Eye injections contaminated during transportation

LAHORE: A laboratory test report of Avastin injection has revealed no contamination in the original drug.

"The contamination was, however, found in the refilled vials or syringes due to mixing of rainwater during transportation through bus cargo services," revealed Ministers of Health Dr Jamal Nasir and Dr Javed Akram while addressing a joint press conference here at DGPR office on Monday.

The ministers confirmed that the original product, manufactured/imported by multinational pharmaceutical company, was safe and therefore will continue to be used for treatment of cancer patients. The use of Avastin injection for treatment of eyes will, however, remain suspended till a committee of ophthalmological experts lay out guidelines in this regard.

The provincial ministers said that a committee consisting of six ophthalmologists has been formed under the direction of Chief Minister Mohsin Naqvi to assess the matter to decide whether or not permission can be granted for use of this injection for the treatment of eyes.

In the light of the recommendations of this committee, the SOPs on the use of injections for eye treatment will be prepared and approved by the Cabinet. The ministers informed that a total of 66 patients were affected by this injection. Almost 80 percent of the affected patients belonged to districts other than Lahore. As many as 57 cases were reported in Southern Punjab.

Dr Javed Akram said that the scope of the inquiry was extended after surfacing of this scandal, which found the practice of the usage of off-label medicines on a large scale.

He said that Avastin injection is free from any contamination. "We will assess the matter to import injections under the government's umbrella," he added. These injections were filled in small syringes and sent to Multan, Bahawalpur, Rahim Yar Khan and Sahiwal and other districts of South Punjab through private bus cargo service.

The standard operating procedures were not followed in the process of transportation of injections, which caused the eye infections among the patients. The drugs, especially injections, are not allowed to be transported via intercity bus cargo services. In buses, the luggage compartment is built under the seats. The injection syringes sent out of Lahore on September 20 were not properly packed. On that day, there was heavy rain in Lahore for 12 hours.

During the journey, water standing on the roads spilled into the luggage compartment of the vehicle, which caused contamination in the injections, minister Dr Jamal Nasir said and added after this incident, Punjab Healthcare Commission (PHC) suspended 22 drug inspectors, while the services of 26 eye surgical centres out of 48 inspected were suspended.

Director General Drugs Control Muhammad Sohail said, “We have identified the root cause of the Avastin injection fiasco as a result of the comprehensive drug analysis conducted by the Drug Testing Laboratories as per international standards. The injection's contamination was caused due to its unauthorised transportation from one city to another via public transport. The injections and medicines are transported from one place to another via safe mode of transportation by placing them in a special box and maintaining the temperature.”

Dr Sohail said Avastin is a time-tested medicine for treatment of cancer patients, and appealed not to discard the medicine or malign the manufacturing/importing multinational pharmaceutical company, he said.

DIG Investigation Imran Kashwar said six culprits were involved in this business, who used to send this injection for dispensing upon patients in South Punjab. Initially, three accused, namely Bilal, Maqsood and Asim, were identified.

"A case has been registered in the Faisal Town police station and five accused have been arrested," he said, adding that all responsible will be strictly punished.