Encuentran plaguicidas con anomalías

decomisan productos vencidos.

Encuentran agroquímicos con anomalías

Mario A. Muñoz
andresm@prensa.com

Al inspeccionar 55 empresas de Panamá Este, Oeste y Centro, las autoridades detectaron un total de mil 658 productos vencidos (mil 230 agroquímicos sin fecha de vencimiento y 428 vencidos).

La Autoridad de Protección al Consumidor y Defensa de la Competencia informó que el Almacén Xtra (251 productos) ubicado en el centro comercial Los Pueblos y el almacén Novey (352 productos) en Calidonia, fueron los comercios con la mayor cantidad de productos sin fecha de vencimiento (entre productos para jardinería y para agricultura).

En la sucursal de Capira del Almacén Casa Económica se encontraron «grandes concentraciones de gases tóxicos, producto del mal manejo de los agroquímicos».

Los productos vencidos al perder sus propiedades se transforman en un riesgo para la salud humana al generar la creencia falsa de que han perdido su poder tóxico. Incluso los envases se utilizan como recipientes para chicha.

———————————————-

salud.

Reportan mal uso de agroquímicos

Mario A. Muñoz
andresm@prensa.com

Las autoridades en un reciente operativo comprobaron en una muestra de 55 locales, entre almacenes y supermercados, que hay un mal uso en la venta de pesticidas, insecticidas y productos para jardinería altamente tóxicos.

Según la Autoridad de Protección al Consumidor y Defensa de la Competencia, el mal uso se extiende a los consumidores, lo que podría traer efectos en la salud.

Cada local debe tener personal idóneo y certificado, requisito que al no cumplirse impide una debida orientación a los consumidores.

En el Centro Agropecuario La Fortuna se encontró un insecticida altamente tóxico-VIDATE 24 SL-, cuyo mal uso puede producir contaminación si se filtra por corrientes de agua.

Las etiquetas por obligación deben estar en español.

Sin embargo, la Autoridad encontró que en las empresas «la información se traduce de forma incompleta»

Otra anomalía es que no se reservan lugares exclusivos a la venta de agroquímicos, tal como indica la ley.

El operativo «Verificación de Agroquímicos» se llevó a cabo desde el 4 hasta el 18 de junio.

La Prensa, 26 de junio de 2007

Préstamo para sanear la Bahía de Panamá

Japón concede préstamo para sanear la bahía

AMPLIAR

B/ 160 millones más.

 Elizabeth González A.


PANAMA AMERICA

POR UN monto de B/.160 millones, Panamá y Japón suscribieron ayer el convenio para el financiamiento de la segunda fase de la primera etapa del Proyecto de Saneamiento de la ciudad y la bahía de Panamá.

El préstamo otorgado por el Banco de Cooperación Internacional del Japón, según el acuerdo, establece que el período de amortización será de 18 años, después de 7 años de gracia, y devengará un interés anual de 1.2%.

Con esa suma se financiarían parte de los fondos requeridos para la segunda fase del proyecto, incluidos aspectos como la contratación de una consultoría para la asistencia en la administración del proyecto, la construcción y operación por cuatro años de una planta de tratamiento de aguas residuales y la construcción de un sistema interceptor de aguas residuales.

Panamá América, 26 de junio de 2007

Inicia I fase del saneamiento de la Bahía de Panamá

BAHÍA DE PANAMÁ.

Dan luz verde a los trabajos de saneamiento

Eliana Morales Gil
emorales@prensa.com

Ayer se concretó otro paso importante para el proyecto de saneamiento de la bahía en la capital. El presidente, Martín Torrijos, entregó la orden de proceder para la instalación de tres colectoras que estarán ubicadas en los ríos que atraviesan la ciudad.

Juan Antonio Ducruet, director del proyecto, aseguró que las colectoras –que son tuberías paralelas a los ríos cuya tarea es la de recoger las aguas residuales– estarán ubicadas en las cuencas del Río Abajo y la quebrada Monte Oscuro. El segundo grupo se instalará en el río Matías Hernández, la quebrada Palomo y la quebrada Santa Rita, y el tercer juego estará en la cuenca del río Juan Díaz, el río Palomo y la quebrada Espavé.

En total, son unos 50 kilómetros de tuberías colectoras, explicó Ducruet. Las empresas Constructora Urbana, FCC Construcción y Constructores Profesionales de Ingeniería serán las encargadas de realizar los trabajos. Esta etapa del saneamiento de la bahía le significa al Estado una inversión de 30 millones de dólares.

La Prensa, 6 de junio de 2007.

Historia del veneno Dietilene glycol en medicamentos en Panamá

DIETILENE GLYCOL. RASFER INTERNACIONAL CULPA A MEDICOM.

El nexo español de la tragedia

La gerenta general de la firma española, Susi Criado, aseguró que no sabía qué uso le darían a la glicerina.

La empresaria anunció que demandará a Medicom. ‘No nos negamos a dar la cara ante nadie’, advirtió.

 

LA PRENSA/Archivo

JARABE. La Caja de Seguro Social distribuyó la medicina con el químico que usualmente se usa como anticongelante. 849078

Santiago Fascetto
sfascetto@prensa.com

La empresa española no tiene dudas. La gerenta general de Rasfer Internacional, Susi Criado, está convencida de que la «glicerina» que mató a cien personas en Panamá se «transformó» en el químico letal dietilene glycol detrás de las paredes de la local Medicom, a quien le envió 46 bidones de esa sustancia química el 23 de septiembre de 2003.

«En ningún momento Medicom nos aclaró que el producto era para uso medicinal, para fabricar fármacos ni para ninguna otra cosa», dijo Criado a La Prensa, en diálogo telefónico desde España. Según consta en la investigación judicial, la empresa panameña no avisó a Rasfer que la glicerina pura debía ser apta para consumo humano.

«Nosotros ni vemos el producto. El ministerio de la Sanidad no nos autoriza a manipular la mercadería», explicó Criado, quien anunció además que demandará a la firma panameña. «Vamos a demandar a Medicom porque nos hicieron mucho daño», dijo.

Medicina tóxica deja rastros

El dietilene glycol ha figurado en por lo menos ocho envenenamientos masivos en el mundo. Los investigadores calculan que miles de personas han muerto. Si bien en muchos casos el origen preciso del veneno nunca se ha determinado, documentos muestran que, en tres de los últimos cuatro casos, fue fabricado en China, importante fuente de medicamentos apócrifos.

Panamá es la víctima más reciente. El año pasado, los funcionarios gubernamentales del país añadieron, sin su conocimiento, dietilene glycol a 260 mil botellas de medicina para el resfriado, con resultados devastadores. Las muertes de Panamá llevan directamente a compañías chinas.

DIETILENE GLYCOL. JUSTICIA ESPAÑoLA ENCUENTRA INCONGRUENCIAS EN DOCUMENTOS.

Tras los pasos de la inofensiva ‘glicerina’

Susi Criado, de la empresa Rasfer, señaló que el Ministerio de Sanidad Español prohíbe que las importadoras revisen la mercancía recibida de países fuera de la Unión Europea.‘No tenemos laboratorio para tocar el producto’, indicó. La Fiscalía de Barcelona fijó en esa ciudad la jurisdicción de la demanda entablada por los familiares de las víctimas. En España, el juicio por este caso podría tener una duración de hasta cinco años.

LA PRENSA/Ana Renteria

FACSÍMIL. A la izquierda se encuentra el análisis en chino de los productos químicos que mandó a España Fortune Way Company. A la derecha, la traducción al español que hizo Rasfer.

Presione para ver

Redacción de La Prensa
panorama@prensa.com

El veneno recorrió sin control 18 mil 496 kilómetros. Pasó por tres continentes. Se subió a dos barcos de carga y traspasó tres aduanas. A pesar del largo viaje y de las innumerables «barreras» legales, el líquido mortal llegó hasta el estómago de cientos de personas, camuflado de inocente jarabe para la tos que distribuyó la Caja de Seguro Social. Y en otros casos se introdujo sigiloso por medio de una pasta para la piel.

El recorrido del mortal químico dietilene glycol, encubierto de «glicerina pura», es una cadena que aún la justicia no puede liberar, aunque ahora asoman algunas pistas.

La empresa española Rasfer Internacional reetiquetó los 46 bidones de supuesta glicerina que envió a Panamá el 23 de septiembre de 2003, según investigaciones realizadas por autoridades judiciales de España.

La gerenta general de Rasfer Internacional, Susi Criado, admitió que un empleado de la empresa -Joan Ramón Bastlledni- sacó las etiquetas que pegó en los envases la firma importadora china Fortune Way Company y colocó unas de Rasfer con la dirección de Medicom, la firma panameña que recibió la mercadería.

«El resto de las etiquetas del fabricante original con el nombre, lote y demás datos no se tocaron. En ningún momento se abrieron ni manipularon los bidones», remarcó Criado, en declaraciones telefónicas a La Prensa desde España.

Pero, según investigaciones realizadas en España, cuyos resultados están contenidos en la asistencia judicial que solicitó el Ministerio Público panameño, cuando los funcionarios de la Policía española llevaron a cabo la inspección en Rasfer descubrieron que en el documento de embarque del producto hubo un error o alteración en la identificación del número de lote.

En sus documentos de compra-venta de la mercancía remitida a Rasfer, las empresas chinas Fortune Way Company (exportadora) y Taixing Glycerin Factory (productora) identifican el lote de glicerina con el número 13071601.

Y con esa misma numeración, la mercancía fue almacenada en Barcelona, pero Rasfer elaboró otro documento vinculado con la transacción del producto, identificando ese mismo lote con el número 25984. Aún así, la numeración de las etiquetas de la sustancia que llegó a Panamá reconocía el lote 130716101.

«El número 25984 corresponde a nuestra referencia. Es un requisito de nuestra norma ISO para seguir la trazabilidad del producto que siempre realizamos. Pero el producto conserva el número de lote original del fabricante», afirmó Criado.

ESPERANDO EN BARCELONA

La glicerina que llegó a España procedente de China el 3 de septiembre de 2003 fue guardada en el depósito aduanero de la empresa Idyca Operador Logístico, en Barcelona. Y allí estuvo almacenada 18 días antes de iniciar su último tramo del viaje hacia Panamá.

«Los bidones estuvieron en los mismos embalajes de almacenamiento con los que llegó a España», dijo la responsable de la empresa española.

Criado está convencida de que la glicerina pura se «transformó» en veneno tóxico detrás de las paredes de Medicom. «No se puede decir que el fabricante no fabricó glicerina, eso se tiene que demostrar», sentenció.

Otro documento hallado por la Justicia ibérica en Rasfer es el número 936622723, fechado el 15 de septiembre de 2003. Allí se informa a Idyca Operador Logístico que al día siguiente (16 de septiembre de 2006), la empresa aduanera Gimax iba a retirar un lote de 55 kilos de «Ácido Undecilémico», que sería enviado por barco a Medicom.

Esa nota es corregida luego y se aclara que, en realidad, se trata de otras ustancias químicas. En ese embarque viajaron, además, los nueve mil litros de glicerina apócrifa.

La ejecutiva declaró que Rasfer no tenía ninguna obligación de controlar el contenido de los productos químicos que llegaron desde China. «La obligación de analizarlo corresponde al fabricante de la materia prima y a quien utiliza dicha materia prima para elaborar medicamentos», dijo.

Inclusive, Criado sostuvo que el Ministerio de Sanidad de España prohíbe que importadores revisen la mercadería llegada de países no pertenecientes a la Unión Europea. «No tenemos laboratorio ni infraestructura para tocar el producto».

Indicó, además, que no se le dio ningún trato especial al cargamento de glicerina durante el transporte por mar desde China a España. «Se trataba de un producto que no requiere almacenamiento específico ni temperatura concreta para su traslado».

El precio de la muerte

Rasfer pagó a la exportadora Fortune Way Company la suma de 9 mil 900 dólares por la glicerina pura del 99.5% y le cobró a Medicom 11 mil 322 dólares. La transacción le dejó a Rasfer mil 422 dólares.

Pero al final, según Criado, Medicom no les pagó ni un solo centavo, por lo que el 25 mayo de 2004 interpusieron una querella ante el Juzgado Tercero de lo Civil de Panamá.

Aclaró, sin embargo, que desistieron de la acción, porque comprobaron la insolvencia de la empresa panameña. «Nuestro abogado nos dijo: a esta gente no la encontramos, dejen la demanda para no perder más dinero».

Según Valentín Jaén, abogado de Medicom, la empresa española miente.

«Nuestros clientes le pagaron a Rasfer en octubre de 2006 parte de la deuda y fue por ello que Rasfer suspendió la demanda».

«A Taixing no le compramos nunca más. Antes le habíamos comprado alguna pequeña cantidad que vendimos en España. Nunca ha pasado nada», alegó Criado.

Hasta que pasó. Cien personas perdieron la vida, según el Gobierno.

Para los familiares de las víctimas, el número se eleva a

(Con colaboración de José Otero, Santiago Fascetto y Rafael Luna Noguera).

‘Le seguimos comprando a Fortune Way Company’

Las ganancias de Rasfer Internacional descendieron al infierno. «Por la tragedia en Panamá perdimos la mitad de las ventas. Más de seis millones de dólares», expresó Susi Criado, máxima ejecutiva de la empresa con sede en Barcelona. Ese bajón de las operaciones hizo, además, que la firma redujera la nómina de personal.A pesar de la crisis a raíz de la glicerina (que terminó siendo dietilene glycol) que llegó desde China y terminó en Panamá, Criado respaldó al exportador del gigante asiático que le vendió el producto químico.

«Le seguimos comprando a Fortune Way Company. Con esa empresa trabajamos desde hace 10 o 12 años», dijo.El camino que tomaron con Taixing Glycerin Factory -el productor que desarrolló la supuesta «glicerina»- fue otro. «A la fábrica jamás le volvimos a comprar. Aparte, nunca más volvimos a comprar glicerina. A Criado le cuesta nombrar el químico que, mezclado con un inocente jarabe desató la mayor tragedia moderna de Panamá.

No quiere o no puede. «Lo que no me deja dormir es la pena de toda esta gente que por un fallo de no se quién se está muriendo», afirmó, cambiando el tono de voz. El 2 de octubre de 2006 quedará en la memoria de todos los panameños. Ese día se confirmó lo impensado. Un remedio para combatir un mal menor terminó llevando a una cama de hospital a cientos de personas. «Nos enteramos de las muertes en noviembre de 2006, en el momento en que vino la inspección de la Agencia Española de Medicamentos. Sin advertirnos nada, nos pidieron toda la documentación y después de revisarla nos dijeron para qué habían venido», narró.

«A mí, me cambió la vida», concluyó.

A otros también.

El juicio sería en Barcelona

La Fiscalía General de España decidió que será Barcelona la jurisdicción de la demanda entablada contra Rasfer Internacional el 23 de abril pasado por los abogados de los familiares de las víctimas.

Michael Pierce, uno de los juristas, confirmó que el traslado del caso fue aprobado la semana pasada y se espera que la querella sea admitida en breve.

La fiscalía española optó por Barcelona, ya que allí está radicada Rasfer, concretamente en la avenida del Jordán, número 26.

El proceso, según explicó el abogado Alejandro Sanvicente, quien lleva el caso en España, da cuenta de que ahora corresponde a la Fiscalía de Barcelona realizar las investigaciones preliminares y si comprueba que hay elementos probatorios remitir el expediente a los tribunales.

En España, dijo, estos procesos incluyen las demandas penales y civiles, y pueden demorar entre cuatro y cinco años.

Pierce consideró que el caso representa una causa de trascendencia internacional, no solo por la cantidad de víctimas involucradas -por lo menos un centenar de muertos-, sino por la implicación de empresas de tres países: CNSC Fortune Way Company y Taixing Glycerine Factory de China, Rasfer de España y Medicom de Panamá.

«Esperamos que estos países adopten medidas más efectivas para controlar el trasiego de materias primas y medicamentos para el consumo humano», dijo.

Indicó que en algunos países se obliga a los importadores a depositar garantías monetarias, que pierden si hay anomalías con las mercancías, lo que los obliga a revisar sus productos antes de entregarlos.

«El problema en China es que hay miles de corporaciones pequeñas como Taixing Glycerine Factory (que produjo la sustancia contaminada con el dietilene glycol), las cuales no tienen cómo exportar sus productos y por tanto los venden a CNSC Fortune Way Company, la cual sí tiene la capacidad de exportación pero reenvía las materias primas sin verificarlas. Allí está parte del problema. No se hacen responsables en China ni en ninguna otra parte del mundo», acotó Pierce.

Fuente: La Prensa, 15 de mayo de 2007.

 V er además: La historia del dietilen glycol en medicamentos en Panamá publicado por el New York Times

From China to Panama, a Trail of Poisoned Medicine

Por considerar de sumo interés nacional el tema del envenamiento de personas en Panamá con medicamentos confeccionados con Dietilen Glycol en vez de Glicerina, le reproducimos el magnífico artículo (en inglés) que hoy ha publicado el New York Times de mayo de 2007.  La Prensa de Panamá ha realizado un reportaje días después que puede ser leído en español aquí.

IN CHINA At least 18 people, most of them in Guangdong Province, died in a month last year after they ingested contaminated medicine.

Published: May 6, 2007

The kidneys fail first. Then the central nervous system begins to misfire. Paralysis spreads, making breathing difficult, then often impossible without assistance. In the end, most victims die.

Many of them are children, poisoned at the hands of their unsuspecting parents.

The syrupy poison, diethylene glycol, is an indispensable part of the modern world, an industrial solvent and prime ingredient in some antifreeze.

It is also a killer. And the deaths, if not intentional, are often no accident.

Over the years, the poison has been loaded into all varieties of medicine — cough syrup, fever medication, injectable drugs — a result of counterfeiters who profit by substituting the sweet-tasting solvent for a safe, more expensive syrup, usually glycerin, commonly used in drugs, food, toothpaste and other products.

Toxic syrup has figured in at least eight mass poisonings around the world in the past two decades. Researchers estimate that thousands have died. In many cases, the precise origin of the poison has never been determined. But records and interviews show that in three of the last four cases it was made in China, a major source of counterfeit drugs.

Panama is the most recent victim. Last year, government officials there unwittingly mixed diethylene glycol into 260,000 bottles of cold medicine — with devastating results. Families have reported 365 deaths from the poison, 100 of which have been confirmed so far. With the onset of the rainy season, investigators are racing to exhume as many potential victims as possible before bodies decompose even more.

Panama’s death toll leads directly to Chinese companies that made and exported the poison as 99.5 percent pure glycerin.

Forty-six barrels of the toxic syrup arrived via a poison pipeline stretching halfway around the world. Through shipping records and interviews with government officials, The New York Times traced this pipeline from the Panamanian port of Colón, back through trading companies in Barcelona, Spain, and Beijing, to its beginning near the Yangtze Delta in a place local people call “chemical country.”

The counterfeit glycerin passed through three trading companies on three continents, yet not one of them tested the syrup to confirm what was on the label. Along the way, a certificate falsely attesting to the purity of the shipment was repeatedly altered, eliminating the name of the manufacturer and previous owner. As a result, traders bought the syrup without knowing where it came from, or who made it. With this information, the traders might have discovered — as The Times did — that the manufacturer was not certified to make pharmaceutical ingredients.

An examination of the two poisoning cases last year — in Panama and earlier in China — shows how China’s safety regulations have lagged behind its growing role as low-cost supplier to the world. It also demonstrates how a poorly policed chain of traders in country after country allows counterfeit medicine to contaminate the global market.

Last week, the United States Food and Drug Administration warned drug makers and suppliers in the United States “to be especially vigilant” in watching for diethylene glycol. The warning did not specifically mention China, and it said there was “no reason to believe” that glycerin in this country was tainted. Even so, the agency asked that all glycerin shipments be tested for diethylene glycol, and said it was “exploring how supplies of glycerin become contaminated.”

China is already being accused by United States authorities of exporting wheat gluten containing an industrial chemical, melamine, that ended up in pet food and livestock feed. The F.D.A. recently banned imports of Chinese-made wheat gluten after it was linked to pet deaths in the United States.

Beyond Panama and China, toxic syrup has caused mass poisonings in Haiti, Bangladesh, Argentina, Nigeria and twice in India.

In Bangladesh, investigators found poison in seven brands of fever medication in 1992, but only after countless children died. A Massachusetts laboratory detected the contamination after Dr. Michael L. Bennish, a pediatrician who works in developing countries, smuggled samples of the tainted syrup out of the country in a suitcase. Dr. Bennish, who investigated the Bangladesh epidemic and helped write a 1995 article about it for BMJ, formerly known as the British Medical Journal, said that given the amount of medication distributed, deaths “must be in the thousands or tens of thousands.”

“It’s vastly underreported,” Dr. Bennish said of diethylene glycol poisoning. Doctors might not suspect toxic medicine, particularly in poor countries with limited resources and a generally unhealthy population, he said, adding, “Most people who die don’t come to a medical facility.”

The makers of counterfeit glycerin, which superficially looks and acts like the real thing but generally costs considerably less, are rarely identified, much less prosecuted, given the difficulty of tracing shipments across borders. “This is really a global problem, and it needs to be handled in a global way,” said Dr. Henk Bekedam, the World Health Organization’s top representative in Beijing.

Seventy years ago, medicine laced with diethylene glycol killed more than 100 people in the United States, leading to the passage of the toughest drug regulations of that era and the creation of the modern Food and Drug Administration.

The F.D.A. has tried to help in poisoning cases around the world, but there is only so much it can do.

When at least 88 children died in Haiti a decade ago, F.D.A. investigators traced the poison to the Manchurian city of Dalian, but their attempts to visit the suspected manufacturer were repeatedly blocked by Chinese officials, according to internal State Department records. Permission was granted more than a year later, but by then the plant had moved and its records had been destroyed.

“Chinese officials we contacted on this matter were all reluctant to become involved,” the American Embassy in Beijing wrote in a confidential cable. “We cannot be optimistic about our chances for success in tracking down the other possible glycerine shipments.”

In fact, The Times found records showing that the same Chinese company implicated in the Haiti poisoning also shipped about 50 tons of counterfeit glycerin to the United States in 1995. Some of it was later resold to another American customer, Avatar Corporation, before the deception was discovered.

“Thank God we caught it when we did,” said Phil Ternes, chief operating officer of Avatar, a Chicago-area supplier of bulk pharmaceuticals and nonmedicinal products. The F.D.A. said it was unaware of the shipment.

In China, the government is vowing to clean up its pharmaceutical industry, in part because of criticism over counterfeit drugs flooding the world markets. In December, two top drug regulators were arrested on charges of taking bribes to approve drugs. In addition, 440 counterfeiting operations were closed down last year, the World Health Organization said.

But when Chinese officials investigated the role of Chinese companies in the Panama deaths, they found that no laws had been broken, according to an official of the nation’s drug enforcement agency. China’s drug regulation is “a black hole,” said one trader who has done business through CNSC Fortune Way, the Beijing-based broker that investigators say was a crucial conduit for the Panama poison.

In this environment, Wang Guiping, a tailor with a ninth-grade education and access to a chemistry book, found it easy to enter the pharmaceutical supply business as a middleman. He quickly discovered what others had before him: that counterfeiting was a simple way to increase profits.

And then people in China began to die.

Cheating the System

Mr. Wang spent years as a tailor in the manufacturing towns of the Yangtze Delta, in eastern China. But he did not want to remain a common craftsman, villagers say. He set his sights on trading chemicals, a business rooted in the many small chemical plants that have sprouted in the region.

“He didn’t know what he was doing,” Mr. Wang’s older brother, Wang Guoping, said in an interview. “He didn’t understand chemicals.”

But he did understand how to cheat the system.

Wang Guiping, 41, realized he could earn extra money by substituting cheaper, industrial-grade syrup — not approved for human consumption — for pharmaceutical grade syrup. To trick pharmaceutical buyers, he forged his licenses and laboratory analysis reports, records show.

Mr. Wang later told investigators that he figured no harm would come from the substitution, because he initially tested a small quantity. He did it with the expertise of a former tailor.

He swallowed some of it. When nothing happened, he shipped it.

One company that used the syrup beginning in early 2005 was Qiqihar No. 2 Pharmaceutical, about 1,000 miles away in Heilongjiang Province in the northeast. A buyer for the factory had seen a posting for Mr. Wang’s syrup on an industry Web site.

After a while, Mr. Wang set out to find an even cheaper substitute syrup so he could increase his profit even more, according to a Chinese investigator. In a chemical book he found what he was looking for: another odorless syrup — diethylene glycol. At the time, it sold for 6,000 to 7,000 yuan a ton, or about $725 to $845, while pharmaceutical-grade syrup cost 15,000 yuan, or about $1,815, according to the investigator.

Mr. Wang did not taste-test this second batch of syrup before shipping it to Qiqihar Pharmaceutical, the government investigator said, adding, “He knew it was dangerous, but he didn’t know that it could kill.”

The manufacturer used the toxic syrup in five drug products: ampules of Amillarisin A for gall bladder problems; a special enema fluid for children; an injection for blood vessel diseases; an intravenous pain reliever; and an arthritis treatment.

In April 2006, one of southern China’s finest hospitals, in Guangzhou, Guangdong Province, began administering Amillarisin A. Within a month or so, at least 18 people had died after taking the medicine, though some had already been quite sick.

Zhou Jianhong, 33, said his father took his first dose of Amillarisin A on April 19. A week later he was in critical condition. “If you are going to die, you want to die at home,” Mr. Zhou said. “So we checked him out of the hospital.” He died the next day.

“Everybody wants to invest in the pharmaceutical industry and it is growing, but the regulators can’t keep up,” Mr. Zhou said. “We need a system to assure our safety.”

The final death count is unclear, since some people who took the medicine may have died in less populated areas.

In a small town in Sichuan Province, a man named Zhou Lianghui said the authorities would not acknowledge that his wife had died from taking tainted Amillarisin A. But Mr. Zhou, 38, said he matched the identification number on the batch of medicine his wife received with a warning circular distributed by drug officials.

“You probably cannot understand a small town if you are in Beijing,” Zhou Lianghui said in a telephone interview. “The sky is high, and the emperor is far away. There are a lot of problems here that the law cannot speak to.”

The failure of the government to stop poison from contaminating the drug supply caused one of the bigger domestic scandals of the year. Last May, China’s premier, Wen Jiabao, ordered an investigation of the deaths, declaring, “The pharmaceutical market is in disorder.”

At about the same time, 9,000 miles away in Panama, the long rainy season had begun. Anticipating colds and coughs, the government health program began manufacturing cough and antihistamine syrup. The cough medicine was sugarless so that even diabetics could use it.

The medicine was mixed with a pale yellow, almost translucent syrup that had arrived in 46 barrels from Barcelona on the container ship Tobias Maersk. Shipping records showed the contents to be 99.5 percent pure glycerin.

It would be months and many deaths later before that certification was discovered to be pure fiction.

A Mysterious Illness

Early last September, doctors at Panama City’s big public hospital began to notice patients exhibiting unusual symptoms.

They initially appeared to have Guillain-Barré syndrome, a relatively rare neurological disorder that first shows up as a weakness or tingling sensation in the legs. That weakness often intensifies, spreading upward to the arms and chest, sometimes causing total paralysis and an inability to breathe.

The new patients had paralysis, but it did not spread upward. They also quickly lost their ability to urinate, a condition not associated with Guillain-Barré. Even more unusual was the number of cases. In a full year, doctors might see eight cases of Guillain-Barré, yet they saw that many in just two weeks.

Doctors sought help from an infectious disease specialist, Néstor Sosa, an intense, driven doctor who competes in triathlons and high-level chess.

Dr. Sosa’s medical specialty had a long, rich history in Panama, once known as one of the world’s unhealthiest places. In one year in the late 1800s, a lethal mix of yellow fever and malaria killed nearly 1 in every 10 residents of Panama City. Only after the United States managed to overcome those mosquito-borne diseases was it able to build the Panama Canal without the devastation that undermined an earlier attempt by the French.

The suspected Guillain-Barré cases worried Dr. Sosa. “It was something really extraordinary, something that was obviously reaching epidemic dimensions in our hospital,” he said.

With the death rate from the mystery illness near 50 percent, Dr. Sosa alerted the hospital management, which asked him to set up and run a task force to handle the situation. The assignment, a daunting around-the-clock dash to catch a killer, was one he eagerly embraced.

Several years earlier, Dr. Sosa had watched as other doctors identified the cause of another epidemic, later identified as hantavirus, a pathogen spread by infected rodents.

“I took care of patients but I somehow felt I did not do enough,” he said. The next time, he vowed, would be different.

Dr. Sosa set up a 24-hour “war room” in the hospital, where doctors could compare notes and theories as they scoured medical records for clues.

As a precaution, the patients with the mystery illness were segregated and placed in a large empty room awaiting renovation. Health care workers wore masks, heightening fears in the hospital and the community.

“That spread a lot of panic,” said Dr. Jorge Motta, a cardiologist who runs the Gorgas Memorial Institute, a widely respected medical research center in Panama. “That is always a terrifying thought, that you will be the epicenter of a new infectious disease, and especially a new infectious disease that kills with a high rate of death, like this.”

Meanwhile, patients kept coming, and hospital personnel could barely keep up.

“I ended up giving C.P.R.,” Dr. Sosa said. “I haven’t given C.P.R. since I was a resident, but there were so many crises going on.”

Frightened hospital patients had to watch others around them die for reasons no one understood, fearing that they might be next.

As reports of strange Guillain-Barré symptoms started coming in from other parts of the country, doctors realized they were not just dealing with a localized outbreak.

Pascuala Pérez de González, 67, sought treatment for a cold at a clinic in Coclé Province, about a three-hour drive from Panama City. In late September she was treated and sent home. Within days, she could no longer eat; she stopped urinating and went into convulsions.

A decision was made to take her to the public hospital in Panama City, but on the way she stopped breathing and had to be resuscitated. She arrived at the hospital in a deep coma and later died.

Medical records contained clues but also plenty of false leads. Early victims tended to be males older than 60 and diabetic with high blood pressure. About half had been given Lisinopril, a blood pressure medicine distributed by the public health system.

But many who did not receive Lisinopril still got sick. On the chance that those patients might have forgotten that they had taken the drug, doctors pulled Lisinopril from pharmacy shelves — only to return it after tests found nothing wrong.

Investigators would later discover that Lisinopril did play an important, if indirect role in the epidemic, but not in the way they had imagined.A Major Clue

One patient of particular interest to Dr. Sosa came into the hospital with a heart attack, but no Guillain-Barré-type symptoms. While undergoing treatment, the patient received several drugs, including Lisinopril. After a while, he began to exhibit the same neurological distress that was the hallmark of the mystery illness.

“This patient is a major clue,” Dr. Sosa recalled saying. “This is not something environmental, this is not a folk medicine that’s been taken by the patients at home. This patient developed the disease in the hospital, in front of us.”

Soon after, another patient told Dr. Sosa that he, too, developed symptoms after taking Lisinopril, but because the medicine made him cough, he also took cough syrup — the same syrup, it turned out, that had been given to the heart patient.

“I said this has got to be it,” Dr. Sosa recalled. “We need to investigate this cough syrup.”

The cough medicine had not initially aroused much suspicion because many victims did not remember taking it. “Twenty-five percent of those people affected denied that they had taken cough syrup, because it’s a nonevent in their lives,” Dr. Motta said.

Investigators from the United States Centers for Disease Control and Prevention, who were in Panama helping out, quickly put the bottles on a government jet and flew them to the United States for testing. The next day, Oct. 11, as Panamanian health officials were attending a news conference, a Blackberry in the room went off.

The tests, the C.D.C. was reporting, had turned up diethylene glycol in the cough syrup.

The mystery had been solved. The barrels labeled glycerin turned out to contain poison.

Dr. Sosa’s exhilaration at learning the cause did not last long. “It’s our medication that is killing these people,” he said he thought. “It’s not a virus, it’s not something that they got outside, but it was something we actually manufactured.”

A nationwide campaign was quickly begun to stop people from using the cough syrup. Neighborhoods were searched, but thousands of bottles either had been discarded or could not be found.

As the search wound down, two major tasks remained: count the dead and assign blame. Neither has been easy.

A precise accounting is all but impossible because, medical authorities say, victims were buried before the cause was known, and poor patients might not have seen doctors.

Another problem is that finding traces of diethylene glycol in decomposing bodies is difficult at best, medical experts say. Nonetheless, an Argentine pathologist who has studied diethylene glycol poisonings helped develop a test for the poison in exhumed bodies. Seven of the first nine bodies tested showed traces of the poison, Panamanian authorities said.

With the rainy season returning, though, the exhumations are about to end. Dr. José Vicente Pachar, director of Panama’s Institute of Legal Medicine and Forensic Sciences, said that as a scientist he would like a final count of the dead. But he added, “I should accept the reality that in the case of Panama we are not going to know the exact number.”

Local prosecutors have made some arrests and are investigating others connected to the case, including officials of the import company and the government agency that mixed and distributed the cold medicine. “Our responsibilities are to establish or discover the truth,” said Dimas Guevara, the homicide investigator guiding the inquiry.

But prosecutors have yet to charge anyone with actually making the counterfeit glycerin. And if the Panama investigation unfolds as other inquiries have, it is highly unlikely that they ever will.

A Suspect Factory

Panamanians wanting to see where their toxic nightmare began could look up the Web site of the company in Hengxiang, China, that investigators in four countries have identified as having made the syrup — the Taixing Glycerine Factory. There, under the words “About Us,” they would see a picture of a modern white building nearly a dozen stories tall, adorned by three arches at the entrance. The factory, the Web site boasts, “can strictly obey the contract and keep its word.”

But like the factory’s syrup, all is not as it seems.

There are no tall buildings in Hengxiang, a country town with one main road. The factory is not certified to sell any medical ingredients, Chinese officials say. And it looks nothing like the picture on the Internet. In reality, its chemicals are mixed in a plain, one-story brick building.

The factory is in a walled compound, surrounded by small shops and farms. In the spring, nearby fields of rape paint the countryside yellow. Near the front gate, a sign over the road warns, “Beware of counterfeits.” But it was posted by a nearby noodle machine factory that appears to be worried about competition.

The Taixing Glycerine Factory bought its diethylene glycol from the same manufacturer as Mr. Wang, the former tailor, the government investigator said. From this spot in China’s chemical country, the 46 barrels of toxic syrup began their journey, passing from company to company, port to port and country to country, apparently without anyone testing their contents.

Traders should be thoroughly familiar with their suppliers, United States health officials say. “One simply does not assume that what is labeled is indeed what it is,” said Dr. Murray Lumpkin, deputy commissioner for international and special programs for the Food and Drug Administration.

In the Panama case, names of suppliers were removed from shipping documents as they passed from one entity to the next, according to records and investigators. That is a practice some traders use to prevent customers from bypassing them on future purchases, but it also hides the provenance of the product.

The first distributor was the Beijing trading company, CNSC Fortune Way, a unit of a state-owned business that began by supplying goods and services to Chinese personnel and business officials overseas.

As China’s market reach expanded, Fortune Way focused its business on pharmaceutical ingredients, and in 2003, it brokered the sale of the suspect syrup made by the Taixing Glycerine Factory. The manufacturer’s certificate of analysis showed the batch to be 99.5 percent pure.

Whether the Taixing Glycerine Factory actually performed the test has not been publicly disclosed.

Original certificates of analysis should be passed on to each new buyer, said Kevin J. McGlue, a board member of the International Pharmaceutical Excipients Council. In this case, that was not done.

Fortune Way translated the certificate into English, putting its name — not the Taixing Glycerine Factory’s — at the top of the document, before shipping the barrels to a second trading company, this one in Barcelona.

Li Can, managing director at Fortune Way, said he did not remember the transaction and could not comment, adding, “There is a high volume of trade.”

Upon receiving the barrels in September 2003, the Spanish company, Rasfer International, did not test the contents, either. It copied the chemical analysis provided by Fortune Way, then put its logo on it. Ascensión Criado, Rasfer’s manager, said in an e-mail response to written questions that when Fortune Way shipped the syrup, it did not say who made it.

Several weeks later, Rasfer shipped the drums to a Panamanian broker, the Medicom Business Group. “Medicom never asked us for the name of the manufacturer,” Ms. Criado said.

A lawyer for Medicom, Valentín Jaén, said his client was a victim, too. “They were tricked by somebody,” Mr. Jaén said. “They operated in good faith.”

In Panama, the barrels sat unused for more than two years, and officials said Medicom improperly changed the expiration date on the syrup.

During that time, the company never tested the product. And the Panamanian government, which bought the 46 barrels and used them to make cold medicine, also failed to detect the poison, officials said.

The toxic pipeline ultimately emptied into the bloodstream of people like Ernesto Osorio, a former high school teacher in Panama City. He spent two months in the hospital after ingesting poison cough syrup last September.

Just before Christmas, after a kidney dialysis treatment, Mr. Osorio stood outside the city’s big public hospital in a tear-splattered shirt, describing what his life had become.

“I’m not an eighth of what I used to be,” Mr. Osorio said, his partly paralyzed face hanging like a slab of meat. “I have trouble walking. Look at my face, look at my tears.” The tears, he said apologetically, were not from emotion, but from nerve damage.

And yet, Mr. Osorio knows he is one of the lucky victims.

“They didn’t know how to keep the killer out of the medicine,” he said simply.

While the suffering in Panama was great, the potential profit — at least for the Spanish trading company, Rasfer — was surprisingly small. For the 46 barrels of glycerin, Rasfer paid Fortune Way $9,900, then sold them to Medicom for $11,322, according to records.

Chinese authorities have not disclosed how much Fortune Way and the Taixing Glycerine Factory made on their end, or how much they knew about what was in the barrels.

“The fault has to be traced back to areas of production,” said Dr. Motta, the cardiologist in Panama who helped uncover the source of the epidemic. “This was my plea — please, this thing is happening to us, make sure whoever did this down the line is not doing it to Peru or Sierra Leone or some other place.”

A Counterfeiter’s Confession

The power to prosecute the counterfeiters is now in the hands of the Chinese.

Last spring, the government moved quickly against Mr. Wang, the former tailor who poisoned Chinese residents.

The authorities caught up with him at a roadblock in Taizhou, a city just north of Taixing, in chemical country. He was weak and sick, and he had not eaten in two days. Inside his white sedan was a bankbook and cash. He had fled without his wife and teenage son.

Chinese patients were dead, a political scandal was brewing and the authorities wanted answers. Mr. Wang was taken to a hospital. Then, in long sessions with investigators, he gave them what they wanted, explaining his scheme, how he tested industrial syrup by drinking it, how he decided to use diethylene glycol and how he conned pharmaceutical companies into buying his syrup, according to a government official who was present for his interrogation.

“He made a fortune, but none of it went to his family,” said Wang Xiaodong, a former village official who knows Mr. Wang and his siblings. “He liked to gamble.”

Mr. Wang remains in custody as the authorities decide whether he should be put to death. The Qiqihar drug plant that made the poisonous medicine has been closed, and five employees are now being prosecuted for causing “a serious accident.”

In contrast to the Wang Guiping investigation, Chinese authorities have been tentative in acknowledging China’s link to the Panama tragedy, which involved a state-owned trading company. No one in China has been charged with committing the fraud that ended up killing so many in Panama.

Sun Jing, the pharmaceutical program officer for the World Health Organization in Beijing, said the health agency sent a fax “to remind the Chinese government that China should not be selling poisonous products overseas.” Ms. Sun said the agency did not receive an official reply.

Last fall, at the request of the United States — Panama has no diplomatic relations with China — the State Food and Drug Administration of China investigated the Taixing Glycerine Factory and Fortune Way.

The agency tested one batch of glycerin from the factory, and found no glycerin, only diethylene glycol and two other substances, a drug official said.

Since then, the Chinese drug administration has concluded that it has no jurisdiction in the case because the factory is not certified to make medicine.

The agency reached a similar conclusion about Fortune Way, saying that as an exporter it was not engaged in the pharmaceutical business.

“We did not find any evidence that either of these companies had broken the law,” said Yan Jiangying, a spokeswoman for the drug administration. “So a criminal investigation was never opened.”

A drug official said the investigation was subsequently handed off to an agency that tests and certifies commercial products — the General Administration of Quality Supervision, Inspection and Quarantine.

But the agency acted surprised to learn that it was now in charge. “What investigation?” asked Wang Jian, director of its Taixing branch. “I’m not aware of any investigation involving a glycerin factory.”

Besides, Huang Tong, an investigator in that office, said, “We rarely get involved in products that are sold for export.”

Wan Qigang, the legal representative for the Taixing Glycerine Factory, said in an interview late last year that the authorities had not questioned him about the Panama poisoning, and that his company made only industrial-grade glycerin.

“I can tell you for certain that we have no connection with Panama or Spain,” Mr. Wan said.

But in recent months, the Glycerine Factory has advertised 99.5 percent pure glycerin on the Internet.

Mr. Wan recently declined to answer any more questions. “If you come here as a guest, I will welcome you,” Mr. Wan said. “But if you come again wanting to talk about this matter, I will make a telephone call.”

A local government official said Mr. Wan was told not to grant interviews.

A five-minute walk away, another manufacturer, the Taixing White Oil Factory, also advertises medical glycerin on the Internet, yet it, too, has no authorization to make it. The company’s Web site says its products “have been exported to America, Australia and Italy.”

Ding Xiang, who represents the White Oil Factory, denied that his company made pharmaceutical-grade glycerin, but he said chemical trading companies in Beijing often called, asking for it.

“They want us to mark the barrels glycerin,” Mr. Ding said in late December. “I tell them we cannot do that.”

Mr. Ding said he stopped answering calls from Beijing. “If this stuff is taken overseas and improperly used. …” He did not complete the thought.

In chemical country, product names are not always what they seem.

“The only two factories in Taixing that make glycerin don’t even make glycerin,” said Jiang Peng, who oversees inspections and investigations in the Taixing branch of the State Food and Drug Administration. “It is a different product.”

All in a Name

One lingering mystery involves the name of the product made by the Taixing Glycerine Factory. The factory had called its syrup “TD” glycerin. The letters TD were in virtually all the shipping documents. What did TD mean?

Spanish medical authorities concluded that it stood for a manufacturing process. Chinese inspectors thought it was the manufacturer’s secret formula.

But Yuan Kailin, a former salesman for the factory , said he knew what the TD meant because a friend and former manager of the factory, Ding Yuming, had once told him. TD stood for the Chinese word “tidai” (pronounced tee-die), said Mr. Yuan, who left his job in 1998 and still lives about a mile from the factory.

In Chinese, tidai means substitute. A clue that might have revealed the poison, the counterfeit product, was hiding in plain sight.

It was in the product name.

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Renwick McLean and Brent McDonald contributed reporting for New York Times, may 6th, 2007.

Original article with pictures in next link of New York Times: