Lahore, Pakistan: About 120 dead from "bad" medication - Pyrimethamine contamination suspected

[Shiloh]

Source: http://www.dawn.com/2012/01/21/seven-more-fall-prey-to-mystery-disease.html

Seven more fall prey to ?mystery? disease in Lahore
Asif Choudary | Metropolitan > Lahore | From the Newspaper
Yesterday

LAHORE: A so far undiagnosed disease claimed lives of seven heart patients registered with the Punjab Institute of Cardiology (PIC) in the last couple of days, hospital sources told Dawn on Friday.

About two dozen critical patients are being treated at various hospitals of the city. City?s major public and private health facilities are receiving PIC patients daily with low platelet and white blood cell counts, dark complexion, black spots on bodies and bleeding....

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Source: http://www.thenews.com.pk/article-31976-Mystery-disease-claims-25-in-Lahore-

Mystery disease claims 25 lives in Lahore
Updated 1 hour ago

LAHORE: At least 50 patients are in critical condition after contracting a mysterious disease from taking free medicines distributed by the Punjab Institute of Cardiology (PIC)...

...The principal of the Allama Iqbal Medical College Dr. Javed Akram during a news conference said 25 people had died from the mysterious disease and 105 patients had been infected....

 

[alert]

Re: Lahore, Pakistan: 25 dead from unidentified disease- medication suspected

Re: Lahore, Pakistan: 25 dead from unidentified disease- medication suspected

http://www.pakistantoday.com.pk/2012/01/pic-brewed-poison-kills-12-more/

LAHORE - Twelve more people including women died of the ?mysterious? reaction being produced by a medicine provided to the heart patients by the Punjab Institute of Cardiology raising the total death toll to 26 on Saturday.
More than 150 patients have been admitted at different hospitals of Lahore including Mayo and Jinnah hospitals after reaction from medicines from PIC while the number of affected people and the number of deaths is also increasing sharply.

[snip]

According to Dr Afzal Shaheen of Jinnah Hospital, the symptoms of this disease include low count of platelets and white cells along with marks on the body. Some patients also bleed from various parts of their body.

 

[alert]

Re: Lahore, Pakistan: 25 dead from unidentified disease- medication suspected

Re: Lahore, Pakistan: 25 dead from unidentified disease- medication suspected

Maybe a toxic dose of blood thinner?

http://www.nation.com.pk/pakistan-n...d-reaction-of-cardiac-medicines-die-in-lahore

Two more victims of alleged reaction of cardiac medicines died on Sunday, bringing the overall death toll to 28 over the last three days.

The deceased included Muhammad Hussain and Pir Ahmed who were under treatment in Mayo Hospital.

According to details, more than 100 critical patients were being treated at various hospitals of the city as the probe committee fears possibility of adulteration in cardiac medicines.

Sources said the patients died due to low platelet and white blood cell counts after they were given medicines of Punjab Institute of Cardiology (PIC).

Public as well as private hospitals were receiving patients daily with low platelets, dark complexion, black spots on bodies and bleeding.

The government has formed a committee of doctors to probe the alleged reaction of cardiac medicines and consequent deaths of patients.

 

[alert]

Re: Lahore, Pakistan: 25 dead from unidentified disease- medication suspected

Re: Lahore, Pakistan: 25 dead from unidentified disease- medication suspected

A heavy metal like mercury or lead is another good guess. Heavy metal poisoning has been mistaken for hemorrhagic fever elsewhere in the world, so the symptoms seem right.

http://www.dawn.com/2012/01/22/drug-reaction-could-claim-more-lives-dr-javed-akram.html

LAHORE: Dr. Prof Javed Akram, the head of the investigation team probing the deaths caused by a cardiac drugs has said that at least 22 people have died due to sub-standard cardiac medicines and the death toll could further rise, DawnNews reported on Sunday.

Talking to the media at Allama Iqbal Medical College, Akram said that 110 patients were admitted at hospitals in Lahore due to the usage of these medicines. He said that 50 patients were in critical condition.

Akram said that the medicine may be contaminated with some heavy metal which gets deposited in the bone marrow and ultimately ends the body?s resistance.

?At present 110 heart patients are admitted in various hospitals of Lahore and the condition of 50 of them is critical. We have withdrawn the suspected medicines and sent samples for tests.?

Akram said the committee would investigate the deaths of heart patients which occurred due to a sudden drop in white blood cells, platelets and bone marrow damage.

?The problem seems to be with just one batch of medicines provided to the Punjab Institute of Cardiology and that has been sealed,? Akram said.

[snip]

 

[alert]

Re: Lahore, Pakistan: 28 dead from unidentified disease - toxic medication suspected

Re: Lahore, Pakistan: 28 dead from unidentified disease - toxic medication suspected

http://www.thenews.com.pk/TodaysPrintDetail.aspx?ID=11917&Cat=13

32 die of cardiac drugs reaction in Lahore

Amer Malik
Sunday, January 22, 2012
10

LAHORE: At least 32 patients have died due to a reaction to cardiac drugs they had consumed earlier. The medicine was provided by the govt-run Punjab Institute of Cardiology (PIC).

Sources told The News that medical experts had suspected five medicines ? Solprin, Zafnol, Concont, Cardiovascin and Isotab ? were provided to the cardiac patients registered with the PIC.

They said the patients taking the medicines were brought to hospitals with symptoms of a sudden drop in platelets and white blood cells and bleeding from different body parts. They said initially they took the symptoms as that of dengue.

More than 150 patients are reportedly under treatment in different city hospitals.

According to details collected from different city hospitals on Saturday, cardiac patients Khurshid Bibi, Ahmad Bashir, Gull Hussain, Ijaz, Nawaz, Aslam and Javed died in the Mayo Hospital while Ghulam Murtaza and Muhammad Amin breathed their last in the Services Hospital and Combined Military Hospital (CMH), Lahore.

Sources further said that the Punjab Health Department had ordered the pharmaceutical companies manufacturing and supplying the affected medicines to withdraw all stocks from hospitals and the market. They said the department had also ordered health EDOs and medical superintendents to immediately stop use of medicines and seal stocks and instructed drug inspectors to withdraw medicines from the registered patients.

However, it was learnt that no cardiac patient died of drug reaction at the PIC because its OPD patients were admitted to public and private hospitals close to their localities.

Meanwhile, Punjab Health Secretary Jehanzeb Khan has constituted a high-powered probe committee.

The committee is headed by Principal of the Allama Iqbal Medical College/Jinnah Hospital Prof Javed Akram while the other members of the committee are PIC Chief Executive Prof Muhammad Azhar, SIMS Principal Prof Faisal Masood, Prof Irshad Hussain (KEMU), Prof Farzana Chaudhry, Head of Pharmacy Department of University of Veterinary Sciences Lahore, Prof Bashir Ahmad, Head of Pharmacy Department Punjab University, Prof Farkhanda Kokab from Institute of Public Health, Addl Secretary Health (Technical) Dr Muhammad Anwar Janjua, Health Director General Health Dr Zahid Pervaiz, Prof Munazza Qayyum, DG Forensic Science Laboratory, Mufti Abdul Salam, Director, Drug Testing Laboratory, Prof Nosheen of Allama Iqbal Medical College, Dr Mubashir Attique, Chief Chemical Examiner, Prof Tahir Javed, Punjab University, Sheikh Akhtar Hussain, Deputy Director Cabinet Division and Ayyaz Ali, Director Pharmacy, DG Health Office.

The health secretary said that all batches of the medicines at the PIC had been withheld pending completion of inquiry, adding alternate arrangements are being made to provide safe medicines to the registered patients. He appealed to the cardiac patients registered with the PIC to immediately stop use of medicines acquired from the hospital.

Inquiry Committee chairman Prof Javed Akram told media that a Centralized Data Collection Centre had been established to collect data about such patients from all the city hospitals.

Moreover, he said that arrangements were being made to analyse local and foreign cardiac medicines used in the PIC, adding samples of affected drugs have been dispatched for examination to the National Institute of Health, Islamabad, Chemical Examiner, Punjab, Organic Chemistry Lab, Punjab University, Lahore, in Pakistan and drug testing laboratories in France and Belgium.

Prof Javed Akram said that a helpline 042-99200688 for the convenience of patients had been established.

 

[alert]

Re: Lahore, Pakistan: 28 dead from unidentified disease - toxic medication suspected

Re: Lahore, Pakistan: 28 dead from unidentified disease - toxic medication suspected

http://www.dailytimes.com.pk/default.asp?page=2012\01\23\story_23-1-2012_pg13_1

[snip]

?The contaminated medicine used by these patients contained arsenic, lead or mercury. While the death toll has already risen to 25, an increase can be expected,? Dr Javed Akram told reporters.

?There are still 105 such patients under treatment in different public hospitals in Lahore. Around 50 of them are in a critical condition,? he added.

 

[Shiloh]

Re: Lahore, Pakistan: 32 dead from "bad" medication - heavy metal contamination suspected

Re: Lahore, Pakistan: 32 dead from "bad" medication - heavy metal contamination suspected

Source: http://www.thenews.com.pk/TodaysPrintDetail.aspx?ID=89024&Cat=5&dt=1/23/2012

?Mystery disease? claims two more lives
Our Correspondent
Monday, January 23, 2012


The ?mysterious disease? or drug reaction has claimed two more lives of cardiac patients, who were registered with the Punjab Institute of Cardiology, Lahore.

Sources in public sector hospitals on Sunday said two cardiac patients, Muhammad Hussain and Pir Ahmad, had expired due to unexplained reasons at Mayo Hospital, as medical experts dealing with the patients were unable to explain a definite cause of their deaths.

The figure of unconfirmed casualties among cardiac patients has crossed 30 till Sunday, whereas at least 50 patients? condition is stated to be serious among more than 150 patients, who were suffering from reaction to medicines provided by the PIC and admitted to different public and private hospitals of Lahore. The patients have been diagnosed with symptoms of a sudden drop in platelets and white blood cells and bleeding from various parts, which also proved fatal among several of them...

 

[alert]

Re: Lahore, Pakistan: 32 dead from "bad" medication - heavy metal contamination suspected

Re: Lahore, Pakistan: 32 dead from "bad" medication - heavy metal contamination suspected

http://tribune.com.pk/story/325920/...o-on-notice-for-refusing-registration-of-fir/

LAHORE: The Federal Investigation Agency has arrested the owners of pharmaceutical factories involved in selling contaminated medicines that have so far killed 32 people.

FIRs have also been registered against them on directions of Interior Minister Rehman Malik.

Meanwhile, names of four drugs have been made public on the official website of Punjab health department and practitioners have been directed not to prescribe them.

The names include Cardiovestin (Simvastatin), Alfagril (Clopidogrel), Concort (Amlodipine) and Soloprin (Asprin). The medicines, consultants have been told, must not be prescribed until a probe into the matter is concluded.

[snip]

 

[alert]

Re: Lahore, Pakistan: 32 dead from "bad" medication - heavy metal contamination suspected

Re: Lahore, Pakistan: 32 dead from "bad" medication - heavy metal contamination suspected

http://www.pakistantoday.com.pk/2012/01/time-to-push-the-panic-button/

LAHORE - With 60 deaths still to be accounted for, the Punjab government has decided to send the drug and blood samples to laboratories abroad to investigate the ‘mystery’ deaths that are being caused by a drug that was distributed free by the Punjab Institute of Cardiology in a bid to fix responsibility of the debacle on someone.
Being severely criticised for a very centralised system in the absence of a health minister, the Punjab government in a high profile meeting on Monday finally decided to send the concerned drug samples to laboratories in Singapore and France in a bid to find out the cause of strange symptoms appearing in heart patients, many of whom have been admitted in different hospitals.

[snip]

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http://www.pakistantoday.com.pk/2012/01/‘my-mother-is-going-to-die’/

LAHORE - Her entire family was alarmed a few weeks ago when Irshad Bibi, an 85-year-old heart patient developed dark spots all over her body. Soon enough, blood starting pouring from her mouth and she also passed it out with urine and faeces.
Clueless, the family from Sheikhupura rushed her to the Punjab Institute of Cardiology (PIC) from where she has been receiving free medicines for the last three and a half years, only to find out that the medicine was “defective” and she could not use it anymore.
PIC doctors asked them to take Irshad to Services Hospital, where she now shares a bed with another patient who suffers from the same ‘mysterious’ illness caused by the medicine that was distributed by the PIC.
“Initially she suffered from a heartburn and fever and then she started bleeding…the doctors asked us to take her to Services Hospital and also asked us to stop using the medicine.

[snip]

 

[alert]

Re: Lahore, Pakistan: 32 dead from "bad" medication - heavy metal contamination suspected

Re: Lahore, Pakistan: 32 dead from "bad" medication - heavy metal contamination suspected

http://www.thenews.com.pk/article-32278-65-die-from-substandard-medicine-in-Lahore

LAHORE: At least 65 patients of the Punjab Institute of Cardiology (PIC) have died after consuming substandard medicine.

Those killed include patients who were receiving treatment at the PIC or had taken medicine distributed by the institute.

Meanwhile the three owners of the pharmaceutical companies who make the medicine have been handed over to the FIA on a three day remand.

On the orders of Interior Minister, Rehman Malik the FIA took action and registered cases against the three pharmaceutical companies.

 

[alert]

Re: Lahore, Pakistan: 32 dead from "bad" medication - heavy metal contamination suspected

Re: Lahore, Pakistan: 32 dead from "bad" medication - heavy metal contamination suspected

It remains unclear whether the issue is a contamination or an overdose:

http://tribune.com.pk/story/326421/free-medicine-manufacturer-says-doctors-prescribers-to-blame/

He said he accused the doctors, staff at PIC and those prescribing the medicines for the entire episode.

Another owner said that the booklet inside the medicine box clearly stated that the medicine was used for blood-thinning and that it was up to the doctor to decide the intake.


[snip]

Death toll rises to 62

At least 62 people have died after reacting to a free medicine from the Punjab Institute of Cardiology (PIC), Express News reported on Tuesday. The government of Punjab has claimed that only 28 have died of the reaction so far.

More than 300 patients are reported to be under treatment at different hospitals in Lahore, out of which 226 patients are at the Services Hospital.

 

[alert]

Re: Lahore, Pakistan: 65 dead from "bad" medication - heavy metal contamination suspected

Re: Lahore, Pakistan: 65 dead from "bad" medication - heavy metal contamination suspected

http://www.dawn.com/2012/01/24/drug-reaction-toll-jumps-to-63.html

LAHORE: A total of 63 heart patients have died over the past three weeks after taking medicines from government hospitals in Lahore.

The stunning fact was revealed at a press briefing by provincial Health Secretary Mohammad Jehanzeb Khan at the Punjab Institute of Cardiology (PIC) on Monday night.

The official confirmed 27 deaths in hospitals while the Principal of the Services Institute of Medical Sciences (SIMS), Dr Faisal Masood, said 36 cardiac patients registered with the PIC had died of suspected drug reaction in the Services Hospital.

He said the 36 deaths were in addition to those officially confirmed by the health secretary.

Both the officials made public the ?official figure? after reporters accused them of concealing facts related to the deaths.

[snip]

 

[Tonka]

Pakistan: 70 dead after taking heart medication

Pakistan: 70 dead after taking heart medication

http://www.lavoz.com.ar/noticias/sucesos/pakistan-70-muertos-tras-consumir-medicamentos-para-corazon
Spanish-English translation

http://www.lavoz.com.ar/noticias/sucesos/pakistan-70-muertos-tras-consumir-medicamentos-para-corazon

Pakistan: 70 dead after taking heart medication
The deaths began to register after the Institute of Cardiology, a province distribute medicines for patients.
25/01/2012 9:41 | Agencia EFE0

At least 70 patients have died in recent weeks after taking heart medication in Pakistan, officials said.
The deaths began to register after the Institute of Cardiology of the eastern province of Punjab (PIC acronym in English) distributed 46 000 medicines for cardiac patients have enrolled.
Health Department sources cited by the Punjab Dawn TV channel and newspaper The News amounted to about 70 dead so far, although other means victims rise to 80.
The press points to the low quality of drugs to explain the episode but authorities have not yet an official release on the situation of patients.
According to the provincial health department, other 178 patients were admitted after taking the drug but were discharged after receiving treatment in hospitals.
The precarious health system is overwhelmed Pakistan to serve a population of 180 million people.
Industry sources of development assistance consulted believe that the decentralization of responsibilities for Health (from the central government to provinces) has not improved the situation.

 

[alert]

Re: Lahore, Pakistan: 65 dead from "bad" medication - heavy metal contamination suspected

Re: Lahore, Pakistan: 65 dead from "bad" medication - heavy metal contamination suspected

http://www.cnn.com/2012/01/25/world/asia/pakistan-tainted-medicine/index.html

Reports: 73 dead from suspected tainted heart medicine in Pakistan

By Nasir Habib, for CNN
updated 9:47 AM EST, Wed January 25, 2012
STORY HIGHLIGHTS
Many of the deaths occurred at the Punjab Institute of Cardiology
The factory that manufactured the drugs has been shut down
Patients had sudden drops in white blood cell counts and excessive bleeding
Islamabad, Pakistan (CNN) -- As many as 73 people have died after taking what officials suspect may have been tainted heart medicine in the eastern Pakistani city of Lahore, the doctor leading the investigation into the deaths told CNN Wednesday.

Dr. Javed Akram said more than 500 other people have been sickened by the medication, including 50 patients who are in critical condition now.

Sixty-five of the fatalities were reported at the Punjab Institute of Cardiology, E Pakistan News reported Tuesday.

The government of Punjab province has sealed the pharmaceutical factory that is believed to have manufactured the medicine.

"The medicine may be contaminated with some heavy metal which created an adverse drug reaction," Akram said.

The medication was provided free of charge by the government-run Institute of Cardiology.

Akram said the patients taking the medicines were brought to hospitals with symptoms of a sudden drop in white blood cell and platelet levels and bleeding from different body parts.

 

[alert]

Re: Lahore, Pakistan: 73 dead from "bad" medication - heavy metal contamination suspected

Re: Lahore, Pakistan: 73 dead from "bad" medication - heavy metal contamination suspected

http://www.onlinenews.com.pk/details.php?id=188534

Death toll from suspected medicine reaction reaches 78
LAHORE: Death toll of victims of suspected medicine reaction mounted to 78 as 2 new cardiac patients died on Wednesday on this count.

One patient, Balqees at Mayo Hospital and the other Rana Anwar at Services Hospital were reported to have died.

Punjab Government has issued directives to PIC to work out postmortem reports of the deceased. The provincial government will also give cheque of Rs 5 lakh each to families of victims.

 

[alert]

Re: Lahore, Pakistan: 73 dead from "bad" medication - heavy metal contamination suspected

Re: Lahore, Pakistan: 73 dead from "bad" medication - heavy metal contamination suspected

http://tribune.com.pk/story/326824/...aths-soar-past-80-authorities-still-clueless/

[snip]

None of the eight different committees constituted by the Punjab government has so far prepared a satisfactory or comprehensive report probing the reasons why the PIC’s free medicine has now claimed over 80 lives. More damage is expected, as the total number of patients who might be at risk after taking free medicine from the hospital is about 46,000.

Dr Javed Akram, the principal of Allama Iqbal Medical College and head of a 22-member committee investigating the incident, had vowed to submit the report investigating the cause of the so-far-mystery disease within 48 hours, but has still to do so.

“Tests and investigations are under way and we are working on it,” Dr Akram told The Express Tribune on Tuesday. Dr Akram, however, feared more deaths, saying the death toll could reach an alarming figure of 100 to 150. He said his team had asked the pharmaceutical companies to provide a record of their medicine.

[snip]

In Karachi, meanwhile, Dr Obaid Ali, analyst at the CDTL, confirmed he had received samples of the three drugs which were given to cardiac patients at the Punjab Institute of Cardiology (PIC). It is believed that one of the drugs, given to heart patients at the PIC, caused bone marrow suppression and aplastic anemia, resulting in the deaths of patients within a few days. Heart patients reached the hospitals with complains of non-stop bleeding from different parts of the body and dark spots all over.

Local experts in Karachi wondered how a medicine produced for the treatment of cardiac diseases could affect bone marrow.

Dr Tahir Shamsi, the medical director of the National Institute of Blood Disease & Bone Marrow Transplantation (NIBD), a pioneer of bone marrow transplantation in the country, said that the ill-effect caused by the tablets is still a mystery, because ingredients used in medicines for the treatment of cardiac illnesses do not contain generic drugs that cause bone marrow suppression.

 

[alert]

Re: Lahore, Pakistan: About 100 dead from "bad" medication - heavy metal contamination suspected

Re: Lahore, Pakistan: About 100 dead from "bad" medication - heavy metal contamination suspected

http://www.thenews.com.pk/TodaysPrintDetail.aspx?ID=12010&Cat=13

LAHORE: Chief Minister Shahbaz Sharif on Wednesday disclosed that approximately 100 cardiac patients had lost their lives so far due to a reaction from medicines, contradicting his own statements that 72 deaths occurred in hospitals and 17 at other places with the total death toll at 89.

[snip]

 

[alert]

Re: Lahore, Pakistan: About 100 dead from "bad" medication - undetermined contamination suspected

Re: Lahore, Pakistan: About 100 dead from "bad" medication - undetermined contamination suspected

Perhaps the contamination occurred not in production, but somewhere afterward?

http://www.thenews.com.pk/TodaysPrintDetail.aspx?ID=89488&Cat=2

[snip]

Some pharmacists raise a query that how it could be possible that the medicines of several companies showed such a reaction. While some other experts expressed apprehensions that may be this issue has been created to remove the misconception of transfer of the Drug Regulatory Authority (DRA) to the provinces from the Federation. A severe dispute emerged after the transfer of the DRA to the provinces from the Federation under 18th Amendment. The Pakistan Pharmaceutical Manufacturing Association (PPMA) opposed the transfer of the DRA to the provinces and due to this all the provinces, except the Punjab, agreed to keep the DRA working under the federation.

 

[Emily]

Re: Lahore, Pakistan: About 100 dead from "bad" medication - undetermined contamination suspected

Re: Lahore, Pakistan: About 100 dead from "bad" medication - undetermined contamination suspected

Perhaps the contamination occurred not in production, but somewhere afterward?

If it wasn't that, the other possibilities for various medicines sold under multiple brands would be:

1. An non-active ingredient(s) common to the various medicines that is contaminated. (The 2007 pet food poisoning happened that way.)

2. A shared production facility where cross-contamination of the medicines occurred. (Actually that was also involved in the 2007 pet food poisonings.)

 

[alert]

Re: Lahore, Pakistan: About 100 dead from "bad" medication - undetermined contamination suspected

Re: Lahore, Pakistan: About 100 dead from "bad" medication - undetermined contamination suspected

http://www.thenews.com.pk/article-32628-6-companies-involved-in-medicine-scandal

ISLAMABAD: Interior Minister Rehman Malik said Thursday that six companies were involved in the substandard medicine scandal.

Malik added that the owners of three of these companies had already been arrested.

101 patients have lost their life after consuming the substandard medicine distributed by the Punjab Institute of Cardiology (PIC).

The Lahore High Court has also summoned responses from the Chief Secretary Punjab, Federal and Provincial Health Secretaries.