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Death toll in tainted Seguro Social medicine case at least 30
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Tainted medicine death toll climbs to at least 32

by Eric Jackson

On October 22, as many Panamanians were going to the polls and many more were boycotting the referendum, two more people died from the effects of ingesting diethylene glycol via medications produced by the Seguro Social. That brought the death toll to 32, but critics of the government allege that a number of deaths that took place before a medical emergency was declared on October 2 that ought to be counted as part of this disaster have not been. A number of other people remain in critical condition and the death toll is thus likely to rise.

The search for the cause of the rash of deaths has followed a twisting trail, with infectious diseases first having been discarded, suspicions of a medication to control high blood pressure to which patients were switched en masse starting in August having led to that drug’s temporary withdrawal from the market, and environmental research by an international team led by the US Centers for Disease Control (CDC) finally establishing a link between many of the deaths and consumption of a sugar-free expectorant produced at the Seguro Social (CSS) lab and often prescribed to diabetics. The presence of toxic diethylene glycol (DEG) in some samples of the syrup was confirmed in a spectrometer at a CDC lab in Atlanta, and the material was also subsequently identified in samples of benedyrl elixir, calomine lotion and moisturizing skin cream also produced by the CSS lab.

At that point Seguro Social chief René Luciani, who’s facing demands for his resignation by opposition politicians and many members of the public at large, declared that it was an “attack on collective security.” Many of the mainstream media began to point fingers at unionized CSS workers, two salient examples being El Panama America’s suggestion that the problem was the result of a strike action in August and September and a screaming La Prensa headline proclaiming that the poisoning was intentional. Prisicila Vásquez, the leader of the AECSS union that represents many of the lab employees objected to these insinuations and called for a more complete investigation that looks at raw materials, suppliers, possible sloppy management practices and other potential causes of the medications’ contamination.

It turned out that Vásquez was right. A search of CSS facilities turned up several containers with labels indicating that they held glycerin, allegedly purchased in 2002 or 2003 and allegedly bearing altered expiration date labels, which were found to have contained a chemical brew that was about one-quarter DEG. Glycerin is used as a component in the manufacture of the tainted medicines.

Three officers of the import company that supplied the material were arrested. Two of those who were detained had nothing to do with the running of the company but just served as front directors under Panama’s corporate secrecy system. The material sold by the importer to Seguro Social came from a Spanish supplier, so prosecutors here asked the courts in Spain to order the depositions of officials at that company.

However, the problem may have been storage at CSS rather than any fault of the suppliers. Glycerin is known to decompose into a mix that includes DEG when heated, so the hypothesis that Seguro Social got good glycerin several years ago, let it sit past its expiration date in a Curundu warehouse where proper storage conditions were not maintained and then used it at the CSS medicine production lab sometime this year has not been ruled out.

The lab where the tainted medicines were made remains closed, with dilapidated and unsanitary conditions on its exterior and surroundings the object of a certain amount of attention and Vásquez complaining that a number of workers whom her union represents may lose their jobs in a move to resolve a problem created by management neglect via the privatization of the facility’s functions.

This would not be the first, or even the second or third, time that multiple deaths have been caused by faults in Panama’s public health care system. Most of these cases have gone unsolved and the investigations have always shielded the higher levels of management. With the presence of international investigators, however, it is unlikely that the precise means by which containers labeled as containing glycerin but instead holding a mixture with DEG in it made their way into the nation’s medicine supply will remain undiscovered or undisclosed.

This story spins off into many noteworthy tangents as well as some ridiculous ones. The timidity of many CSS health care professionals in a situation where saying anything on the record could result in retribution from the political activists who run Seguro Social, seething labor unrest within the public health system, neglect of basic sanitary considerations like the elimination of rat nesting conditions around a medicine production lab, public panic and loss of confidence in their health care providers and a profound lack of scientific knowledge among many of the Panamanian journalists who have been covering this story for the mainstream media are some of the consequential side issues.

In addition to the continuing scientific investigation by Panamanian and foreign experts, the case is the subject of an ongoing prosecutor’s probe that’s looking into various theories of intentional or negligent crimes. Because at least the sugar-free expectorant was not properly tested and registered as required by law, there may be some legal consequences for that regardless of whether that fault it is found to have played any part in the deaths.