Rajasthan Maternal Deaths: State mandates strict SOP compliance in Medical College Hospitals

Jaipur: In a move to strengthen patient safety and prevent maternal and post-surgical complications, the Rajasthan Medical Education Department has directed all medical colleges and attached hospitals to ensure “airtight execution” of standard operating procedures (SOPs) across critical care areas and surgical units.

The directive follows the deaths of seven women after childbirth in Kota and Bikaner, as well as complications reported in eight post-delivery cases in Jodhpur. An investigation by AIIMS Delhi into these incidents highlighted gaps in the implementation of SOPs in labour rooms, operation theatres, and other critical care units.

Also Read:8 Women Suffer C-Section Complications at Jodhpur Hospital, 25 medicines suspended

Medical Dialogues had previously reported that in a fresh case of health complications following Caesarean deliveries in Rajasthan, the health of eight women deteriorated at Paota District Hospital in Jodhpur, prompting a high-level inquiry and raising concerns over healthcare standards. 

Acting on AIIMS recommendations, the state has instructed institutions to strengthen infection control measures, improve operation theatre management, upgrade critical care systems, and ensure uniform clinical practices. Hospitals have been directed to adopt protocols issued by the National Medical Commission, Indian Council of Medical Research, and the Union Health Ministry. 

Speaking to TOI, a senior medical education department official said, “The order states that departments of medical colleges must prepare SOPs using national protocols (NMC, ICMR and Union health ministry), circulate them among faculty, staff and resident doctors, and conduct training sessions to ensure adherence.”

The order has been circulated to principals and controllers of medical colleges, hospital superintendents, and principal medical officers of district hospitals, making them directly responsible for implementation and compliance reporting.

Department heads have also been directed to display SOPs prominently across hospitals and ensure that all clinical functions strictly adhere to the prescribed procedures.

“The SOPs will be displayed at all relevant places in the department sessions for strict adherence, and their functioning will be as per the issued SOPs. Principals, controllers, hospital superintendents and PMOs will strictly ensure compliance,” the official said, reports TOI.

Hospitals have been asked to establish and enforce strict preoperative and postoperative protocols for common procedures, with copies of these guidelines to be submitted to medical superintendents and college principals.

In a separate infection-control measure, the directive bars doctors, nurses and paramedical staff from travelling in OT or ICU scrubs from home to hospitals. Staff must arrive in regular clothing and change into designated uniforms within hospital premises before entering critical care areas. Movement outside OT and ICU zones in scrubs has also been restricted.

Patients are also required to be transferred to operation theatres only in clean hospital-issued gowns, with strict instructions against shifting them in street or ward clothes. Hospitals have been asked to stagger patient transfers to avoid crowding near OT gates, with transfers ideally occurring no more than 15 minutes before scheduled surgeries.

The order further mandates continuous monitoring in intensive care units, ensuring that no ICU remains without a designated doctor. Hourly bedside charts must record vital parameters, fluid balance, ventilator settings, and high-risk medication usage, with immediate escalation to senior consultants in case of deterioration.

Also Read:Woman dies, 5 critical after C-sections at Kota Hospital; high-level probe ordered