A hospital is one of the most infrastructure-dependent environments in any city. Patients may depend on uninterrupted electrical power. NICUs and ICUs depend on controlled temperature and ventilation. Operating theatres depend on reliable HVAC and electrical systems. Fire protection must work when everything else is going wrong.
Yet many of these systems remain largely invisible during normal hospital operations — until something fails.
The fire at the Pakistan Institute of Medical Sciences (PIMS), Islamabad, on 26 August 2026, in which at least 14 newborns died, has once again brought hospital infrastructure and emergency preparedness into sharp focus. UNICEF expressed concern following the deaths, while an interim government inquiry subsequently reported significant fire-safety and emergency-preparedness shortcomings, including the absence of a fire alarm and sprinkler system in the affected nursery.
The lesson for hospital management should not simply be about what happened at one facility. The bigger question is:
What risks already exist inside our own hospital — and would we know about them before they become an emergency?
Hospital fires are not hypothetical
The PIMS tragedy is not an isolated reminder — hospitals have faced this risk before, both close to home and around the world.
Local Incidents Pakistan
- 2026 PIMS, Islamabad — At least 14 newborns died in a nursery fire; an interim inquiry cited the absence of a fire alarm and sprinkler system in the affected area.
- 2024 Sahiwal Teaching Hospital — 11 infants died in a paediatric-ward fire reportedly linked to a short circuit in an air-conditioning system.
- 2024 Sindh Govt. Hospital, Liaquatabad — Four hospital employees died in an emergency-department fire.
- 2020 Services Hospital, Lahore — A fire in an emergency operation theatre caused one death and injuries.
- 2012 Services Hospital, Lahore — Four newborns died and 17 people suffered burn injuries in a fire.
- 2010 Mayo Hospital, Lahore — Smoke engulfed an ICU following a short circuit, affecting patients and staff.
Timeline compiled by Dawn.
International Incidents Global
- 2015 Jazan General Hospital, Saudi Arabia — At least 25 people died and 123 were injured when a fire hit the ICU and maternity areas; the Ministry of Health attributed it to an electrical short circuit in the incubator area.
- 2018 Sejong Hospital, Miryang, South Korea — At least 37 people died and more than 140 were injured; investigators examined possible wiring defects alongside rapid smoke spread and evacuation difficulties.
- 2019 Hospital Badim, Rio de Janeiro, Brazil — 11 deaths were linked to smoke inhalation and interrupted life-support equipment during the fire.
Reported by The Guardian, Yonhap News Agency, and UOL Notícias.
These incidents demonstrate an important point: hospital infrastructure failures are not hypothetical risks. The details differ from hospital to hospital, but the underlying lesson is the same — a technical problem can become a patient-safety emergency when critical systems, fire protection, evacuation, emergency procedures and human response are not sufficiently resilient.
The problem is bigger than fire
When hospitals hear "MEP safety," the discussion can easily narrow to fire protection. It shouldn't — risk exists across the entire hospital infrastructure.
Hover or tap a card below for what each area actually covers.
Electrical & Emergency Power
Reliable power for critical care.
Main distribution, emergency power, generators and UPS, critical-load segregation, protection systems, earthing and emergency changeover — because a failure here can mean an ICU ventilator or OT loses power, not just the lights.
HVAC & Ventilation
Healthy environment. Controlled. Safe.
Equipment condition, ventilation performance, filtration, air changes, plant-room condition and backup capacity — critical for pressure relationships and air quality in the OT, ICU and NICU, not just comfort.
Fire & Life Safety Systems
Early detection. Rapid protection.
Detection and alarm systems, suppression and sprinklers, fire pumps and water availability, fire-rated doors, emergency lighting, exit routes and staff preparedness.
Medical Gas Infrastructure
Safe supply. Critical support.
Oxygen, medical air and vacuum distribution, isolation valves, alarms, cylinder storage and pipeline interfaces — especially in the NICU, ICU, OT and ER.
Plumbing & Public Health
Clean water. Safe sanitation.
Potable water supply, hot and cold systems, drainage, sanitary systems, storage, pumps and backflow prevention — essential services a hospital can't safely operate without.
ELV & Building Safety Systems
Secure. Connected. Always on.
Access control, CCTV, nurse-call, structured cabling, public address, building management and fire-alarm interfaces — the network behind communication, access and response.
Compliance Review
Standards. Regulations. Peace of mind.
Checking current certification, inspection records and maintenance contracts against actual on-site conditions — because paperwork and physical safety can drift apart over time.
Risk Analysis & Recommendations
Identify. Prioritize. Mitigate.
Turning findings into what's critical, urgent, plannable and worth monitoring — a prioritised action plan, not just a list of defects.
The underlying vulnerability can exist for months or years before it surfaces. Proactive assessment doesn't aim to predict the exact accident — it identifies the conditions that increase the probability or consequences of one.
What should a hospital MEP risk assessment examine?
A hospital-wide assessment should consider both individual systems and how those systems interact. Special attention should go to areas where infrastructure failure has immediate consequences:
- NICU
- ICU
- Operating Theatres
- Emergency Department
- Cath Labs
- Dialysis Units
- Isolation Areas
- Maternity & Neonatal Areas
The BRIX Hospital MEP Assessment
Through its Integrated Infrastructure Solutions, BRIX Ventures works with specialised technical expertise to assess critical MEP infrastructure across a hospital, area by area — moving hospital management from reactive maintenance to proactive risk management.
- Electrical & emergency power
- HVAC & ventilation
- Fire & life safety systems
- Medical gas infrastructure
- Plumbing & public health
- ELV & building safety systems
- Compliance review
- Risk analysis & recommendations
From inspection to risk prioritisation
A useful assessment shouldn't simply produce a long list of defects. Hospital management needs to know what's critical (could affect patient safety or continuity of care), what's urgent (needs immediate corrective action), what can be planned (fits the maintenance or capex programme), and what should be monitored (needs periodic inspection). This turns an engineering inspection into a risk-management tool — an approach that mirrors the WHO's Hospital Safety Index, which focuses on identifying vulnerabilities and helping managers prioritise actions to strengthen safety and preparedness.
Compliance is not the same as safety
A hospital may hold certificates, inspection records and maintenance contracts — that doesn't automatically mean every critical system is operating safely today. Equipment deteriorates. Buildings change. Departments expand. Electrical loads increase. New medical equipment is installed. Walls and partitions are modified. HVAC systems are altered. Emergency routes can become obstructed. Staff and procedures change. Risk changes with the facility — so hospital safety should be treated as a continuous process rather than a one-time compliance exercise.
The cost of prevention is different from the cost of failure
A proactive MEP assessment may identify an overloaded circuit, a deteriorating cable, a defective protection device, a non-functional alarm, an inadequate emergency-power arrangement, a ventilation deficiency, an inaccessible fire-fighting system, a blocked emergency route, a medical-gas vulnerability, or an ineffective maintenance practice. These are problems that can be planned, prioritised and corrected. After an incident, the same problems become patient risk, operational disruption, asset damage, reputational damage, regulatory exposure and financial loss.
A safer hospital starts before the emergency
Hospitals exist to save lives — their infrastructure must be designed, maintained and assessed with the same seriousness. The objective of a Hospital MEP Safety, Compliance & Risk Assessment is not to create fear. It is to create visibility: to identify weaknesses that may otherwise remain hidden, understand which systems are critical, prioritise corrective action, and ultimately —
Identify the risk before it becomes an incident.
Frequently asked questions
What is a Hospital MEP Safety, Compliance & Risk Assessment?
It is a structured technical review of a hospital's mechanical, electrical and plumbing (MEP) infrastructure — including electrical power, HVAC, fire and life safety, medical gas, plumbing, and ELV/building systems — carried out to identify safety gaps, compliance concerns and failure risks before they affect patient care.
Why do hospitals need an MEP risk assessment before an incident happens?
Hospital infrastructure failures rarely start as sudden events. Aging equipment, inadequate maintenance and unnoticed deterioration typically build up over months or years before they surface as an electrical fault, HVAC failure or fire. A proactive assessment identifies these warning signs while they can still be planned and corrected, rather than after they become a patient-safety emergency.
What critical systems does a hospital MEP assessment cover?
A comprehensive assessment covers six areas: electrical and emergency power (distribution, generators, UPS, critical-load segregation); HVAC and critical ventilation (filtration, pressure relationships, backup capacity); fire and life safety (detection, suppression, evacuation routes); medical gas infrastructure (oxygen, medical air, vacuum, alarms); plumbing and public health systems (water, drainage, backflow prevention); and ELV/building systems (access control, CCTV, nurse-call, communications).
Which hospital areas need the most MEP risk attention?
High-dependency areas where an infrastructure failure has immediate patient consequences deserve special focus: the NICU, ICU, operating theatres, emergency department, cath labs, dialysis units, isolation areas, and maternity and neonatal wards.
Is having compliance certificates the same as being safe?
No. A hospital can hold valid certificates, inspection records and maintenance contracts while critical systems still carry undetected risk, because equipment deteriorates, departments expand, electrical loads increase, and layouts change over time. Safety should be treated as a continuous process, not a one-time compliance exercise.
- UNICEF — Statement on the deaths of 14 newborns following hospital fire in Islamabad, Pakistan
- Dawn — No lessons learnt: a timeline of hospital fires reported in Pakistan since 2010
- The Guardian — Fire kills 25 in Saudi hospital's maternity ward and intensive care unit
- Yonhap News Agency — Hospital fire kills at least 37, injures over 140
- UOL Notícias — Incêndio no Hospital Badim: quem são as vítimas
- World Health Organization — Hospital Safety
- World Health Organization — Hospital Safety Index: Guide for Evaluators, 2nd ed.
- ABC News — 14 newborns killed in fire at Pakistan hospital, doctor says