Coldrif syrup was supplied only in Chhindwara:Banned for under-4s, 7 of 9 victims in this age group; expert says cause of death from medicine unclear

Nine children have died from kidney failure in Chhindwara, Madhya Pradesh, after being given Coldrif and Nextro-DS cough syrups on the advice of local doctors. Three teams are currently investigating the case, and it has emerged that the syrup was supplied from Jabalpur. In Chhindwara, the syrup was provided by Mahakaushal dealer Kataria Pharmaceuticals at the request of a manager from Sri Sun Pharma. Notably, Coldrif syrup was demanded only in Chhindwara, not elsewhere in the Mahakaushal region. Director of Health Services issued letters Shockingly, in 2023 the Director General of Health Services had issued letters to all states warning that medicines of this formula should not be given to children under four years old. Despite this, doctors in Chhindwara prescribed it. Seven out of those who died were aged four years Of the nine children who died, seven were aged four years or younger, while the other two were five years old. So far, reports for nine of the 19 collected samples have been received, all showing no irregularities. However, the reports for Coldrif and Nextro-DS syrups are still awaited. Mahakaushal dealer ordered 660 Coldrif syrups In September, Mahakaushal dealer Kataria Pharmaceuticals ordered 660 Coldrif syrups from Sri Sun Pharma in Chennai. Of these, 594 were supplied to three medical shops in Chhindwara – Ayush Pharma, New Apna Pharma, and Jain Medical General Store – while the remaining 66 were kept at the dealer’s office. Following the incident, Jabalpur Drug Inspector Sharad Kumar Jain, acting on the Drug Controller’s instructions, inspected Kataria Pharmaceuticals’ office at Naudra Bridge. He confirmed that Sri Sun Pharma has only one dealership in the Mahakaushal region and that Coldrif syrup is not supplied anywhere else in Madhya Pradesh. Even in Chhindwara, it was sent to only three shops. Investigations by three teams Authorities are investigating how nine children died. Questions include whether the cough syrup was contaminated or if other factors were involved. Three separate teams are probing the matter at central, state, and district levels: Dealer background and supply Kataria Pharmaceuticals has held the Sri Sun Pharma dealership in Chennai for 20 years, ordering different syrups regularly. Satish Verma, the company’s representative in Chhindwara, requested the Coldrif supply. Dealer Rajpal Kataria stated that the company’s medicines have never caused harm before, and it is under investigation whether the children’s deaths were caused by the syrup. Warnings against syrup use in young children The Directorate General of Health Services (DGHS) had issued a letter on December 18 2023 to all states stating that Chlorpheniramine Maleate IP 2mg plus Phenylephrine HCL 5mg drops should not be given to children under four years old, and this warning must appear on the drug label. Despite this, the syrup was prescribed in Chhindwara. Sample collection and testing A joint team from the National Centre for Disease Control (NCDC), National Institute of Virology (NIV), Central Drugs Standard Control Organisation (CDSCO), and state officials collected six samples, including cough syrups, from the site. Tests found no Diethylene Glycol (DEG) or Ethylene Glycol (EG) in these samples. The State Food and Drug Administration (SFDA) collected 13 additional samples. Reports for three – Defrost syrup, Vox MDS syrup, and Alto E syrup – have been received, all showing no irregularities. Reports for the remaining eight samples, including Coldrif and Nexa-DS, are still pending. Joint monitoring and future steps A high-level meeting on Friday brought together officials from NCDC, NIV, CDSCO, the Madhya Pradesh Public Health and Medical Education Department, and SFDA via video conferencing. Officials said reports for the remaining 10 samples, including Coldrif and Nexa-DS, are expected within three to four days. Even if these reports come back normal, a fresh survey of affected areas will be conducted to trace the source of ethylene glycol and diethylene glycol, chemicals used in the vehicle industry that can cause kidney failure in children. Expert comment on the matter Chandresh Jain, former secretary of the Jabalpur Chemist Association, said it is too early to conclude anything. Medicine is life-saving, and the exact cause of death from any medicine cannot be easily determined