The Bombay High Court on Tuesday took serious cognizance of “defective” ventilators supplied to the Marathwada region through PM Cares funds.
The Prime Minister’s Citizen Assistance and Relief in Emergency Situations Fund (PM CARES Fund) was created on 27 March 2020, following the COVID-19 pandemic in India. The purpose of the fund, as stated by the Indian government, is for combating, and containment and relief efforts against the coronavirus outbreak and similar pandemic-like situations in the future. Although the documentation for the constitution of the fund has not been made public, the Government of India has stated that the Prime Minister of India, Narendra Modi, is the chairman of the fund and that trustees include the Defense Minister Rajnath Singh; Home Minister Amit Shah and Finance Minister Nirmala Sitharaman, in the Government of India.
Since the inception of the fund by Prime Minister Modi, there has been wide criticism of the fund, raising questions about the transparency of the fund and utilisation of the amount collected.
Moreover, the Government of India has initially claimed that the fund is a private fund, and denied that the PM CARES Fund is a public fund for the purposes of transparency laws such as the Right to Information Act 2005, even though the Fund uses government infrastructure and the national emblem of the Government of India. In December 2020, the Government of India reversed its stance and admitted that the PM CARES Fund was a public fund, but still refused to disclose information regarding it under the Right to Information Act 2005.
An RTI Response
A recent response to an RTI application filed by Commodore Lokesh K Batra reveals that the PM-CARES fund gave away Rs 2000 Crore for the procurement of ventilators to fight the Covid-19 pandemic. The RTI response gives a detailed breakup of the orders given by the centre to different companies, the amount of ventilators procured from those companies, and the amount paid to them for the procurement of these ventilators.
The response states: “The undersigned CPIO is concerned with the purchase of ventilators. The Ministry of H&FW has ordered 30000 ventilators from Bharat Electronics Limited for Rs.1513.92 crore vide Purchase Order dated 3.4.2020. In addition to this on behalf of this Ministry, HLL Lifecare Limited, the central procurement agency appointed by the Government has ordered the following ventilators in April 2020.”
The response further gives a breakup of 28,850 ventilators ordered by the procurement agency from various vendors.
The Backdrop
According to a report by Huffington Post in June 2020, two government-appointed committees flagged concerns about the reliability and capability of 10,000 low-cost ventilators, ordered by the Narendra Modi government as part of India’s response to the Covid-19 pandemic.
In a clinical evaluation report dated June 1, 2020, a committee of doctors said that the Modi government could buy these ventilators, made by Indian startup AgVa Healthcare, but added that AgVa’s Covid-model ventilators “should not be considered as a replacement for high-end ventilators in tertiary care ICUs”.
Another report by Huffington Post in September 2020 suggests that Andhra Pradesh Medtech Zone (AMTZ), a public sector enterprise under the government of AP, received the order for 13,500 ventilators from the government’s procurement agency HLL. However, the report says that AMTZ passed on 10,000 ventilators to be manufactured to another company called Trivitron.
Trivitron Healthcare, a 23-year old Chennai-based medical technology company, got government orders to build 7,000 “basic” and 3,000 “advanced” ventilators, paid for from the PM CARES fund. But when Trivitron got the order, neither of their basic nor advanced ventilator models existed—not even working prototypes.
A report by The Hindu from August 2020 states that Jyoti CNC Automation and Andhra Pradesh MedTech Zone (AMTZ) failed a clinical evaluation by the Health Ministry’s technical committee, and were subsequently dropped from the list of the “Make In India” vendors.
On May 15, Ahmedabad civil hospital superintendent J.V. Modi had also written to the State government’s medical services provider, saying that the Dhaman-1 ventilators manufactured by Jyoti CNC were “not able to bring desired results” according to the head of the anesthesia department. He asked the State provider to immediately acquire high-end ICU ventilators instead. The opposition Congress party in the State had called for an inquiry.
It remains a mystery why the government, despite a number of red flags, continued with these vendors, as the recent RTI response suggests.
State Governments Complain
Maharashtra Pradesh Congress Committee’s Sachin Sawant on May 14 accused the BJP-led central government of providing faulty ventilators purchased using the money from the PM CARES Fund and asked for a state-level inquiry into the matter.
His allegations came after a committee of medical experts appointed by Government Medical College Aurangabad submitted its report on the ventilators. The committee found that all the ventilators provided to the college were “useless.” The report stated how even technicians from the company that provided the ventilators were unable to fix the ventilators and the ventilators were unable to provide the tidal volume of oxygen required to keep oxygen saturation high in ICU patients, rendering them unhelpful for the purposes of an ICU ventilator.
The Rajasthan government had also raised similar concerns in April. Following complaints from multiple districts, the Rajasthan government wrote to the Centre over “faulty” ventilators received by the state under PM Cares.
Dr Lakhan Poswal, principal of Ravindra Nath Tagore Medical College, Udaipur, said, “We had received 85 ventilators under PM Cares and apart from ours, the feedback from other medical colleges is that they are not effective. Our anaesthetists and intensive care doctors of medicine (department) don’t have confidence in PM Cares ventilators at all. The ventilators run for 1-2 hours and then they stop working. So, Udaipur had received 85 ventilators, and I spoke to principals of all medical colleges and the ‘CV 200’ and ‘AgVa’ ventilators of Indian Government are not effective”
The same issue was also found in Punjab where the Vice-Chancellor of Baba Farid University of Health Sciences said of the 82 ventilators provided under PM CARES Fund, 62 were defective since its arrival. The response came from the VC after an AAP MLA tweeted pictures of unused ventilators lying abandoned in GGSMC Faridkot.
The hospital staff said the ventilators supplied to them by the Centre were not reliable since most of those only functioned for just one or two hours after installation.
Similar incidents of “defective” ventilators procured by the PM-CARES fund have been reported from different states.
PMO Orders Audit
On May 5, 2021, Prime Minister Narendra Modi ordered an “immediate” audit of installation and operation of ventilators provided by the central government, according to a statement from the Prime Minister’s Office.
This came against the backdrop of reports about ventilators supplied under Prime Minister’s Citizen Assistance and Relief in Emergency Situations (PM CARES) Fund lying unutilized in some states, even as covid-19 patients are gasping for breath due to medical oxygen shortage.
“The Prime Minister took serious note of some reports about ventilators lying unutilized in storage in some states and directed that an immediate audit of installation and operation of ventilators provided by the central government should be carried out. The Prime Minister added that refresher training for properly operating ventilators should be provided to healthcare workers if necessary,” the statement added.
The statement, however, did not mention the “faulty” ventilators many states complained about.
Bombay High Court Rebukes
On Tuesday, the Aurangabad bench of Bombay High Court took serious cognizance of “defective” ventilators supplied to the Marathwada region through PM Cares funds. The High Court directed the Central Government’s lawyer to inform about the action to be taken against the supplier and remedial steps to be taken to address the issue.
The High Court noted that out of 150 ventilators supplied through PM Cares funds in the region, except 37 ventilators which are yet to be unboxed, 113 ventilators put to use at government or private hospitals are found to be defective.
“We find the situation as regards to dysfunctional ventilators through the PM Cares fund to be quite serious…ventilators are believed to be lifesaving instruments and malfunctioning can put lives of patients in danger,” the HC said.
“The company (errant) should not get away with this. It is the state exchequer money, it’s not bounty to be distributed,” the court orally observed.
“We appreciate that the Central ministry gave them (ventilators), but it is likely to be a health risk or health hazard to the patients…Let the government realize they had supplied inferior quality ventilators, let them go back and replace them with certain good quality ventilators. If the PM cares fund is to be used for providing ventilators, it should be ventilators worthy of medical use, if they ain’t worthy of the same, it is just a box,” the High court said in strong remarks.
The ventilators discussed in this case were manufactured by Jyoti CNC automation, reported The Indian Express.
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