygen-related devices inside the nursery.
What the initial PIMS report found
The PIMS administration’s preliminary report says the fire began when a nebulizer associated with oxygen monitoring near an incubator ruptured.
The device reportedly burst and the oxygen then caught fire. Although the fire was initially small, the report says it spread rapidly.
Smoke subsequently entered the infants’ respiratory systems through the oxygen pipes, according to the findings.
The report attributed the deaths to a combination of oxygen disruption and burn injuries. The finding is particularly significant because the infants were being treated in a neonatal care environment where many babies can be dependent on oxygen, respiratory support and other life-sustaining equipment.
The report is an initial assessment, however, and further investigation is expected to establish the precise circumstances surrounding the equipment failure and whether all relevant fire and oxygen-safety measures were in place.
15 newborns died while one baby was rescued
The fire broke out at approximately 6:45am on Wednesday in the nursery of the gynaecology ward at PIMS, according to rescue officials.
The latest hospital administration account says 16 newborns were inside the nursery when the fire started.
One baby was rescued, while 15 others died, according to the preliminary report.
The death toll had remained uncertain throughout the day because different authorities initially reported different figures.
PIMS spokesperson Dr Aneeza Jalil initially said 14 newborns had died. Rescue officials, however, reported that 15 babies had died after 16 newborns were present in the nursery.
Subsequent government statements and reports by official news agencies also cited 14 deaths, while the Islamabad district administration said the exact number of casualties was being verified.
The latest PIMS administration report now puts the number of newborn deaths at 15.
The discrepancy will still need to be reconciled through hospital records and the findings of the official investigations.
New finding differs from earlier explanation of fire
The preliminary PIMS report is significant not only because it describes how the fire may have spread, but because it differs from the explanations provided shortly after the incident.
Rescue officials had initially said the blaze started after an air-conditioning compressor exploded.
Federal Health Minister Syed Mustafa Kamal also said an air-conditioning unit allegedly exploded in the intensive care area and that oxygen intensified the fire.
PIMS officials, meanwhile, initially indicated that the fire appeared to have been caused by a short circuit.
Federal Parliamentary Affairs Minister Tariq Fazal Chaudhary likewise said initial reports pointed towards a short circuit while stressing that the precise cause would have to be established through investigation.
The latest hospital report now points towards an oxygen-related device near an incubator.
That change makes the investigation into the equipment used inside the nursery particularly important.
How the fire may have overwhelmed the neonatal unit
The preliminary report describes a chain of events that may explain why the fire became so dangerous so quickly.
According to the findings, the oxygen-related device ruptured, oxygen ignited and the fire spread through the nursery.
Smoke then entered the infants’ respiratory systems through the oxygen pipes, while the disruption of oxygen supply and burn injuries contributed to the deaths.
Unlike most hospital patients, newborns in a neonatal intensive care environment cannot simply walk away from a fire. Some may be dependent on incubators, oxygen delivery systems, monitoring equipment or other forms of specialised support.
This makes the integrity of oxygen infrastructure and the availability of rapid evacuation procedures particularly important in neonatal units.
The report therefore raises questions that go beyond the device that allegedly ruptured. Investigators will need to establish whether the oxygen system was properly installed, maintained and monitored, whether the equipment had previously shown signs of failure and whether adequate safeguards existed to prevent an equipment malfunction from developing into a fatal fire.
Fire-safety arrangements also under investigation
The new finding comes as authorities investigate wider allegations about fire safety and emergency preparedness at PIMS.
Rescue sources had alleged that fire hoses lacked couplings, no water was available at a fire point and emergency evacuation routes were locked.
They also alleged that no doctors, ward boys or other hospital staff were present inside the incubation centre when the fire broke out.
These allegations have not been independently established and remain subject to investigation.
The emergency response time has also become a disputed issue.
According to the Capital Emergency Service and CDA Fire Department, the fire call was received at 6:54am, with fire and rescue teams reaching PIMS within seven minutes. Six fire brigade vehicles and four ambulances participated in the operation.
Sources familiar with the incident, however, told Medical News Pakistan that firefighters reached the hospital approximately 20 to 25 minutes after the fire started.
Establishing the exact timeline will be critical because the difference between the reported response times could have significant implications for the assessment of the emergency response.
PM removes health secretary as inquiries begin
The tragedy has already resulted in major administrative action.
Prime Minister Muhammad Shehbaz Sharif ordered the immediate suspension and removal of Federal Health Secretary Aslam Ghouri following a high-level meeting on the PIMS nursery deaths.
The prime minister also ordered a high-level inquiry to determine the circumstances surrounding the tragedy and fix responsibility.
Former Interior Secretary Shahid Khan was appointed chairman of the inquiry committee, while Establishment Secretary Dr Barrister Nabeel Awan was named among its members.
Separately, the Islamabad administration constituted a seven-member fact-finding committee to investigate the fire.
The committee, headed by the Additional Deputy Commissioner General, Islamabad Capital Territory, includes senior officials from Capital Emergency Services, CDA, Islamabad Police, IESCO and PIMS.
Its mandate includes determining the exact cause of the fire, assessing whether functional fire-safety measures were available and evaluating the response time and effectiveness of firefighting and rescue operations.
The committee was directed to submit its report within 24 hours.
The key questions investigators must answer
The preliminary PIMS report provides a new explanation for the fire, but it also opens several questions that will need to be answered before the incident can be fully understood.
Investigators will have to establish:
- What exactly caused the nebulizer or oxygen-related device to rupture?
- Was the device properly installed and maintained?
- How did oxygen ignite following the rupture?
- Did the oxygen pipes contribute to the movement of smoke or fire?
- Were oxygen-delivery systems functioning safely?
- Were fire extinguishers, hoses and other firefighting equipment functional and immediately accessible?
- Were evacuation routes unlocked and usable?
- Which doctors, nurses and other hospital staff were present when the fire began?
- How long did it take for the emergency call to be made?
- How quickly did firefighters actually reach the nursery?
Perhaps the most important question will be whether the deaths could have been prevented if the equipment, fire-safety systems and emergency response had functioned as required.
Preliminary report may reshape the PIMS fire investigation
The PIMS administration’s initial report has significantly changed the focus of the investigation.
What was initially described by some officials as a possible short circuit or air-conditioning compressor explosion is now being attributed in the hospital’s preliminary findings to a ruptured oxygen-related device near an incubator.
That finding does not, by itself, settle the matter.
The government’s investigations will have to examine the physical evidence, the equipment involved, hospital maintenance records, oxygen infrastructure, fire-safety arrangements and the sequence of events inside the nursery.
The conflicting accounts over the cause of the fire, emergency response time, presence of hospital staff and number of newborn deaths make those investigations particularly important.
For the families who lost their newborns, however, the central issue is no longer simply how the fire started. It is whether the tragedy could have been prevented — and whether failures in equipment, safety systems or emergency response allowed a fire inside a hospital nursery to become fatal.
The preliminary PIMS report has provided the first detailed explanation of how the blaze may have begun and spread. The final investigations will now have to determine whether that explanation stands up to the evidence and who, if anyone, should be held responsible.
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