Investigation into Fatal Fire in Lovech Psychiatric Hospital Highlights Issues in Patient Treatment and Safety Measures

On the day of the accident, Georgi was nervous, pushed the doctor on duty and she ordered isolation
The fire on the fatal day activated an alarm that only the patients heard, but not the staff

The young man who died in a fire in the isolation ward of the Lovech psychiatric hospital was sentenced to lie in the isolation ward for 9 hours, 6 of them tied up.

According to the ombudsman, Diana Kovacheva, this measure is torture. She insists on special supervision of the investigation by the prosecutor’s office. And also to monitor all coercive measures in psychiatry, to change the regulation on isolation.

Georgi, 25 years old, who died in a fire in the isolator, entered for treatment voluntarily, 24 days before the accident. Until the day of the fire, the boy was calm, there was no evidence of aggression, all the patients liked him because he treated them to coffee and cigarettes. And according to the Ombudsman’s team, there are no therapeutic indications that would require the isolation and tying up of Georgi.

On the day of the accident, he was still nervous. He found out that his mother came to visit, but they didn’t let her in because he was aggressive. According to her information, Tovava pushed the doctor on duty and she ordered an isolator, in this case equipped as a soft room.

“There are measures that are applied that in practice can be accepted as torture, it is about the fixation and mobilization of patients, as the regulation itself allows for multiple fixations in practice due to its unclear regulation,” said Diana Kovacheva to BNT.

A soft room generally allows acute patients to be isolated as part of therapy without risk of injury and without having to be restrained. However, it is a controversial practice as it can deepen the patients’ crisis due to painful and humiliating experiences. That is why there are supposed to be strict rules and a ban on using them as punishment. But not in the case of Georgi. who had been isolated and tied up for hours on the day of his death.

“Unfortunately, the problem is systemic, funding is scarce, including in terms of food and medicine for these people, which means that not only are they sometimes tortured because of the measures that fix them, but they are also malnourished and undertreated,” the ombudsman specified .

The fire on the fatal day had activated an alarm that only the patients heard, but not the staff. In the public order for the equipment of the 5 soft rooms in the hospital, the inspectors also found other misunderstandings – surveillance cameras that do not record and do not reproduce sound. Therefore, in addition to in-hospital control, the ombudsman advocates special supervision of the prosecutor’s office in psychiatry

“More specifically, supervision of the measures that are applied, because these are coercive and punitive measures, and psychiatric hospitals themselves are places of detention. To monitor this case closely. Moreover, it shows a systemic problem, and I think that the prosecutor’s office should really exercise this control for legality, because it has such powers,” Kovacheva added.

The Ministry of Health has already disciplined the director of the hospital and ordered a fire safety inspection of the hospital. A review of medical practices is still pending. The minister, himself a psychiatrist, agrees to change the isolation rules, but as a matter of urgency, says he sees no moves to change the system.

“We cannot do much, because the people who are housed in these hospitals must be housed somewhere,” said Prof. Dr. Hristo Hinkov – Minister of Health.

And according to the minister, control in psychiatry is extremely low. But he does not think that the inclusion of civil supervision in the implementation of the restrictive measures, – according to the recommendations of the ombudsman, is a working mechanism.

“Look, the control must be carried out in one place by the ministry and by the authorities and by the regional health inspectorates. The authorities charged with this task, the non-governmental organizations, could not carry out such effective control, because these are closed departments with a special regime. Psychiatric care in the country is in a dire state and this is being reported. I myself feel a certain guilt for the fact that I am already starting the fifth month of this post as a minister and these issues still cannot be resolved,” commented Prof. Dr. Hristo Hinkov.

However, the Minister of Health believes that he will be able to make more money for psychiatry in the new budget. There is also the ambition to introduce two clinical pathways in the new framework contract, which should strengthen control and quality of services.

2023-10-19 18:15:00


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