JPMC faces scrutiny after critically ill patient dies following transfer to NICVD amid alleged referral protocol violations

KARACHI: The death of a 65-year-old critically ill patient shortly after being transferred from the Jinnah Postgraduate Medical Centre (JPMC) to the National Institute of Cardiovascular Diseases (NICVD) has raised serious questions about emergency referral protocols, inter-hospital communication, and patient safety in Pakistan's public healthcare system.

The incident has triggered an internal inquiry at JPMC, while NICVD has issued a clarification stating that the hospital received the patient without prior notification and in an extremely critical condition.

Internal memorandum issued over alleged referral protocol violations

According to information available, the patient, identified as Abdul Rasheed, son of Karim Tibba, was referred from JPMC's Emergency Department to NICVD on July 28, 2026. The patient later died despite emergency resuscitation efforts.

Following the incident, the Emergency Department supervisor at JPMC issued a memorandum seeking an explanation from the night shift in-charge, Dr Waqas, over the circumstances surrounding the patient's transfer.

The memorandum alleges that established referral protocols were not followed during the transfer. It states that appropriate communication with the receiving hospital was not completed before the patient was moved and that the required referral documentation was also incomplete.

The document further describes the incident as a serious violation of hospital policy and patient safety procedures and warns that improper referral practices could also compromise medico-legal documentation.

NICVD says no prior communication was received

In a separate statement, NICVD said the patient arrived at its Emergency Department in an extremely critical condition.

According to the hospital, its emergency team immediately initiated all necessary life-saving interventions, including cardiopulmonary resuscitation (CPR). Despite extensive efforts, the patient could not be revived and was pronounced dead.

NICVD stated that no prior notification or formal coordination was received from JPMC before the patient's arrival.

The institute emphasized that advance communication between referring and receiving hospitals is essential when critically ill patients are transferred, allowing specialist teams to prepare in advance and facilitate immediate treatment upon arrival.

The hospital reiterated that timely coordination and complete clinical information are fundamental components of safe emergency referrals and can significantly improve continuity of care.

Night shift in-charge responds

Responding to the allegations, Dr Waqas said that the Emergency Department was simultaneously managing a serious road traffic accident (RTA), requiring the attention of all available doctors.

He further claimed that Rescue 1122 personnel transferred the patient before the referral documentation had been completed.

Dr Waqas also stated that similar situations have occurred previously at the hospital and suggested that such incidents are not uncommon in the emergency setting.

Why referral protocols matter

The case has once again highlighted the importance of standardized emergency referral systems for critically ill patients.

Safe inter-hospital transfer generally requires stabilization of the patient, advance communication with the receiving facility, complete transfer documentation, and appropriate monitoring throughout transportation. These measures help ensure continuity of care and enable receiving hospitals to mobilize the necessary personnel and resources before the patient's arrival.

Failure to adhere to these procedures may result in delays in definitive treatment and can complicate both clinical management and medico-legal accountability.

Focus shifts to patient safety and emergency coordination

While both JPMC and NICVD have presented their respective accounts of the incident, the case has brought renewed attention to the effectiveness of emergency referral systems within Pakistan's public healthcare network.

At the time of publication, no final inquiry report has been released, and responsibility for any procedural lapses has yet to be formally determined.

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