LAHORE, Nov 27: Special teams investigating the deaths apparently caused by the intake of a cough syrup find themselves in the usual blind alley: an absence of advanced laboratories in the country to detect “inactive ingredients” in a medicine.

The investigation teams in their initial assessment had declared that narcotics or such other prohibited substance might have been added to the cough syrup, which led to the deaths of 17 young people.

The officials stressed postmortem of the bodies and laboratory analysis of the contents or organs to determine the cause of deaths. The bodies were dispatched for autopsy the result of which is awaited.

Similarly, the samples for pathology and chemical analysis also were sent (the reports are awaited in this case, too).

Meanwhile, a first Drug Testing Lab (DTL) analysis released a couple of days ago declared “the syrup contains active ingredients – Dextromethorphan and chlorpheniramine maleate. No step has been taken for analysing the drug to detect inactive ingredients which also have serious side effects.

A senior official close to the probing team told Dawn that the most crucial step of the ongoing investigations was to trace inactive ingredients in the syrup. He said the government officials had faced an awkward situation earlier when the Punjab Institute of Cardiology scam surfaced in February 2012. At that time they had found all major labs in the country incapable of providing the service.

Even the DTL and the PCSIR labs had expressed their inability to process the drugs in the PIC scam for examining inactive ingredients. Consequently, he said, the inquiry process came to a halt for some time and later the samples of the controversial drugs were dispatched to the British Medicines and Healthcare Products Regulatory Agency (MHRA) to examine the adulteration of inactive ingredients.

The MHRA -- an executive agency of the Department of Health, UK -- in its reports had traced 50mg Pyrimethamine contamination in the drug (Isotab 20mg tablet). The inquiry report was later finalised on the basis of the said report.

“Our labs including the DTL, the PCSIR and the newly- established Forensic Science Agency are still incapable of detecting unknown chemicals which are either added accidentally or with bad intention,” the official said, adding that the probing teams would have to approach the MRHA or other labs abroad for the purpose.

Special Assistant to Chief Minister on Health Khwaja Salman Rafique admitted that the country lacked this vital facility. He said the Punjab government was considering a proposal to investigate the fresh case of drug reaction on the lines of the PIC scam probe.

A five-member team of medical experts has finalised and forwarded its preliminary report to the Punjab government. The report suggests that the cough syrups of all pharmaceutical companies and related drugs should be put in the prescription list to avoid such incidents in future.

The team is headed by King Edward Medical University’s Prof Dr Irshad Hussain and also comprises senior faculty members and the chief chemical examiner.

“The medical and clinical history of those who died or developed health problems said they all were drug addicts,” Prof Irshad said, while quoting contents of the report. He said the victims had been taking the syrup for the last one year.

According to the signs and symptoms they might have taken heavy dose of Dextromethorphan which led to abnormal blood pressure and heart beat.

Prof Irshad said the report also carried guidelines for treatment of patients visiting emergencies of the state-run hospitals with the complaints of drug(s) reaction.


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