10 die due to PIC medicine reaction

At least 10 cardiac patients died due to reaction from medicines provided by the Punjab Institute of Cardiology (PIC) Lahore, a private TV channel reported.
More than 150 patients have reached different hospitals of Lahore after reaction from medicines from PIC while the number of affected patients and people dying due to the medicine reaction is increasing.
Health Secretary Jahanzeb Khan, while talking to the channel, said that deaths due to medicine reaction were deplorable and strict action would be taken against the responsible.
Provincial Health Minister Saeed Elahi said the tragedy happened due to improper storage of medicines and added that stern action would be taken against the people behind this mishap.

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1) It is effective for the treatment of many neuromusculoskeletal conditions, such as back pain, neck pain, headaches, etc. 

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3) It is usually covered by private health insurance, so the cost is low 

4) Doctors of chiropractic have some of the highest patient satisfaction ratings of all doctors because they often will take the time to discuss the health problems, options for treatment, etc.

Free medicine disaster: Lab with expired licence supplied PIC

LAHORE: 

As the death toll of those who took free medicine from the Punjab Institute of Cardiology (PIC) crosses 100, the story – perhaps inevitably – has moved into the realm of the corrupt and sinister.

It has emerged that the licence of one of the three pharmaceutics laboratories that supplied the apparently contaminated drugs to the PIC expired in April 2011. The company continued to manufacture the medicines in bulk and even supplied them in the open market in addition to governmental hospitals.

The licence of Alfalah Pharma (Pvt) Limited expired seven months ago – but provincial drug inspectors were totally ignorant of this fact, according to sources. The factory has now been sealed by authorities.

The facts were uncovered by federal drugs inspectors as well as officials from the Federal Investigation Agency (FIA), and raise uneasy questions about the workings of regulatory authorities.

Meanwhile, the PIC is yet to provide relevant records to the joint investigation team, despite several reminders.

The FIA continues to probe the matter. On Wednesday it sent a sample of the tablet Solprin, manufactured by Pharmawise Laboratories (Pvt) Ltd, to the Central Drug Laboratory in Karachi for analysis. The FIA also sent letters to the provincial secretary of health as well as other officials to find out the exact death toll.

The investigating team has also examined records relating to stock, supply and manufacturing of the companies who made the drugs.

The situation is only worsening, however, as the Punjab government on Wednesday withdrew a batch of 200,000 aspirin tablets from the PIC after they were found to be contaminated.

Parliamentary Secretary for Health Dr Saeed Elahi, confirmed the story to The Express Tribune and called for an immediate withdrawal of the drug from the hospital’s dispensary.

The batch was dispatched to PIC’s dispensary from December 16 to January 12. Elahi also said that the government had ordered an investigation to find out why the medicine was contaminated.

After the PIC’s free heart medicine fiasco, another spate of panic might start, as there is a chance that tablets from this batch might have been sent to other pharmacies in the city.

The panic will take some time to subside, as it has emerged that 400-500 patients were given the same medicine at the hospital.

The medicine triggered an unknown disease that is said to get deposited in the bone marrow and ultimately ends the body’s resistance. The generation of white blood cells stops in the body and a severe chest infection also takes place.

The Punjab government has tried to calm anger, and distributed compensation cheques on Wednesday to the relatives of those who died after taking the PIC drugs.

This was not enough for the leader of the opposition in the province, Raja Riaz, who said that Punjab Chief Minister Shahbaz Sharif, who is ultimately in charge of the health ministry, is responsible for the casualties.

Riaz said that it was the function of health minister to overlook the performance of his department, but unfortunately the obstinate CM has not learnt the lesson after about 800 people died of dengue last year.

He said that Sharif has been too ashamed to come to the Punjab Assembly and urged him to explain him actions in person.

Riaz had earlier told the media that the PPP is considering asking relatives of those who have died to lodge an FIR against Sharif and the negligence of his departments. He also demanded that the chief justice of Pakistan take suo moto notice on the PIC incident. 

2012 Pakistan fake medicine crisis

During late January 2012, a fake medicine crisis at the Punjab Institute of Cardiology (PIC) hospital in the Lahore region of Punjab, Pakistan, claimed the lives of over 100 heart patients. According to various reports, the incident involved patients who had been receiving treatment at the hospital and had been prescribed with counterfeit antihypertensive medicines.^[1] The spurious medicine(s) triggered a serious adverse reaction by depositing itself in the bone marrow and ending the body's resistance. The generation of white blood cells stopped in the body. Among the symptoms of the disease were a severe chest infection, change in skin colour/pigmentation, low platelet count and blood vomiting.^[2]

Suspect drugs include isotab (isosorbide nitrate), lipitor (atorvastatin calcium), cardiovestin (simvastatin), alfagril (clopidogrel), concort (amlodipine), and soloprin (aspirin).

The medicines were being distributed by the hospital free of charge mainly to poor people. These had been purchased directly from a health charity International Health Partners (IHPs) in an agreement facilitated by the regional world health organization office.^[3] The total number of people who may be at risk after taking medicine from the hospital may be as high as 46,000 according to one report.^[4]

Contents   [hide]  1 Crisis 2 Inquiry 3 International Reaction 4 See also 5 References

[edit]Crisis

In mid-January 2012, several cardiac patients registered with the Punjab Institute of Cardiology (PIC) started showing up at different public and private hospitals in Lahore suffering from a sudden drop in platelets and white blood cells and bleeding from different parts of the body. The doctors initially took the symptoms as that of dengue outbreak that had hit the city in the last Fall. However, it was soon realized that the symptoms were seen in a PIC cohort and were more consistent of a drug reaction. As a result, the Department of Health constituted a high-powered committee to probe the incident.

[edit]Inquiry

Almost all victims were from the Lahore area. One fatality was also recorded in Multan.^[5] The Chief Minister of Punjab Shahbaz Sharif vowed "stern action" against those responsible and announced a compensation of Rs. 500,000 each for the victims' families.^[4] The Federal Investigation Agency (FIA) formed an investigation team to probe the incident on the orders of Minister for Interior Rehman Malik.^[6] The team arrested some people reportedly involved in the distribution of the medicine. Cases were also registered against three pharmaceutical companies who made the medicine.^[1][2]

Investigations revealed that the licence in one of the three pharmaceutical laboratories which supplied the contaminated drugs to the PIC had long expired in April 2011. Despite this, the company continued to manufacture the drugs in bulk and supplied them to government hospitals and open markets.^[7] As the death toll exceeded one hundred, the Lahore High Court ordered respondents involved in the case to file their replies by the 30th of January.^[8]

Tests performed by the British Medicines and Healthcare Products Regulatory Agency (MHRA) in the United Kingdom indicated that one of the five suspected drugs - Isotab - was contaminated. The report also showed that Isotab contained Pyrimethamine which is in fact used for the treatment of malaria. The presence of pyrimethamine proved to be toxic.^[9]Tests done at the Central Drugs Laboratory in Karachi also verified the presence of pyrimethamine used in certain combinations to treat malaria in a sample of the Isotab tablet (20mg). The laboratory also declared a batch of Alfagril as substandard.^[10]

The FIA, while seizing raw material from two of the raided firms; Swiss Pharmaceuticals and Zafa Pharmaceuticals, also sealed a Karachi-based factory of Efroze Chemical Industries. The FIA also put names of three owners of the raided firms on the Exit Control List (ECL) besides blocking the official website of Efroze Chemicals. The sealed factory was located in Korangi Industrial Area, Karachi.^[11]

The Pakistan Medical Association (PMA) condemned that a lapse in quality control while acquiring medicines was the main reason for the deaths caused by drug reaction and has demanded the federal and provincial governments to establish a drug regulatory authority.

Karachi: Expired medicines seized in raid on hospital

KARACHI: Officials of the Anti-Corruption Establishment (AEC), Sindh, raided theLyari General Hospital on Saturday for allegedly causing losses to the nationalexchequer, and seized a large quantity of medicines, which also included expiredones.

According to Director ACE (Inquiries) Javed Ahmed Baloch, they had received information that some staffers of the hospital were involved in embezzlement vis-à-vis purchasing medicines and also usingexpired medicines.

Consequently, an investigation was initiated and a raid was conducted on the hospital on Saturday evening. During the raid, the store and administration office were searched and the staffers on duty were held. During the verification process, many medicines used for heart and other ailments were found expired and even the hospital staff had no record of the inventory.

The ACE officials seized many medicines which were found to be spurious or of low quality as well as their purchase record. The scrutiny of the record revealed that one rupee was the official price of a medicine, and when the hospital purchased it in a bulk quantity it cost Rs50 paisa, but in their tender record the staff had purchased it forRs3.75, which was much higher.

Similarly, the rates of many other medicines were shown much higher in the hospital record. Javed Baloch said that they would complete the inquiry within two to three days, following which responsibility would be fixed and the elements found involved in this practice would be taken to task.

Expired medicines in Pakistan

THIS is regarding a dangerous dilemma which is faced by the citizens of Pakistan in general and by the residents of Mansehra in particular.

I bought a medicine from a store located opposite the District Headquarters Hospital (Mansehra) for my wife. I was shocked to learn from a nurse there that it was an expired medicine. I was further shocked on learning that the medicine had been kept in store even though it had expired six months back.

I am sure that during the past six months many packets of this expired medicine must have been sold to patients. I had been buying the medicine from the store for at least a month. It is pathetic that neither the owner of the store nor any drug inspector did anything to remove expired medicines from stock. This shows that there is a symbiotic relationship between owners of pharmaceutical stores and (read drug inspectors).

I request the authorities concerned to make sure that no expired drugs are sold in Mansehra.