LAHORE – District and Sessions Court Lahore dismissed National Hospital & Medical Centre’s appeal against Punjab Healthcare Commission (PHC) ruling that found the hospital and members of its medical staff responsible for medical negligence, administrative lapses and systemic failures in treatment of a cardiac patient who died after being discharged twice from the emergency department within hours.
Punjab Healthcare Commission (PHC), and the court upheld findings of medical negligence, administrative failures and systemic deficiencies against National Hospital & Medical Centre, DHA, and members of its medical staff over the death of a patient who allegedly suffered a heart attack after being discharged twice from the hospital.
The court found that the evidence on record sufficiently established medical negligence, administrative lapses and violations of emergency care protocols, leaving no legal basis to interfere with the penalties imposed by the healthcare regulator.
According to court records, the deceased Bakhtiar Ahmad Maila arrived at National Hospital’s Cardiac Emergency at around 11:15 pm on March 28, 2024, complaining of severe chest tightness, shortness of breath, headache and swelling below his ear. His family informed doctors that he had a documented history of heart disease and had previously undergone stent placement.
Despite the patient’s cardiac history, the family alleged that the attending physician, Dr. Somia, called his symptoms to a gastric problem, administered injections including Risek and Onset, and assured them that the ECG findings were consistent with his previous stents rather than an ongoing cardiac event.
A blood sample for troponin test, which is routine blood work in heart attack, was taken at around 11:40 p.m., but according to the complaint, no cardiologist was consulted and no further cardiac evaluation was initiated.
The family maintained that although the patient repeatedly expressed concern that his symptoms are akin to a heart attack, they were told the pain was gastrointestinal, possibly caused by food consumed at Iftar.
The patient’s condition deteriorated after returning home. At around 2:30 a.m., he developed worsening jaw pain, chest discomfort and shortness of breath and was brought back to National Hospital, this time through the general emergency department because the chest emergency physician was unavailable.
The family alleged that Dr. Umaima Fatima reviewed the earlier troponin result, which was reported as normal, and ruled out a cardiac condition without repeating diagnostic investigations. Instead, the patient was diagnosed with an ear, nose and throat (ENT) problem, administered pain medication including Toradol and later Tonoflex, and discharged again at approximately in wee hours.
The complaint said that despite repeated requests by the family, no on-call cardiologist was summoned, no specialist consultation was arranged and no repeat ECG or troponin testing was performed. Only minutes after reaching home, Bakhtiar Ahmad Maila collapsed, and was rushed back to the hospital but arrived unresponsive. According to the record, no vital signs could be detected and he was declared dead.
The family then approached PHC that a cardiologist familiar with the case reviewed the sequence of events and concluded that the patient’s symptoms, including chest pain, jaw pain and a history of coronary stenting, were highly suggestive of acute coronary syndrome.
According to the complaint, the cardiologist said that internationally accepted emergency protocols require serial ECGs and serial cardiac enzyme testing before excluding a heart attack in high-risk patients. He maintained that diagnosing a gastric disorder after only a single ECG and one troponin test was premature and that the patient should have remained under observation with specialist review.
After a detailed inquiry, Punjab Healthcare Commission’s Board of Commissioners issued its decision on July 4, 2025, holding that allegations of medical negligence and administrative mismanagement against National Hospital had been substantiated.
The Commission imposed a Rs200,000 penalty on National Hospital, citing multiple violations, including failure to comply with standard operating procedures for cardiac emergencies, failure to maintain complete medical records during the patient’s first emergency visit.
It also mentioned lack of communication with the patient’s family, failure to consult the on-call cardiologist despite repeated presentations with cardiac symptoms.
PHC also slammed Rs200,000 fine on Dr. Umaima Fatima, concluding that she failed to conduct essential clinical assessments despite the patient’s deteriorating condition, did not arrange cardiology consultation, failed to repeat ECG and troponin testing, and incorrectly ruled out a cardiac condition before discharging the patient.
Dr. Somia received a formal warning over inadequate medical documentation and poor communication with the patient’s family during the patient’s initial visit.
National Hospital & Medical Centre, through its Chief Operating Officer Dr. Jehanzeb Khan Aurakzai, challenged the PHC decision before the District and Sessions Court Lahore under Section 31 of the Punjab Healthcare Commission Act, 2010.
In its appeal, the hospital argued that it had maintained a reputable standing in healthcare services and challenged the Commission’s findings and penalties.
The court found that despite patient’s multiple visit to hospital within a few hours, he was managed each time by junior doctors rather than a cardiology specialist.
Meanwhile, Bakhtiar Ahmad’s family said the penalties imposed by the PHC were grossly inadequate considering that a patient had lost his life after allegedly being denied appropriate emergency cardiac care.
The family called for cancellation of National Hospital’s operating licence, legal proceedings against the hospital’s Chief Executive Officer (CEO) and Chief Operating Officer (COO), revocation of the medical licences of the two treating doctors and substantially higher financial penalties against the institution.
They have also requested that the hospital be directed to pay compensation equivalent to 2.5 percent of its total revenue from the previous financial year.
According to the family, any compensation awarded would not be retained for personal benefit but would instead be donated to credible organisations working to strengthen emergency medical services and improve the training of competent, ethical and accountable doctors in Pakistan.
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