KUALA LUMPUR, August 26 — Last July 27, an ambulance from Slim River Hospital was carrying a patient to Raja Permaisuri Bainun Hospital in Ipoh, Perak, when a tyre burst. But luckily, the tyre tread didn’t come off and the vehicle didn’t crash.
One week later on August 4, at about 6.40am, the right rear tyre of another ambulance (registration number W4802M) burst on the way back to Slim River Hospital after taking a 66-year-old patient, Azizah Dolah, to Ipoh for a CT scan.
But this time, according to early police investigations, the burst tyre caused the vehicle to skid, crash into a road divider, and overturn, killing Azizah and the 37-year-old driver, Mohd Hafidz Mohd Bahari. Hafidz died on the spot from head injuries, while the patient died because her oxygen equipment came off. Hafidz left behind an unemployed wife, and three children aged 11, eight, and two.
Images on Facebook of the ambulance’s burst tyre showed what people claimed appeared to be a retreaded tyre, with a torn up tread lying on the ground nearby. A doctor, a nurse, and a senior health care assistant (PPK) survived the crash. Police have classified the case under Section 41(1) of the Road Transport Act 1987 for causing death by reckless or dangerous driving.
Before the deadly August 4 accident and the July 27 burst tyre incident, the tyre of another Slim River Hospital ambulance similarly exploded on December 21, 2018, on its way to Raja Permaisuri Bainun Hospital while carrying a patient. But the tyre tread didn’t come off and the vehicle could be controlled.
Ambulances from the Ministry of Health (MOH) hospital in Slim River send patients to and fro the nearest public facility in Ipoh every day on a 105-km route because Slim River Hospital lacks a CT scanner.
Speaking to CodeBlue, a source from Slim River Hospital alleged that the W4802M ambulance from the August 4 accident previously suffered a burst tyre on an unspecified date without getting into a crash, but another source disputed this had happened.
Eight sources working in Slim River Hospital, who spoke to CodeBlue on condition of anonymity for fear of losing their jobs, claimed that the government hospital ambulances’ tyres exploded between one and three times this year before the deadly crash, as well as three times in 2018, none of which resulted in accidents.
Four sources also related how UEM Edgenta, a government-linked company (GLC) in charge of the hospital ambulances’ maintenance, replaced the tyres of Slim River Hospital’s entire ambulance fleet of the remaining seven vehicles, a lorry, and three hearse vans last August 7, three days after the fatal accident.
Seatbelts, a source said, were also placed on stretchers in some of the ambulances that did not have those. Another source claimed that seatbelts in the stretchers of some ambulances were previously missing buckles.
A new spare tyre was even placed in the lorry, even though the vehicle is purportedly only used about once a month at most. The new tyres (Continental for the ambulances and vans; Silverstone for the lorry) were, according to a source, taken from nearby car workshops in Slim River, including at one called Pertamina Auto Servis Bengkel C.W Sdn Bhd. The ambulances previously used Toyo and GT Radial tyres.
I’m Scared Of Taking The Ambulance
A source alleged that Ambulance W4802M from the fatal crash did not have a seatbelt on its stretcher. Another source claimed that the radio on Ambulance W4802M had been broken for a long time, despite complaints to UEM Edgenta.
Yet another source alleged that the door on the patient’s side of Ambulance W4802M in the deadly accident couldn’t be opened from the inside because its handle was busted, with staff supposedly complaining about it to UEM Edgenta for over a year.
UEM Edgenta — which is majority-owned by UEM Group Berhad, a wholly-owned subsidiary of Khazanah Nasional Berhad — provides hospital support services for Slim River Hospital, among 32 MOH hospitals in Perak, Kedah, Penang and Perlis in a 10-year concession ending 2025.
“Those ambulances are a silent killer.”A Slim River Hospital staff
“Now, all the ambulances and the lorry have changed to new tyres. Why? Why did they change to new tyres? There must be something wrong,” a source told CodeBlue.
“I’m scared already as I take the ambulance every day. When we complain about problems, sometimes the company even scolds us and says other people don’t face problems. There are many problems that they don’t address.”
He claimed that UEM Edgenta inspectors did not conduct proper maintenance checks on Slim River Hospital ambulances and there was no proper oversight of their work, saying: “They just simply look, touch, ‘okay, looks fine’, write in the book that it’s good. No one supervises them. Even those who supervise them are their friends, can settle.”
Problems With Ambulance Maintenance?
Another source urged authorities to investigate the Slim River Hospital ambulance crash, alleging that “something appears to be wrong with the maintenance”.
“That’s what we’re angry about. When there’s an accident, then they frenziedly fix things.”
He claimed that “we already told Edgenta services that there are no seatbelts; they just ignored us, they think that sort of thing is not important.”
Another source said UEM Edgenta inspects ambulances in Slim River Hospital every six months, checking the tyres, oil, fire extinguishers, and all the equipment in the vehicles.
But he alleged that UEM Edgenta did not do proper checks, accusing the GLC of “simply changing sticker labels” on expired equipment like fire extinguishers during its biannual inspections.
He also claimed that the hospital support services provider replaced broken ambulance lights with a different type from one that is meant to be used, despite complaints from workers to their supervisor.
“Sometimes, even when the window cracks and we complain, they say the hospital has to come up with the money. ‘No need lah’.”A Slim River Hospital staff
The source also complained that in Slim River Hospital, medical assistants are given full control of the ambulances, rather than the drivers, even though the former don’t ride the ambulance. Medical assistants in other government hospitals, he said, simply looked after the medical equipment in the ambulance, while drivers were the ones in charge of the vehicle maintenance.
“If you survey Sungai Buloh, Selayang, or Ipoh [Hospital], if the ambulance is damaged, it’s 100 per cent the driver who manages it. If the workshop sends it back and the driver is dissatisfied, the driver will reject it, you know, at least in other places. But here, even if we’re dissatisfied, we’re forced to accept it,” the source said.
“These medical assistants — you don’t take the ambulance, you don’t know the condition of the ambulance, whether it can travel far or not, but they’re the ones making the decisions. Management here is different.”
Hafidz Was A Careful Driver
The ambulance taken by the late Hafidz, said another source, was an Iveco model that was taller than the Toyota ambulances, with a high roof that allowed one to stand in the vehicle.
“That ambulance was much higher than normal ambulances; it’s really easy to overturn,” said the source.
The source also alleged that when a nurse went to the Muallim district police headquarters in Slim River to lodge a report about the August 4 crash, police reportedly told the staff that there was no need to file a complaint because the driver would be blamed.
“Based on their experiences, that’s what the police said. I found it weird,” he said.
“Why is it that they’re blaming the driver even though investigations haven’t completed yet? So, we got fed up and mad; it’s as if management wants to blame the deceased.”A Slim River Hospital staff
Another source said Hafidz was a careful driver, saying that he has never seen the latter speed, or fall asleep or nod off in the ambulance. Whenever they drove to Ipoh, Hafidz sometimes napped for one to two hours upon arrival while waiting for their patient for five to six hours. And on their way back to Slim River, if he felt sleepy, he would doze for 45 minutes at a rest and service area (R&R) with the doctor’s permission.
“He didn’t like speeding. Even during emergencies, he was steady. He wasn’t fast, he wasn’t slow; he was just fine. He used to ask the doctor, ‘Boss, is the patient okay?’. Okay, maintain. He never wanted to rush. He always prioritised safety.”
The source claimed that Hafidz told him before the crash that there was something wrong with the ambulance tyres.
“He had an instinct and a feeling that something was wrong. So I said, ‘you’d better check,” said the source. “Then I heard about the accident.”
Puspakom Report May Take A Month
Muallim district police chief Supt Wan Kamarul Azran Wan Yusof told CodeBlue that Puspakom inspected Ambulance W4802M on August 21, but it would take up to a month for the national vehicle inspection company to issue a report about the accident.
“Sometimes it’s fast, sometimes it’s slow, it depends on their management,” Wan Kamarul said.
“Police can’t verify if it’s a retreaded tyre or not; we’re not the experts,” he added, referring to “speculation” on the internet about the ambulance’s so-called retreaded tyre.
When asked about allegations that Muallim police had told a Slim River Hospital staff there was no need to file a complaint about the crash, Wan Kamarul said he was unaware about that.
“Anyone can file a report,” he said. “Police can’t stop the public from filing a report.”
A Puspakom official confirmed that inspectors from the vehicle inspection company have examined the ambulance on-site at the Slim River police station, but declined to comment on the inspection, saying it was up to the police to issue a statement.
MOH officials met last August 6 to audit the accident, where they visited the ambulance in the Slim River police station and the crash site. The meeting was chaired by Dr Teo Aik Howe, an emergency specialist from Penang General Hospital, and included Malaysian Institute of Road Safety Research (MIROS) director-general Dr Siti Zaharah Ishak, occupational safety and health officials, emergency specialist Dr Sarah Syeikh Abdul Karim from Sungai Buloh Hospital, Perak state health department deputy director (Medical) Dr Norisah Mahat Nor, as well as MOH officials from the engineering, medical practice, disease control, and medical development divisions.
Two sources told CodeBlue that MOH’s internal audit has yet to make a conclusion, with one saying that officials couldn’t conclude that a burst tyre had caused the crash. MOH has yet to publicly release the results of its internal investigation.
UEM Edgenta’s 10-Year Concession With MOH
Under UEM Edgenta’s 10-year health care support services concession with MOH hospitals in the northern region that was signed in 2015, the GLC provides services like health care waste management, cleansing, linen and laundry, facilities engineering maintenance, biomedical engineering maintenance and facilities management services.
According to UEM Edgenta’s 2018 annual report, revenue for its health care support division increased to RM984.6 million in the 2018 financial year from RM904.2 million in 2017. Profit after tax rose to RM86.5 million last year from RM80.7 million in 2017.
The health care support division contributed 45 per cent of UEM Edgenta’s full-year revenue in 2018 of RM2.18 billion from continuing operations, with revenue growing by 3.3 per cent from 2017.
“Contribution from the concession business, operated through Edgenta Mediserve Sdn Bhd (‘Edgenta Mediserve’), continues to remain stable on a year-on-year basis as profitability increased with the new variation orders secured from Ministry of Health, Malaysia,” said the report.
Edgenta Mediserve even received a four-star award for “excellent hospital support services” from MOH.
When asked to explain why UEM Edgenta changed the tyres of Slim River Hospital’s entire ambulance fleet after the accident, or why tyres were not replaced after earlier incidents of burst tyres, the company declined comment, with a spokesman telling CodeBlue last Friday that UEM Edgenta wanted to wait for MOH’s response first because the company was a service provider to the ministry.
MOH: No Ambulance Tyres Changed After Crash
When asked why didn’t Slim River Hospital or UEM Edgenta replace the tyres of the ambulances after at least two occasions of burst tyres — last July 27 and December 21 — MOH’s engineering division said tyres are changed based on mileage, three years from the manufacture date, and the tyre’s physical condition.
“The tyres of Slim River Hospital ambulances were not changed before the day of the accident because they still fulfilled the above criteria,” MOH’s engineering division told CodeBlue in a statement late last night.
MOH also confirmed there was no record of a change of tyres for any Slim River Hospital vehicle last August 7.
“However, on August 8 2019, UEM Edgenta replaced five tyres for a lorry (WHY2193) and five more tyres for a passenger van (AFD9756). These replacements were made because those tyres were nearing the expiry date that was set by MOH, which is three years from the manufacture date,” said MOH.
This was despite four sources claiming that Slim River Hospital’s entire ambulance fleet received new tyres after the fatal accident.
MOH’s engineering division also said all stretchers in MOH ambulances are furnished with straps that are examined and verified by the user and concessionnaire before they are given to the hospital.
“In reference to the Hospital Support Services (PSH) contract between the government and the concessionnaire, the company is required to ensure that all parts procured from the supplier and manufacturer are sufficient, new and original,” said MOH.
“Throughout the duration of the PSH contract, the issue of supplying retreaded tyres has never been raised because requirements of tyres are monitored periodically according to specification.
“The cause of the accident is still being probed by the Independent Investigation Committee. A thorough investigation will be conducted, without simply focusing on the vehicle’s tyres.”
MOH’s engineering division also said it was the responsibility of the driver and officers in a vehicle to ensure that each department vehicle is in good and safe condition.
“According to the PSH contract, the concessionaire is responsible for conducting maintenance works periodically (monthly or yearly), or to check every 5,000km or three months once (whichever is earlier), while breakdown works are as per user request.”
When asked if MOH would suspend its concession with UEM Edgenta, the ministry said this would not arise because of the August 4 accident, but action would be taken against the company based on the PSH contract if it was proven to be responsible for the crash.
“The PSH contract has terms and conditions on the termination of services, but for this case, termination is not so straightforward. If necessary, the government’s highest levels will need strong justification to stop the related PSH service.”