PIC medicine disaster: Isotab is the killer pill

Published: February 2, 2012

CM Shahbaz Sharif revealed that Isotab tablets had been contaminated with an anti-malarial chemical. PHOTO: FILE

LAHORE: 

A London laboratory has determined that Isotab, a medicine manufactured by Efroze Chemical Industries, caused the reaction that has so far cost 120 lives.

At a press conference on Wednesday, Chief Minister Shahbaz Sharif revealed that Isotab tablets, which are meant for heart patients, had been contaminated with an anti-malarial chemical, which resulted in fatalities to patients who used it daily. The medicine was given free of cost to patients of the Punjab Institute of Cardiology (PIC).

A doctor familiar with the investigation, who did not want to be named, told The Express Tribune that there were dangerous quantities of the chemical, Pyrimethamine, in Isotab.

Explaining the reaction to the body, the doctor said: “Pyrimenthamine is found in Fansidar, an anti-malarial drug. This chemical reduces folic acid, which is responsible for production of blood. Isotab is given to heart patients twice daily to lessen the burden on their heart. The chemical found in Isotab, however, was equal to 10 tablets of Fansidar, which means those who used this medicine twice a day were effectively taking 20 tablets of Fansidar, which suppressed the bone marrow, disturbed blood production, and ultimately caused death.”

The doctor said that the other four medicines under suspicion – Cardiovestin, Alfagril, Concort and Soloprin – were manufactured by lesser-known pharmaceutical companies. “We didn’t expect Isotab to be contaminated because it’s manufactured by Efroze Chemical Industries, who have around 80 registered medicines in Pakistan. We suspected the above four medicines, but Isotab has turned out to be the one with faults,” he said. He added that drug testing laboratories in Pakistan had previously cleared Isotab.

At the press conference, Shahbaz was in no mood to accept responsibility, claiming that the circulation of the faulty medicine was a conspiracy against Punjab.

“A high-ranking person in Islamabad is responsible for this,” he said, adding that official letters had been written to the federal government with these allegations. Referring to the treatment of patients, the chief minister said that folic acid was being used as an antidote.

Shahbaz also announced that the London laboratory’s report would be forwarded to the World Health Organisation.

Meanwhile, Governor Sardar Latif Khan Khosa took a different view to the chief minister. He announced that the federal government would compensate the families of those who died of the drug reaction. “This is an extreme form of criminal negligence. The Punjab government should accept its negligence. By raising fingers toward President House in Islamabad, the provincial government cannot beguile people,” the governor said.

The owner of Efroze Chemical Industries did admit on Wednesday that the batch of Isotab produced for the PIC containted Pyrimethamine. However, the owner told Express News that his factory should not be closed down, as it had been producing drugs for 35 years and exported them to over 20 countries.

Terming the disaster a ‘conspiracy’ to malign the factory’s name, the owner said that in September last year, some material was stolen from their warehouse, and this might have been used in adulterating the batch of medicines. He said that only this particular batch was spurious and that the rest of the medicines produced by the factory did not have any issues.

The Federal Investigation Agency, meanwhile, has closed the factory after inspecting the premises and meeting staff on Wednesday. The three pharmaceutical laboratories in Lahore which were originally suspected of foul play have been cleared of any criminal offence. However, a medicine called Alfagril, produced by one of the laboratories, has been declared substandard – though not spurious – a source with ties to the FIA said.

It’s obviously more serious for Isotab, which has been taken off the shelves in Pakistan and banned across the world.

(Read: Medicine crisis – who is to blame?)

(With additional reporting by Asad Kharal)

Published in The Express Tribune, February 2nd, 2012.

Reader Comments (32)

  • Mudassar.R
    Feb 2, 2012 - 4:25AM

    Thats all we can get from our govt. Be it provincial govt, or capitcal govt, I dont care who is responsible, I , being a common man, care about the health and safetly of a common citizen. And this is the safety we are getting. At the end of every probelm , every catastrphy , we receive two speeches, one from national and other from provinsial govt, blaming each other. thats all these “Leaders” can give us. nothing more they are capable of.
    for God sake, 120 people died, I wish one had died from families of these higher ups, from each govt, so that they would had known the intensity of the issue. and what they are doing is just blaming.
    both of the heads should not only be sacked by hanged on murder cases for these 120 killings. but who cares, they care only about the numbers, he number of seats in lower and upper houses in next elections.
    pitty on the nation, who electes people like these.

    Recommend

  • Rehbar
    Feb 2, 2012 - 5:17AM

    I am not Punjabi, but I am amazed how to people of Punjab it doesn’t seem to matter even when hundreds of their people are intentionally being murdered as a result of this political war-fare between the powerful ruling factions of the country. Need to wake up Punjabis!!!

    Recommend

  • Imran
    Feb 2, 2012 - 5:34AM

    Khadim-e-Aala has gone nuts! Perhaps crushed under the burden of 18 Ministries!

    Recommend

  • kala_bacha
    Feb 2, 2012 - 8:27AM

    first people stop blamming each other. Instead Try to make every efforts people take folic acid. How long we will fight on people dead bodies!Recommend

  • Feb 2, 2012 - 8:41AM

    The drug had shown that it was a deliberate attempt to malign Punjab and kill punjabi people

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  • Humanity
    Feb 2, 2012 - 8:46AM

    Shahbaz was in no mood to accept responsibility, claiming that the circulation of the faulty medicine was a conspiracy against Punjab.

    Very Khadim-e-Aala like !!

    Recommend

  • Kazmis
    Feb 2, 2012 - 9:24AM

    I find people always complaining, cursing leaders and blaming each other. All blogs are full of such sentiments. People have no commonsense regarding what and how this happened. Seriously think and give best opinion rather than cursing. Iso-sorbite mononitrate is for heart, it carries oxygen to diffrent parts of body, while pyrimethamine is an anti parasite drug used to kill parasites. How the two combined?, why? and why a big company was involved?. Drug factory can not do it except some terrorist act. Blaming CM etc is ridiculous. The indications are alarming and my friends be CAREFUL in future.

    Recommend

  • Blithe
    Feb 2, 2012 - 9:29AM

    This is clearly negligence from Federal Government.
    You just cannot absolve drug regulation – it is and has to be
    a Federal subject.

    I’m sick of the politics around this.
    Even though the drugs came from Karachi,
    the Federal Government is still playing petty provincial
    politics.

    This factory owner from Karachi must compensate each and
    every family effected by this.

    Recommend

  • Ali
    Feb 2, 2012 - 9:32AM

    @Rehbar: Brother i am Punjabi and from Lahore we have awakened and our full support is with PTI.

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  • Dr. Ishtiaq
    Feb 2, 2012 - 9:37AM

    I wonder how come a 20mg tablet contains 50mg additional drug without increasing the size of the tablet. This seems something fishy. The best way to prove is to look for this chemical (serum drug level) in the blood of the infected patients.

    Recommend

  • Reema
    Feb 2, 2012 - 9:44AM

    Stop the blame gameRecommend

  • Nasir Iqbal Khawaja
    Feb 2, 2012 - 10:02AM

    Mian Sb. and his team have reached to killer medicine of Karachi.
    The question is that why Pakistani Laboratories did not found the problem.
    Mian Sb. please donot stop to give free medicine to poor people.

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  • sid
    Feb 2, 2012 - 10:46AM

    being a physician myself, the explanation given by the doctor sounds pretty absurd, how can a 20 mg isosorbide tab have enough pyrimethamine as 20 fansidar tabs. blood levels are a very easy screening tool in this situation. efroze chemicals is not the only drug company doing mishaps like this, surely ecery drug company must have bypassed quality and safety procedures.. we need a central authority like the american FDA which strictly controls quality and makes sure the citizens of the country are protected. all we have is PPP AND PML. may Allah save our souls. May Allah bribg solace and peace to the berieved families.

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  • Tariq Chundrigar
    Feb 2, 2012 - 2:12PM

    Efroze exports to 20 countries. These countries should take stock. Something like this can only happen when the bribery chain allows it, from top to bottom, and this is the real conspiracy against the Pakistani. There is a dire need for an honest regulatory body, which does not take bribes to register drugs, as is the current case.

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  • susheel kumar
    Feb 2, 2012 - 2:21PM

    i think this is responsibility of punjab govt, im also doctor, govt should take actions against responsible,, and there should be drug regulatory authority, and avoid liscensing every person that he can open his pharma company.

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  • Qadus
    Feb 2, 2012 - 6:39PM

    @Dr. Ishtiaq:
    A 20 mg tab can easily contain 50 mg extra, size is determined by inert materials (vehicles) and coating.

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  • romeo
    Feb 2, 2012 - 10:27PM

    Please stop inciting the people of Punjab, the people died were all Pakistani’s. Efroze Chemical Industries should be closed down for good. The M.D, Chairman, Directors, Lab-In charge and Quality Control of Efroze Chemical Industries and Minister of Ministry of Health should all be arrested and charged with Mass Murder. At least Mr. Gilani can do this.

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  • mks
    Feb 2, 2012 - 11:02PM

    @susheel kumar:
    gooooodRecommend

  • betterwords
    Feb 3, 2012 - 10:44AM

    Many questions and no answer ?
    Who did this ? Why ? How ? Where ? In a private lab (stolen material) or at Elfroz ? Is ithis an international or domestic trick to hurt Pakistan’s image ? Indian Invovlment ( to hurt PAK medicine export ) ?
    Other international agents (US.. bad apple always) ?

    Oky this too much but we need to find the reason and orgion of this evil pill as its matter of 120 lives.Recommend

  • Ahsan
    Feb 3, 2012 - 5:07PM

    It is not a domestic fight it is an international fight…….We all must stop fighting with each other so that we can focus on the bigger conspiracy played against us….

    It is a suspected economic warfare…

    http://drugsanddeathsinpakistan.blogspot.com/2012/02/prof-javaid-akram-and-others-declares.html

    Recommend

  • Surayya
    Feb 3, 2012 - 6:08PM

    @Tariq Chundrigar:

    And I suppose you know it – how again? So you are saying that out of a MILLION tablets that this company makes, the ONE batch that is contaminated with a MORE expensive raw material than the others added (mind you, the reason the other labs did not catch it or call it sub-standard was because all the other raw materials were added as required), PROVES that money was exchanged? How again does this work???

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  • Abid
    Feb 3, 2012 - 8:04PM

    20 countries export
    35 years of service
    Efroze is a clean company dirty politics and conspiracy they are being framed
    They will come out clean eventually Recommend

  • H.L
    Feb 4, 2012 - 12:59PM

    Agreed with Abid…morever media is also just doing propaganda claiming Mr Abdullah Feroz ran along with his sons whereas it is just an absurd news he has not done any wrong there is no body who is mad enough to dis repute his company , a company which has name in local and International market, it has been used since decades and by so many cardiac patients there is not a single instance when some thing of this sort happens ..and why are ppl just dying in punjab and not in otha cities or contries this is just to disrepute the company name and brand name and it is more of a political issue now, politicians are just doing blame games it is though agreed that a batch was contaminated and we can think it this way too mite b some employee has done it out of rivalry or mite be any foreign forces india or some otha pharma companies might buy an employee inorder to hamper export of pharma and otha pharma companies can take favour from this situation as in terms of sales they could increase their sales incase one pharma is closed that is the theory of market share, and no body can bring a deliberate disrepute to the comapny

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  • U.S
    Feb 4, 2012 - 3:33PM

    Probe teams are facing difficulties due to missing purchase record of injurious PIC drug Isotab.

    According to the sources, Pakistan Institute of Cardiology administration gave order of 2 million Isotab tablets to Efroze Pharma in September 2011. As per record of PIC, the delivery of 2 million tablets was shown in two batches i.e. J092 and J095 from which there were received 1.05 million tablets of batch J092 and 0.95 million tablets of batch J095.

    Surprisingly, the tablets recovered from the patients, affected from contaminated medicines, were of batch J093 but there is no record of this batche in the PIC neither any lab test has been conducted of this batch.

    The tablets sent by the Punjab government for foreign test were also from batch J093 but there was no stamp of hospital on it.

    According to sources investigation teams are facing difficulties due to missing record of batch J093

    Recommend

  • U.S
    Feb 4, 2012 - 3:34PM

    Probe teams are facing difficulties due to missing purchase record of injurious PIC drug Isotab.

    According to the sources, Pakistan Institute of Cardiology administration gave order of 2 million Isotab tablets to Efroze Pharma in September 2011. As per record of PIC, the delivery of 2 million tablets was shown in two batches i.e. J092 and J095 from which there were received 1.05 million tablets of batch J092 and 0.95 million tablets of batch J095.

    Surprisingly, the tablets recovered from the patients, affected from contaminated medicines, were of batch J093 but there is no record of this batche in the PIC neither any lab test has been conducted of this batch.

    The tablets sent by the Punjab government for foreign test were also from batch J093 but there was no stamp of hospital on it.

    According to sources investigation teams are facing difficulties due to missing record of batch J093Recommend

  • mnxa
    Feb 4, 2012 - 3:50PM

    what abt da other 4 medications ( clopidogrel etc)..?? what was da final verdict for them??

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  • U.S
    Feb 4, 2012 - 3:55PM

    My question would be when there is no record of receiving that batch and when the company has a different batch No supplied to the hospital how can Punjab Government send a non-registered batch for testing and seal the company on this basis.
    Efroze Pharma has a clean record for the past 35 years, I as a user of their medicine know that their products of the highest quality and standard.

    The fact that its a huge conspiracy against the firm may InshALLAH come in front of the public soon but the thing which is most upsetting is that the people of our country form opinions about things without even knowing anything. The comments above about the company being shut and Mr. Abdullah Feroz be punished. On what basis have you formed the opinion and who gives you the right to pass judgements without knowing any history about the company or the people owning it!
    The first free of cost BURNS hospital for the poor runs under the presidentship of Mr. Abdullah Feroz, so the millions of dollars you are assuming are in his bank account actually go to the poor. The least we can do for such great people is pray for them!
    The media should be responsible and rather than trying to earn money over every news, The news must first be confirmed! Also, they should show what the later investigations are showing in favor of the company as a BREAKING NEWS because if people have the right to know, they have the right to know everything!

    Recommend

  • Adduu
    Feb 4, 2012 - 6:02PM

    I use the daibeties medicines from Efroze in England for my mum
    Politicians are killing every industry Railway,Pia,Gas,Steel mil,it’s now exports 20coubtries buying medicines only punjab gets the hit is this a joke
    Efroze is clean isotab will be back on shelfs
    Adduu uk

    Recommend

  • Kazmis
    Feb 4, 2012 - 10:59PM

    @U.S:
    Yes all details should be given equal chance. Media is just trying to move affairs in a single direction.. Surprisingly whole media. It seems that all channels are under one hand. Karachi Factory is serving all people of Pakistan since long and this is going to be the ultimate. when some one is raising the voice regarding the batch number , Investigate it please.

    Recommend

  • Dr. Amir Khan
    Feb 10, 2012 - 11:01PM

    Yeah I do agree that it was just an error. The Chairman of Efroze has himself agreed to the same however their case should be tried under the Drugs Act and Not under the Murder Act (302)

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  • Dr. Amir Khan
    Feb 10, 2012 - 11:05PM

    Isnt it crazy that now entrepreneurs are now being tried for mistakes made by technical staff. The Drugs Act states that the company has to have a Production and a Quality Control Managers with certain qualifications and experience. The Chairman or the Managing Director of the company do not even have the power to start a product for production or to release a batch. In case they dont have the authority how can they be liable for a mistake which the technical staff made. I personally feel that the Production and Quality Control manager of the company should be tried and the management should be set free

    Recommend

  • Ahsan Iqbal
    Feb 13, 2012 - 10:18AM

    @mnxa: This is the final verdict for the rest of the suspected medicines…

    http://drugsanddeathsinpakistan.blogspot.com/2012/02/british-medicines-and-healthcare.htmlRecommend

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