So this happend to me, too. I acually had the fight with the wichts and I had to fight Azo - but everyone upstairs was also hostile (not the guards in the basement, tho). I didn't have Aloth with me at the time and I hadn't found the scepter pieces for Nans yet - so now the sanitarium is empty of people (all dead) and the warden won't talk to me. It seems I won't be able to finish those two quest lines. Now I'm already way to far past this to being bothered to go back to an old save before (which I actually still have), but I hope this gets fixed in time for my next playthrough!