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Contaminated Cardiac Drugs Kill More Than 100 in Pakistan

January 27, 2012 (Lahore, Pakistan) — More than 100 people have died in Pakistan and hundreds more have been hospitalized after having received contaminated drugs for heart conditions. And many more people may have been exposed, authorities say.
The drugs, given out free by the state, were supplied by the government-run Punjab Institute of Cardiology in Lahore, according to multiple media reports.
Patients have experienced a rapid drop in white blood cells and platelets and damage to bone marrow, with bleeding from the nose, mouth, and urinary tract reported.
The owners of three pharmaceutical companies suspected of supplying the medicines have been arrested and the factories closed down. Five other companies are said to be subject to legal action.
At a press conference earlier this week, Health Secretary Dr Jahanzeb Khan said five different medicines were given to cardiac patients at the Punjab Institute of Cardiology. The drugs implicated included include versions of simvastatin, clopidogrel, amlodipine, and aspirin, according to local reports [1]. Samples of the drugs have been sent to Europe for testing. The contaminant is not yet known, but it has been speculated that it could be a heavy metal such as mercury or lead.
Khan reported that the contaminated medicines could have been given to up to 46 000 patients. The authorities are in the process of contacting these patients and offering them advice.
The deaths started to be reported in December, and the authorities have been criticized for their slow response, with alerts about the contaminated drugs having been announced only in the past few days. The authorities have also been criticized for buying drugs from cheap sources.
Speaking on January 26, Parliamentary Secretary for Health Dr Saeed Elahi reported that five tablets--Cardiovastation, Concont, Isotab, Solprin, and Atenolo--were implicated and that around 451 patients were affected [2].
Elahi explained that the Punjab Institute of Cardiology purchases medicines from the company that bids the lowest rate. The contaminated medicines were distributed from December 15, 2011 until the first week in January [3]. He said the first case was diagnosed on December 20, 2011, but the issue was confirmed on January 5, 2012, when about seven people had died. Elahi added that the distribution of the suspect drugs had been suspended, and 70% of the tablets already distributed had been recovered. He also noted that raw material used in the medicines was imported from China and Dubai.
According to postings on one Pakistani political website [4], all drugs used in heart disease are imported from abroad (mainly China and India), with Pakistani companies just formulating the finished dosage form, and the import process and health system is running "without any inspection and monitoring system."
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