370:. The manufacturers that exported the syrup to other countries in the current spate of incidents are four Indian manufacturers (Maiden Pharmaceuticals, Marion Biotech, QP Pharmachem, and Synercar), one Chinese manufacturer (Fraken Group) and one Pakistani manufacturer (Pharmix Laboratories). Safety alerts have been issued by government agencies in the affected countries, as well as by countries conducting tests on their behalf and the WHO, while investigations into the matter continue. The WHO has urged countries to enhance surveillance and offer support to countries lacking testing resources.
201:
expiration date to four years before selling it to the government of Panama. Neither the trading companies involved nor the government lab in Panama that processed the ingredient tested the substance for verification. Chinese authorities said they would no longer allow the name "TD glycerin" to be used. One of the country's officials overseeing food and drug safety was sentenced to death in late May on charges related to the scandal. The Panama government detained several officials as well as employees of
Medicom and set up a $ 6-million fund for the victims.
179:
suffered the same fate. Following an inquiry, Tyno cough syrup, produced and distributed by Reko Pharma in Lahore, was identified as the cause of the fatalities in Lahore. Many of the victims from the two incidents were drug addicts seeking intoxication. The syrup was later found to contain too much
365:
is working with six additional countries, bringing the total to 15 countries, to track these dangerous medicines. The WHO team lead said that tainted syrups are an ongoing risk. He cautioned that the presence of contaminated medicines could persist for several years, as warehouses may still contain
300:
The Indian government has mandated that after June 2023, cough syrup manufacturers must have their products tested before exporting them. These companies are required to obtain a certificate of analysis from a government-approved laboratory. A list of approved laboratories, both at the central and
248:
state, who holds a senior position in the state health department, accepted a bribe and switched samples of contaminated cough syrup before the state government laboratory tested them. The cough syrup in question was produced by Maiden
Pharmaceuticals, and it has been implicated in child deaths in
84:
as a physician and had noticed a number of deaths that seemed to coincide with the distribution of the government-issued cough syrup. The government rebuffed his attempts at investigating the medication. In response, Bennish smuggled bottles of the syrup in his suitcase when returning to the
200:
originated from a
Chinese manufacturer, which exported it as industrial "TD glycerin" under a shelf life of one year. The letters "TD" were shorthand for "substitute" in Chinese. When Panama-based Medicom received the product from a Spanish trader, it changed the name to "glycerine" and the
131:(AKI). In October, health officials reported around 200 cases of AKI in children, most of who were aged under five. Indonesia temporarily banned the sale and prescription of all syrup and liquid medicines as it was not clear if these medicines were imported or locally produced.
276:
said that 18 children died from renal problems and acute respiratory disease after drinking cough syrup manufactured by Indian drug maker Marion
Biotech. The statement did not specify over what time period the deaths occurred. As a result, Marion Biotech, was suspended from
296:
that Marion purchased industrial-grade propylene glycol as an ingredient from Maya
Chemtech India, which is not licensed to sell pharmaceutical-grade materials. Maya is not facing charges but the investigation is ongoing. Marion did not test the ingredient it purchased.
257:
in the syrup. Indian authorities, however, did not find any toxins, but did identify labeling issues with Maiden
Pharmaceuticals' cough syrup. Naresh Kumar Goyal, the founder of Maiden Pharmaceuticals, has previously denied any wrongdoing in the production of the syrup.
317:
in
Naturcold, reaching as high as 28.6% – over 200 times the acceptable limit, which should not exceed 0.1%. This highly toxic solvent, normally used in air-conditioners and fridges, can lead to severe symptoms, including acute kidney injury and even death if ingested.
321:
The packaging of the deadly medicine falsely claimed that it was produced by a
British company called Fraken International (England), but no such company exists in the UK. The actual manufacturer was Riemann Private Ltd, an Indian company based in
51:
There have been poisonings in
Bangladesh, Indonesia, Marshall Islands, Pakistan, Panama, The Gambia, India (twice), Uzbekistan, and Cameroon between 1992 and 2022, due to contaminated cough syrup and other medications that incorporated inexpensive
727:
151:, had been found to contain "unacceptable amounts of diethylene glycol and ethylene glycol" in tested samples. Sudhir Pathak, managing director of QP Pharmachem, claimed that the batch of 18,346 bottles had been exported to
134:
In
November 2023, Afi Farma's chief executive and three other officials, whose cough syrup was linked to the deaths were sentenced to two-year prison sentences and fined 1bn Indonesian rupiah ($ 63,029; £51,7130) each.
884:
1003:
241:
In December 2022, a parliamentary committee in The Gambia recommended prosecution of the Indian company, Maiden Pharmaceuticals. It also recommended banning all products by the firm in the country.
342:
keeps an eye on counterfeit claims of UK origin made by foreign pharmaceutical companies, as such claims are used to add credibility to otherwise adulterated, unlicensed, or substandard medicines.
1026:
223:
from kidney failure. The products (Promethazine Oral Solution, Kofexmalin Baby Cough Syrup, Makoff Baby Cough Syrup, and Magrip N Cold Syrup) are believed to be contaminated with
875:
793:
624:[General Administration of Quality Supervision, Inspection and Quarantine: Responsibility for the drug poisoning incident in Panama lies with the businessman].
994:
361:
is addressing the global threat of toxic cough syrups that have caused the deaths of more than 300 children across multiple countries in 2022 and 2023. The
658:
339:
959:
925:
421:
The syrupy poison, diethylene glycol, is an indispensable part of the modern world, an industrial solvent and prime ingredient in some antifreeze.
687:
582:
346:
235:
1087:
379:
278:
107:
about his experience, writing that, given the amount of medication prescribed, death tolls "must be in the tens of thousands".
815:
784:
273:
219:
announced a link between four paediatric cough syrups from one Indian pharmaceutical company and the deaths of 66 children in
40:
540:
80:. For example, Michael L. Bennish, an American pediatrician who works in developing countries, had been volunteering in
514:
249:
Gambia. Tests conducted by two independent laboratories on behalf of the WHO confirmed the presence of lethal toxins—
848:
345:
Riemann Pvt Ltd is under investigation and faces potential disciplinary action from the Indian drug regulator, the
244:
Indian authorities started conducting an inquiry into an April 2023 allegation that a pharmaceutical regulator in
155:
after obtaining all necessary regulatory approvals and that he was unaware of how the product had ended up in the
119:, were reported to be linked to cough syrup and liquid medication. The syrup contained "unacceptable amounts" of
1112:
1062:
267:
160:
640:
349:. Despite the ongoing investigation, the company continues its operations and drug manufacturing activities.
309:
The Naturcold brand of cough syrup from India was associated with the tragic deaths of multiple children in
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210:
607:
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144:
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231:. The products involved were manufactured by Maiden Pharmaceuticals of India in December 2021.
72:
providers and governmental agencies due to difficult communication between the governments of
1092:
1077:
282:
570:
234:
This has led to Maiden Pharmaceuticals' products being banned in The Gambia; a probe by the
1082:
960:"Fake British cough syrup linked to Cameroon child deaths was made in India, officials say"
728:"Four India-made cough syrups under the scanner; CDSCO initiates probe after WHO red-flags"
77:
621:
238:
and volunteers from health agencies in The Gambia going door to door in an urgent recall.
8:
128:
577:
408:
35:, a cheaper alternative to glycerine for industrial applications. Diethylene glycol is
967:
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314:
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197:
120:
94:
73:
53:
32:
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181:
156:
659:"Medical Product Alert N°6/2022: Substandard (contaminated) paediatric medicines"
250:
124:
171:
In December 2012, toxic cough syrup led to a death toll of between 16 and 30 in
434:
36:
1051:
971:
937:
827:
459:
148:
90:
86:
68:
Discovering and tracing a toxic syrup to its source has been difficult for
69:
24:
876:"Exclusive: Indian firm used toxic industrial-grade ingredient in syrup"
849:"Uzbekistan Arrests Four Over Child Deaths Linked To Indian Cough Syrup"
23:
have occurred in developing countries. In these cases, an ingredient in
286:
220:
172:
81:
301:
state government level, was provided where the samples can be tested.
116:
98:
57:
28:
995:"Exclusive: WHO says toxic syrup risk 'ongoing', more countries hit"
926:"Bogus British company caught selling toxic cough syrup in Cameroon"
757:"Marion Biotech: Uzbekistan links child deaths to India cough syrup"
486:"Guaifenesin: WHO issues alert over another India-made cough syrup"
327:
310:
152:
1027:"WHO says more contaminated medicinal syrups found in new regions"
335:
293:
245:
688:"Warning over cough syrups after 66 children die in the Gambia"
460:"Boss of Indonesia cough syrup maker jailed after child deaths"
435:"Indonesia bans all syrup medicines after death of 99 children"
323:
193:
176:
1025:
Rigby, Jennifer; Deshmukh, Shubhendusatish (7 December 2023).
326:, and it appeared to be exported to global markets, including
143:
In April 2023, World Health Organization (WHO) reported that,
331:
175:, while in November of that year, at least 19 individuals in
785:"Exclusive: India probes bribery claim in toxic syrup tests"
313:. WHO testing on June 27, 2023, revealed alarming levels of
641:"Panama agency's prepared 'medicine' has deadly effects"
281:, an Indian government-linked trade group. As a result,
900:"India makes cough syrup testing mandatory for exports"
330:, by another Indian company, Wellona Pharma, based in
97:, which can appear very similar to the less dangerous
515:"Toxic cough syrup kills 16 in Gujranwala: officials"
572:"From China to Panama, a Trail of Poisoned Medicine"
404:"From China to Panama, a Trail of Poisoned Medicine"
340:
Medicines and Healthcare products Regulatory Agency
993:
874:
783:
138:
101:. Bennish went on to author a 1995 article in the
873:Sharma, Saurabh; Das, Krishna N. (28 June 2023).
816:"A scandal rocks India's pharmaceutical industry"
1049:
958:Lateef, Samaan; Lovett, Samuel (27 July 2023).
568:
401:
147:TG syrup manufactured by QP Pharmachem Ltd in
19:Since the 1990s, several mass poisonings from
1024:
694:. Guardian staff and agencies. 6 October 2022
957:
569:Bogdanich, Walt; Hooker, Jake (6 May 2007).
541:"Toxic cough syrup kills dozens in Pakistan"
402:Bogdanich, Walt; Hooker, Jake (6 May 2007).
682:
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347:Central Drugs Standard Control Organisation
115:In 2022, deaths of nearly 100 children in
89:, allowing pharmaceutical laboratories in
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602:
600:
564:
562:
397:
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192:In May 2007, 365 deaths were reported in
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380:List of medicine contamination incidents
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749:
608:"China Blames Panama For Tainted Drugs"
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734:(video). Mirror Now. 6 October 2022
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41:multiple organ dysfunction syndrome
13:
887:from the original on 30 June 2023.
585:from the original on 13 March 2023
14:
1129:
1088:Health disasters in North America
1006:from the original on 30 June 2023
898:Mollan, Cherylann (23 May 2023).
796:from the original on 14 June 2023
992:Rigby, Jennifer (16 June 2023).
782:Das, Krishna N. (14 June 2023).
433:Mao, Frances (20 October 2022).
43:(MODS), especially in children.
1018:
985:
951:
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853:Radio Free Europe/Radio Liberty
841:
808:
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622:"质检总局：巴拿马药品中毒事件责任在巴商人_新闻中心_新浪网"
359:World Health Organization (WHO)
139:Marshall Islands and Micronesia
16:Mass poisonings since the 1990s
614:
533:
478:
452:
426:
268:Uzbekistan cough syrup scandal
31:(glycerol), was replaced with
1:
924:Newey, Sarah (20 July 2023).
639:Kraul, Chris (20 June 2007).
385:
261:
204:
63:
352:
274:Uzbekistan's health ministry
110:
7:
373:
304:
166:
10:
1134:
265:
211:Gambia cough syrup scandal
208:
93:to identify the poisonous
46:
187:
610:. CBS News. 31 May 2007.
366:barrels of adulterated
184:, a cough suppressant.
104:British Medical Journal
712:: CS1 maint: others (
289:arrested four people.
1113:2022 health disasters
1063:2007 health disasters
283:state security police
215:In October 2022, the
129:acute kidney injuries
78:developing countries
74:developed countries
1118:2022 in the Gambia
1108:2022 in Uzbekistan
763:. 29 December 2022
732:The Economic Times
578:The New York Times
547:. 29 December 2012
521:. 29 December 2012
409:The New York Times
272:In December 2022,
39:and can result in
1103:2022 in Indonesia
645:Los Angeles Times
466:. 2 November 2023
315:diethylene glycol
255:diethylene glycol
225:diethylene glycol
198:diethylene glycol
121:diethylene glycol
95:diethylene glycol
54:diethylene glycol
33:diethylene glycol
21:toxic cough syrup
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1073:Health in Panama
1068:Medical scandals
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492:. 26 April 2023
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229:ethylene glycol
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125:ethylene glycol
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1098:Mass poisoning
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628:. 31 May 2007.
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1093:Adulteration
1078:Antitussives
1034:. Retrieved
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1008:. Retrieved
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551:28 September
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127:, linked to
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18:
1083:Drug safety
767:29 December
663:www.who.int
338:. The UK’s
145:Guaifenesin
70:health care
56:instead of
37:nephrotoxic
25:cough syrup
1052:Categories
470:2 November
444:20 October
386:References
287:Uzbekistan
279:Pharmexcil
262:Uzbekistan
221:The Gambia
205:The Gambia
173:Gujranwala
161:Micronesia
82:Bangladesh
64:Bangladesh
977:22 August
972:0307-1235
943:22 August
938:0307-1235
858:7 January
833:7 January
828:0013-0613
738:9 October
698:9 October
669:9 October
353:Worldwide
117:Indonesia
111:Indonesia
99:glycerine
58:glycerine
29:glycerine
1004:Archived
904:BBC News
885:Archived
794:Archived
761:BBC News
708:cite web
583:Archived
545:ABC News
519:Dawn.com
496:26 April
490:BBC News
464:BBC News
439:BBC News
374:See also
328:Cameroon
311:Cameroon
305:Cameroon
167:Pakistan
153:Cambodia
1031:Reuters
1000:Reuters
881:Reuters
790:Reuters
589:4 March
415:4 March
336:Gujarat
294:Reuters
246:Haryana
227:and/or
47:History
1036:24 May
1010:2 July
970:
936:
909:23 May
826:
800:2 July
324:Indore
196:. The
194:Panama
188:Panama
177:Lahore
332:Surat
236:CDSCO
1038:2024
1012:2023
979:2023
968:ISSN
945:2023
934:ISSN
911:2023
860:2023
835:2023
824:ISSN
802:2023
769:2022
740:2022
714:link
700:2022
671:2022
591:2015
553:2023
527:2023
498:2023
472:2023
446:2022
417:2015
357:The
253:and
159:and
123:and
76:and
363:WHO
285:in
217:WHO
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