Panama agency's prepared 'medicine' has deadly effects

Since then, his condition has become known only too well to Panamanians who have friends or relatives among the hundreds of identified victims.

The culprit is not a microorganism, but diethylene glycol, a toxic automotive antifreeze component that was mixed mistakenly by this country's social security agency into 450,000 bottles of cough syrup for distribution to the poor. At least 20,000 were distributed across the country.

Ingestion of the toxic brew can cause kidney failure, chronic headaches, high blood pressure, and in the current Panamanian episode, there have been at least 67 confirmed deaths. Fatalities here actually may have exceeded 300, officials say.

The fatal ingredient originated in China. It was shipped to a Spanish company and then to the private firm Medicom in Panama that resold it to the country's social security agency, which mixed the "medicine" in its laboratory. The Panamanians thought they got glycerine, a component of many medicines, but in fact got the highly toxic diethylene glycol.

Although the case is still playing out amid much finger pointing, the poisoning seems to be a tragic confluence of confusion over labeling, sloppy controls along the supply chain, and poor to nonexistent testing in the Panamanian labs where the syrup was mixed.

For example, a Chinese investigation found that the product had been labeled "TD glycerin," a misleading name that could be confused with glycerine, a harmless, more expensive sugar substitute.

And the Panamanian firm had ordered glycerine, and didn't know that the chemical it received was not in fact medicinal.

Panama's social security agency lab could have averted the disaster if it had properly tested the syrup, officials said.

"The terrible sin of Panama is having a system where you have a production laboratory mixing medicine that doesn't adequately test components," said Jorge Motta, a Stanford-educated doctor who is director of the Gorgas Memorial Institute, a research institution specializing in tropical medicine.

Last week, after an autopsy was performed on Allan's exhumed body on orders of the attorney general's office, and tell-tale signs of the toxic chemical were detected in his remains, his name was added to the official list. His family now becomes eligible for a share of $6 million that the government has set aside for a victims fund.