Toxic cough syrup


Toxic cough syrup refers to a number of incidents in which one of ingredients in cough syrup, glycerine, has been replaced with diethylene glycol leading to mass poisonings. Diethylene glycol is a less-expensive alternative to glycerine for industrial applications; however, diethylene glycol is nephrotoxic and can result in multiple organ dysfunction syndrome, especially in children.

History

There were poisonings in Panama, China, Haiti, Bangladesh, Argentina, Nigeria, and India between 1992 and 2007, due to contaminated cough syrup and other medications that incorporated inexpensive diethylene glycol instead of the intended glycerine.

Panama

In May 2007, 365 deaths were reported in Panama.
In Panama, the imported diethylene glycol came from a Chinese manufacturer, sold under the unfortunate name TD glycerine, which means 'glycerine substitute'. A Spanish middleman filling the customs declaration changed the name to glycerine.
The China Food and Drug Administration did not regard the toxic cough syrup scandal as being China's fault. The Chinese manufacturer exported the diethylene glycol under the name TD glycerine, but the Spanish middleman Aduanas Javier de Gracia changed the name to glycerine when he filled the customs declaration in Panama.

Bangladesh

Discovering and tracing a toxic syrup to its source has been difficult for health care providers and governmental agencies due to difficult communication between the governments of developed countries and developing countries. For example, Michael L. Bennish, an American pediatrician who works in developing countries, had been volunteering in Bangladesh 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 United States, allowing pharmaceutical laboratories in Massachusetts to identify the poisonous diethylene glycol, which can appear very similar to the less dangerous glycerine. Bennish went on to author a 1995 article in the British Medical Journal about his experience, writing that, given the amount of medication prescribed, death tolls "must be in the tens of thousands".