NEW DELHI — Thirty children have died at a public hospital in India over the past two days, with government critics blaming a shortage of oxygen after a supplier of liquid oxygen cut off deliveries because of unpaid bills.

Government officials were scurrying to explain what had happened, admitting that the state-run hospital owed more than $50,000 to a supplier of liquid oxygen and that oxygen supplies had been “disrupted.”

“There was some payment issue to the oxygen supplier, and there was a shortage of liquid oxygen,” said Anil Kumar, the commissioner of the city of Gorakhpur. But, he added, “those deaths were not due to lack of oxygen.”

Other officials said the hospital had a backup oxygen supply, though they did not explain why so many children had died in such a short time. Since Monday, a total of 60 children have died at the hospital, many from acute encephalitis and others in the neonatal unit.</s>Baba Raghav Das Medical College in UP's Gorakhpur is the biggest hospital in the district.

Gorakhpur, Uttar Pradesh: Sixty children, including many newborn babies, have died in the last five days at a hospital in Gorakhpur, Uttar Pradesh Chief Minister Yogi Adityanath's parliamentary constituency. 23 died on Thursday, when the hospital reported a disruption in oxygen supply, but the state government has emphatically stated that no child died because of a lack of oxygen. It has, however, admitted there could be negligence and has ordered an investigation. The Chief Minister had visited the state-run Baba Raghav Das Medical College, Gorakhpur's biggest hospital, on Wednesday.</s>At least 30 children died in the state-run Baba Raghav Das Medical College in Gorakhpur during the last 48 hours, district magistrate Rajeev Rautela said.

He said 17 children died in the neo-natal ward, 5 in AES (acute encephalitis syndrome) ward and 8 in the general ward.

To a specific question as to whether the deaths occurred due to shortage in supply of oxygen, Rautela said he found out from the doctors that no death occurred due to lack of oxygen.

Hindi daily Hindustan says that the hospital had run out of oxygen due to non-payment of close to Rs 69 lakhs. The supply of liquid oxygen was reportedly over on Thursday and all the cylinders ran out today.

Gorakhpur was the Lok Sabha constituency of current Uttar Pradesh Chief Minister Yogi Adityanath.</s>Thirty children, including 17 newborns, have died in the last 48 hours after oxygen supply to the children’s department in Baba Raghav Das Medical College and Hospital in Uttar Pradesh’s Gorakhpur district was disrupted, ANI reported on Friday. The authorities had to use gas cylinders as a replacement in the ward.

Earlier, reports had attributed the deaths to encephalitis, a condition which causes high fever and brain inflammation. However, a statement released by the hospital later showed only five of the 30 deaths were of children suffering from the acute encephalitis syndrome. Seventeen deaths were reported from the neo-natal ICU.

Twenty three children died on Thursday night, while seven lost their lives on Friday after oxygen supply to the hospital was disrupted at 7.30 pm on Thursday. “On August 10, at 7.30 pm, the pressure in the liquid oxygen started falling,” the hospital said in a statement. “Fifty-two oxygen cylinders kept in reserve were used as a replacement. Fifty cylinders were sourced from IGL Faizabad that arrived at 1.30 pm on August 11 in ward No 100. These were immediately connected by the central pipeline operator.”

“On August 11, at 8.30 am, again cylinders came from IGL Faizabad, and were used,” the statement said. “At 1.30 pm, 22 cylinders came from Modi Pharma Gorakhpur. At 4.30 pm, 36 cylinders came from Modi Pharma that were used. Hundred cylinders were sent to Modi Pharma for refill.”

The hospital added that they were hoping that the 100 cylinders would come back by 11 pm on Friday.

The oxygen supply was allegedly stopped after the hospital failed to clear the suppliers’ bill of Rs 67 lakh, the Hindustan Times had reported. “The supply of liquid oxygen was disrupted yesterday day due to pending payments. We had requested the suppliers not to disrupt supply,” District Magistrate Rajeev Rautela had said.

However, Uttar Pradesh’s Medical Education Minister Ashutosh Tondon said, “no deaths were caused due to lack of oxygen supply”, according to ANI. He said seven people died on Friday, out of which three deaths were reported from the neo-natal ICU. “Two others died due to acute encephalitis syndrome and two due to non-AES today [Friday],” he said. Tondon said the district magistrate has ordered a magisterial inquiry into the incident. “The report will be out in the next 24 hours,” he said.</s>Parents of at least 35 children who have died in a hospital in northern India over the past three days have alleged the fatalities were due to a lack of oxygen supply in the children’s ward.

They said the oxygen supply to the ward ran out on Thursday night and relatives were given self-inflating bags to help the children breathe.

“That’s the time when the death of the children peaked,” said Mritunjaya Singh, whose seven-month old son was admitted to the hospital and was not among the dead.

The Uttar Pradesh government has ordered an investigation.

District Magistrate Rajiv Rautela said on Saturday the deaths of the children being treated for different ailments at the Baba Raghav Das Medical College Hospital in Gorakhpur city in Uttar Pradesh state were due to natural causes.

He denied that the lack of oxygen led to their deaths.

Prashant Trivedi, the state’s top health official, admitted there was a problem in the pipeline supplying oxygen.

“But the situation was managed through oxygen cylinders. The hospital administration has enough supply of cylinders in its stock. So the report about death of children because of oxygen issue is false,” Mr Trivedi said.

The parents said the company that supplies oxygen to the hospital had earlier threatened to stop oxygen distribution unless the government paid their long overdue bills.

Rautela said that the hospital owed 6.8 million rupees (£81,900) to the company, but added that it had adequate numbers of oxygen cylinders.

The hospital, which has become a major centre for children with encephalitis, has treated nearly 370 cases in the last two months. Of these, 129 children had died, said Satish Chandra, a hospital spokesman.

Gorakhpur is located 185 miles south-east of the state capital, Lucknow.</s>Local reports citing unnamed sources say supply of oxygen at Baba Raghav Das Medical College in Gorakhpur was cut off.

At least 30 children have died in 48 hours at a hospital in eastern India with local media reporting the deaths occurred when a company supplying oxygen cut off supply after a payment dispute.

Officials denied a lack of oxygen was to blame for the deaths. District Magistrate Rajiv Rautela said on Saturday the deaths of the children being treated for different ailments were caused by natural causes.

The state-run Baba Raghav Das Medical College (BRD) in Gorakhpur ran out of oxygen at 1am local time on Friday, forcing medics to use manual ventilators on patients, the Hindustan Times reported.

The newspaper said doctors made frantic calls to the supplier, Pushpa Sales, in order to restore the oxygen supply as the children started dying.

BRD, which is in the state of Uttar Pradesh, had run up debts of $6.9m Indian rupees ($107,000), a sales representative at the company responsible for suppying the oxygen said.

Siddharth Nath Singh, the states's health minister, said "those behind any kind of laxity will not be spared" but denied the children had died after being deprived of oxygen, according to the Times of India.

He warned political opponents "this is not the time to play politics".

Parents said oxygen supply ran out Thursday night and patients' families were given self-inflating bags to help the children breathe.

"That's the time when the death of the children peaked," said Mritunjaya Singh, whose seven-month-old son was admitted to the hospital and was not among the dead.

Prashant Trivedi, the state's top health official, admitted there was a problem in the pipeline supplying oxygen.

"But the situation was managed through oxygen cylinders. The hospital administration has enough supply of cylinders in its stock. So the report about death of children because of oxygen issue is false," Trivedi said.

The deaths and alleged circumstances surrounding the events in Gorakhpur led to an outpouring of grief and anger on Indian social media.

On his Twitter account, cricketer Indian Mohammad Kaif wrote: "Tragic to hear loss of lives of innocent children in Gorakhpur. This is unacceptable. Incompetence [is] the main reason for such tragedies."

Another Twitter user named Nupur wrote: "No excuse for what's happened in Gorakhpur. Heads must roll. Responsibility assigned. Arrests done. INEXCUSABLE."

On the Indian news station Times Now, coverage of the deaths included a ticker flashing across the screen asking "who will answer for the deaths?".</s>Nearly 60 children have died in the past five days in Gorakhpur's Baba Raghav Das Medical College hospital, forcing Uttar Pradesh government to launch a magisterial enquiry into the incident. Media reports suggest the reason for the deaths is shortage of oxygen supply, which was cut off by the provider due to non-payment of money to the tune of Rs 66 lakh.

Nearly, thirty children lost their lives in the past 48 hours reportedly due to infections and disruption of oxygen supply in the paediatrics ward in the hospital, although the district administration have rejected that latter as a reason for deaths.

Two days ago, Chief Minister Yogi Adityanath visited the paediatric ward of the hospital and also inaugurated the ICU, Critical Care Unit and visited the ward where children infected with Japanese encephalitis virus were being treated.

Yogi Adityanath had said that a meeting was held with the principle secretaries of health and medical education regarding this disease.

A report on Friday from the BRD Medical College gave a break-up of the 60 deaths since August 7 under categories listed as NICU (neonatal intensive care unit ), AES, non-AES:

Gorakhpur's district magistrate Rajeev Rautela said that no deaths have taken place in the medical college due to lack of oxygen supply. The seven deaths that reportedly took place on Saturday, August 12, were due to various other medical reasons.

In response to the accusation made about dues to be paid to the company supplying oxygen cylinders, he said that there had been an alternative arrangement of 50 oxygen cylinder that was put to use. Hence there was no oxygen shortage. He also said that more oxygen cylinders will be brought from the neighbouring district.

Meanwhile, he assured that the issue will be probed and the results will be out in the next 24 hours, based on which action will be taken accordingly.

Congress president Sonia Gandhi who expressed her grief towards the families who lost their children due to 'medical negligence', urged the UP government to take immediate action against the ones responsible.

Former UP chief minister Akhilesh Yadav blamed the state government for the deaths and demanded compensation for the kin of the children.</s>NEW DELHI — Thirty children have died at a public hospital in India over the past two days, with government critics blaming a shortage of oxygen for the surge after a supplier of liquid oxygen cut off deliveries because of unpaid bills.

Government officials were scurrying to explain what happened, admitting that the state-run hospital owed more than $50,000 to a supplier of liquid oxygen and that oxygen supplies had been “disrupted.”

“There was some payment issue to the oxygen supplier, and there was a shortage of liquid oxygen,” said Anil Kumar, the commissioner of Gorakhpur. But, he added, “those deaths were not due to lack of oxygen.”

Other officials said the hospital had a backup oxygen supply, though they did not explain why so many children had died in such a short time span. Since Monday, a total of 60 children have died at the hospital, many from acute encephalitis and others in the neonatal unit.

The hospital, Baba Raghav Das Medical College, is in Gorakhpur, a city several hundred miles east of New Delhi, India’s capital. It is the rainy season in India, a time when officials say it is not unusual for as many as 10 children to die there every day from Japanese encephalitis, a mosquito-born disease.</s>On Saturday evening, oxygen cylinders were still being dragged down the corridors of the Baba Raghav Das Medical College in Gorakhpur. The liquid oxygen supplied through pipes to the wards had run out around 7.30 pm, Thursday, August 10, after the hospital failed to pay the dues of the private company supplying the oxygen. Thirty children died in the 48 hours that followed, even as the hospital pressed oxygen cylinders into service.

The outrage over the deaths brought the state health minister and the Union health secretary rushing to Gorakhpur on Saturday. The state health minister Siddharth Nath Singh denied that the deaths had been caused by lack of oxygen supply. “Between 7.30 pm and 11.30 pm [on Thursday], the cylinders were used,” he said. However, he admitted that between 11.30 pm and 1.30 am, there were not enough cylinders in the children’s wards. “After 1.30 pm, more cylinders were brought and the oxygen supply was restored,” he said.

But parents who lost their children in the hospital told reporters that because of the shortage of oxygen supply, doctors had asked them to use manual resuscitators also called ambu-bags – bag-like devices to inflate the lungs of unconscious patients – to keep their babies oxygenated and alive. Sri Kishan Gupta who lost his four-day-old baby said: “Wo bole aap dabaate rahiye, machine hai hi nahi.” Keep pressing on the bag, they said, as there were no machines.

Chief Minister Adityanath, who has won five elections from this eastern Uttar Pradesh city since 1998, avoided comment on the deaths, but blamed the outbreak of encephalitis in Gorakhpur on the lack of cleanliness. However, a statement released by the hospital on Saturday showed only five of the 30 children who died on August 10 and August 11 were suffering from Acute Encephalitis Syndrome, which causes high fever and brain inflammation. Seventeen deaths were reported from the neonatal intensive care unit, where newborns are admitted.

Government doctors who specialise in treating children in intensive care units said that disruption of oxygen supply can prove fatal. “Oxygen is just like a medicine,” said Dr Jayshree Mondkar, head of neonatal intensive care unit, Lokmanya Tilak General Medical College in Mumbai. “If the oxygen delivery to the child is stopped, the baby will turn blue (because of lack of oxygen) in his body and may even die.” It is the same for adults if the oxygen being delivered to them is stopped – the outcome is fatal.

Managers of Pushpa Sales, the company that was contracted to supply oxygen to the medical college and hospital, had written to the principal Rajiv Mishra on August 1, asking for unpaid dues amounting to Rs 65 lakh. The oxygen supply operators at the hospital wrote to Mishra, the chief medical superintendent and the nodal officer of the National Health Mission on August 3 and August 10, alerting them to the fact that the company might cut oxygen supply to the hospital if dues were not paid.

Deflecting blame for the failure, on Saturday, Ashutosh Tandon, the state minister of medical education, said Uttar Pradesh government had released the funds on August 5, reported The Indian Express. Tandon claimed Mishra confirmed the funds had been deposited in his account by August 7. Scroll.in could not speak to Mishra to confirm the minister’s claims.

On August 9, a day before the oxygen supply was disrupted, Chief Minister Adityanath had visited the hospital. After inaugurating a 10-bed Intensive Care Unit and a six-bed Critical Care Unit, he had visited a ward meant for children with Acute Encephalitis Syndrome. On Saturday evening, however, the state health minister Siddharth Nath Singh said no one had brought the problem of dipping oxygen supply to the chief minister’s notice.

Despite all the attention to the incident, more than 72 hours later, the piped oxygen supply to the hospital was yet to be restored. At the time of writing this report on Saturday night, the hospital was still ordering oxygen cylinders from private companies.

When the liquid oxygen supply failed on Thursday, the hospital had 52 oxygen cylinders in reserve, a statement released by the hospital said, while more than 80 cylinders were ordered from other companies on Friday. A day later, the hospital appeared to have stepped up orders. Amit Modi of Modi Chemicals Private Limited said his company had received an order and had delivered 300 cylinders of about 46 litres each to the hospital. Modi said that his company will be able to supply these cylinders only for a few days, not on a long-term basis. “Only liquid oxygen will be able to fulfil the requirement of the hospital,” he said.

A doctor at the hospital, who did not want to be identified, said there was never any worry about oxygen supply while liquid oxygen was being piped in. He added that one of the causes of the large number of deaths was congestion at the hospital that was causing cross-infections. In the neonatal ward, one bed was being used for three to four babies.

There are three ways in which hospitals can connect patients to an oxygen source.
• Liquid oxygen: A big tank is filled with liquid oxygen on a periodic basis. From here, the oxygen is supplied in pipes to the wards. This is also called piped oxygen.
• Centralised oxygen: In a room, several big oxygen cylinders are kept from where the pipes or tubes are connected to the wards where patients are admitted. If the hospital’s piped oxygen gets over, it could make arrangements for these cylinders.
• Portable cylinders: These are small cylinders, which can be carried around. If there is a problem with the main liquid oxygen supply, these portable cylinders can be attached next to the bed of the patient and oxygen supply can be restored.

Public hospitals have designated officers to maintain the smooth functioning of liquid oxygen systems. The piped oxygen systems are equipped with dials which indicates the amount of oxygen left. When the indicator crosses a particular mark, the officers are supposed to call the suppliers and ask for the tank to be refilled. Even oxygen cylinders have an inbuilt dial that shows when the level of oxygen gets reduced and needs to be refilled.

Authorities who are responsible for managing an uninterrupted supply of oxygen to the hospital wards in Maharashtra expressed surprise at the reports of the Gorakhpur hospital running out of liquid oxygen supply.

“There are several checks in place to ensure that the liquid oxygen in the plant never runs out,” said Dr Pallavi Sapale, dean of Government Medical College in Miraj in Maharashtra who, in her capacity as the the dean, is closely involved in the process of maintaining the oxygen plant. “We have an officer who takes the reading of the plant twice every day to check the quantity available,” she said. “Once it crosses the mid-level mark, we inform the supplier to send us the oxygen and it is replenished.”

Sapale recalled an incident where the supplier was not in a position to supply liquid oxygen and another supplier was contacted immediately. “Another thing we do is use jumbo cylinders, which are as safe as liquid oxygen and can be used to deliver oxygen to patient,” she said.

Apart from these large oxygen cylinders, there are small portable oxygen cylinder which are generally used when transporting patients in ambulance or within the hospital on a stretcher. “The effect of oxygen delivered by the cylinder compared to the liquid oxygen plant is the same,” explained Mondkar. “You have to monitor the cylinders and immediately change to another cylinder, when the oxygen in the cylinder attached to the patient is about to finish.”

Sapale said the saturation levels of the patients will be affected if the oxygen delivery is disrupted. “There are so many alarms to know that the oxygen is getting over,” she said. “First, there is meter – like you have on motorcycles – which shows the level of oxygen in the cylinders,” she said. “Also, if the oxygen supply to the patient is lowered, his saturation levels will be affected and the doctor or nurse can immediately check.”</s>New Delhi: In a major development, raids were conducted at the Lucknow-based firm, which used to supply oxygen cylinders to Gorakhpur's Baba Raghav Das Medical College Hospital, where 63 children lost their lives due to encephalitis, claims report of a leading news channel.

The hospital in its report stated that nearly 300 extra oxygen cylinders were provided late on Friday evening because of the pending previous bills. It also informed that even after several requests, the distributor of the liquid oxygen in the hospital stopped the supply due to the over pending payment.

However, authorities at the gas agency dismissed hospital report saying,"Deaths are not due to oxygen supply cut-off, no one can stop supply like this, we know consequences."

Meanwhile, Uttar Pradesh Health Minister Siddharth Nath Singh has assured quick action against those involved in the alleged disruption in the supply of liquid oxygen.

"People responsible for this will not be spared. Quick action will be taken against the ones responsible for this, as it is a very serious issue," Siddharth Nath said after meeting Chief Minister Yogi Adityanath.

State Minister for Medical Education Ashutosh Tandon reiterated the same and said action will be taken after detailed probe on the matter.

"The Chief Minister has given us proper instruction on this issue. We will leave for Gorakhpur soon and after details analysis of the situation will take further decision on the same," Tandon said.

Earlier in the day, the alleged disruption in the supply of liquid oxygen at the hospital claimed lives of three more children.

The shortage of oxygen allegedly led to encephalitis, which is a sudden onset inflammation of the brain, following which the children died.

The families of the children have claimed that the doctors were not treating them well and the hospital was not even providing the medicines which were required for the treatment.

As per the locals, though the hospital is supposed to provide free medical assistance, neither there is proper medical facility available nor are the patients provided free medicines.

Gorakhpur DM Rajeev Rautela said that the cause of the deaths at the BRD Hospital was the disruption in the supply of liquid oxygen and has further appealed to the suppliers to not cut the supply henceforth.

Following this report, the Uttar Pradesh Government jumped in defence of the medical college, while also assuring that the District Magistrate has ordered a magisterial inquiry into the incident and the report will be out in 24 hours.

"There haven't been any deaths due to lack of oxygen supply. And 'only' seven children have died today. Today three deaths happened in Neonatal ICU, two due to Acute Encephalitis Syndrome (AES) and two due to Non-AES," UP Medical Education Minister Ashutosh Tandon said.

He further said that the arrangement of oxygen cylinders was duly made and a strict action will be taken against those responsible for the mishap.

Meanwhile, according to data procured from the BRD hospital, in past five days - from August 7 to August 11, a total of 60 deaths have occurred in the hospital.
Over the past two days, 30 children from Baba Raghav Das Medical College have died, allegedly due to lack of oxygen supply to the wards.