A five-member panel probing the case of deaths of children at a civic hospital has found that there was an "alarming situation" of non-availability of anti-diphtheria serum (ADS) between last December and September 22, and most of the patients were "not vaccinated" against the infectious disease.

The committee, which also had as members doctors from the Delhi government's Maulana Azad Medical College and the Centre's RML Hospital, also observed in its report that most of these patients died due to "heart complications and airway obstruction".

North Delhi Mayor Adesh Gupta had set up the panel in the last week of September and it submitted its report on September 26, which was tabled in the House Wednesday. Few more diphtheria-related deaths have been recorded at the facility after the submission of the report. 

He had last week also suspended medical superintendent of the Maharishi Valmiki Infectious Diseases Hospital Sushil Kumar Gupta for alleged lapses in connection with the deaths of these children at the facility. As many as 30 deaths due to diphtheria have taken place in September at the Maharishi Valmiki Infectious Diseases Hospital at Kingsway Camp, which is the highest for this month since 2015. The number of patients admitted in September this year stands at 223, also the highest since 2015.

The NDMC-run hospital, said to be the largest such facility in Asia, procures ADS from Central Research Institute (CRI), Kasauli. "During the period of December 2, 2017 and September 22, 2018, there was not a single dose of ADS in the hospital," according to the report.

The report also said that medical superintendent Gupta took a "considerable time" to issue the letter to the higher authorities (DGHS) and also allegedly "failed" to timely communicate the factual position of the non-availability of the ADS to NDMC commissioner.

The documents on records show that the MS of the hospital invited quotations from eight private firms for procurement of ADS, it said. "Had the MS reported in time the alarming situation of non-availability of ADS to his higher authority more attempts could have been initiated at the higher levels also to procure it from private firms," the report said.

The panel members visited the hospital on September 25 and 26 and conducted inspection of all relevant facilities and reviewed the records and documents. "On inspection of the diphtheria wards, it was note that wards were poorly-lit, proper isolation facilities were not available, intravenous infusion pumps and continuous cardiac-respiratory monitoring facilities were not available and there was no intensive care or high-dependency facilities for sick patients," the report said. "Blood bank facilities are not available in the hospital or in the neighbouring Rajen Babu T Hospital," it added.

"Most of the children were non-vaccinated against diphtheria and were from rural areas of Uttar Pradesh and presented late to hospital and as a result developed complications leading to death," it said. The panel has recommended setting up of intensive care unit and high-dependency unit for monitoring of sick patients, and to start blood bank services and a 24-hour ambulance service.

According to information shared by the NDMC during its House proceedings Wednesday, a total of 61 deaths have taken place due to diphtheria this year. The rest of the 30 deaths had taken place this year from January till September, a senior official said.

Last year, 102 deaths had taken place due to diphtheria, 133 in 2106 and 88 in 2015, according to the information shared by the NDMC authorities. The fatalities reported in previous years for September are -- 22 (in 2015), 26 (2016) and 20 (2017). A senior NDMC official said 1,00 vials of ADS were ordered from a private company on September 25, out of which 550 have been delivered till October 3. "Fifty vias are expected from CR, Kasauli by October 4," he said.