A model of Russian ventilator that the Kremlin sent to the United States as part of a high-profile shipment of medical supplies has been banned after being suspected of causing two deadly fires in coronavirus hospitals in Moscow and St. Petersburg.
In a statement issued Tuesday, Roszdravnadzor — Russia’s state health watchdog — said it would suspend the use of all Aventa-M ventilators, manufactured since April 1 by the Ural Instrument Engineering Plant (UPZ) in Chelyabinsk, a subsidiary of state-owned, U.S.-sanctioned Rostec.
An investigation has been opened into the cause of the fires, which killed five in a blaze in St. George’s hospital in St. Petersburg Tuesday and one at Moscow’s City Clinical Hospital no. 50 Saturday.
In interviews with The Moscow Times, doctors and medical professionals working with the ventilators, including at the St. George’s hospital, criticized the medical equipment, pointing to technical shortfalls and comparing the Russian-made model unfavorably with Western counterparts.
They also said the speed with which Russia has mobilized its health system to combat the coronavirus could be to blame, both in terms of production and implementation of the equipment.
“To some extent we expected something like this,” a pediatric resuscitator and consultant to several St. Petersburg hospitals who asked for anonymity to speak candidly told The Moscow Times.
“As cynical as it sounds, we are glad that there was a fire before a dozen patients died and a dozen doctors were sent to prison,” the consultant added, highlighting fears that frontline medical staff would be blamed for an apparent technical malfunction.
Production surge
Production at the UPZ plant had accelerated rapidly since the outbreak of the pandemic to meet surging demand.
On April 15, UPZ signed a 7.5 billion ruble ($100 million) contract with the Russian government to produce more than 6,700 Aventa-M ventilators. Including regional contracts, more than 10,000 Aventa-Ms have been ordered this year. That compares with just 278 in 2019, according to data shared with The Moscow Times by the Moscow-based Headway Group, which tracks government tenders.
The massive uptick in output was cheered on by state television at the time.
“They used to make 10 per day; now they make 100 per day,” a presenter for Channel One said in a segment broadcast on the day of the deal, noting that the factory was working around the clock and aiming to produce 6,000 ventilators within a month.
“In order to complete the government order, workers from all over Russia are being recruited to the factory,” the presenter added.
But critics say that because Russia has long relied on foreign-made ventilators, it was not prepared for such an increase in production.
“My experience shows that quite often the equipment isn’t as accurate,” pulmonologist Vasily Shtabnitsky told The Moscow Times at the start of the pandemic, expressing worries that the authorities had moved to purchase Russian equipment. “It can be broken and its usability isn’t great.”
The St. Petersburg hospital consultant echoed that sentiment. “It’s not just about this specific Urals plant,” they said. “The phenomenon is systemic. Our equipment is dangerous for patients.”
Following the tragedies in recent days, medical professionals have begun expressing their concerns more loudly.
“It’s an absolutely unpredictable machine,” one medical professional told the Moskovsky Komsomolets newspaper Tuesday, referring to the Aventa-M ventilator. “You cannot leave it unattended.”
“There is no specific weak point, but they are generally of poor quality. Hamilton [a Swiss manufacturer] and Aventa? It’s like a Mercedes and a Zhiguli,” said another professional, referring to a Russian-brand vehicle.
Mobilization shortfalls
Like the UPZ plant, hospitals in March and April were rushing to boost their capacities and reprofile their treatment capabilities to take in Russia’s increasing numbers of coronavirus patients.
That left medical workers facing the combined difficulties of dealing with an unfamiliar illness with unfamiliar equipment.
“It felt rushed — we didn’t have a lot of time to get used to them,” a doctor at St. George’s Hospital in St. Petersburg, who was off duty when the fire struck, told The Moscow Times on Tuesday, referring to the Aventa-M ventilators.
Noting that the hospital had been recently transformed to admit coronavirus patients, the doctor added that St. George’s hospital only received the ventilators on May 1, giving medical workers a short window to get them up and running.
“The medical staff were already used to the older Western ones we had that worked really well,” the doctor said. “Unfortunately those were running out.”
“Aventas have an extremely complicated interface,” said the consultant at the hospital. “You can’t just use them without extensive practice.”
Three days before the St. Petersburg tragedy, an Aventa-M ventilator had short-circuited in Moscow’s City Clinical Hospital no. 50, leaving one patient dead.
A nurse who works in a different intensive care unit at the hospital said the unit that caught fire was staffed with temporary workers brought in from other hospitals and new equipment.
“When the pandemic started all of us who worked here previously were told to grab everything and move into the next building,” said the nurse.
The rushed mobilization has also placed Russian medical workers themselves at risk. Last month, a urologist at a veterans’ hospital in Moscow died just two weeks after the clinic began taking in coronavirus patients.
“Our doctors do not know how to work in such conditions,” a nurse at the veterans’ hospital told The Moscow Times after the death. “We had quiet, peaceful work with older people, and now there is this emergency.”
Since health care staff have started to catch the virus, Russian doctors began keeping an unofficial tally of medical worker deaths. As of Wednesday, the total had reached 170.
American connection
At the beginning of April, Russia shipped 45 Aventa-M ventilators to the United States, responding to calls from state governors in New York and New Jersey as well as from President Donald Trump to help fill the country’s ventilator shortage.
The St. Petersburg fire adds the latest layer of controversy to that deal, which had already come under attack in Russia. Critics interpreted it as giving up much-needed medical supplies for a PR victory.
Meanwhile, in the United States, questions arose after it emerged that the UPZ plant was a subsidiary of sanctioned Rostec.
U.S. authorities confirmed they had not used the Russian-made ventilators — which were manufactured before the April 1 cutoff date for the recall.
“Thankfully, the flattening curve meant these ventilators were not needed, but they were held in reserve in case the situations in New York and New Jersey worsened,” the U.S. Federal Emergency Management Agency (FEMA) said in a statement to The Moscow Times.
The agency added it would wait for a Russian investigation into the fire to decide what to do with the ventilators — a move the doctor at the St. George’s hospital in St. Petersburg believes is wise.
“I would advise the Americans against using our ventilators,” he said. “Why? Show them what ours did to the patients.”