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Death toll at 40, scandal continues to unfold

Torrijos backtracks, shakeup expected over poisoned medicines

by Eric Jackson, mainly from other media

As this story was written, the nation was waiting for President Torrijos to announce changes in the Ministry of Health, the Social Security Fund or both due to the poisoned medicines affair. So far the official death toll is at 40 persons, but at least a dozen other deaths are suspected to be linked to the contamination of cough syrups and antihistamines contaminated with diethylene glycol (DEG). Although three dignitaries of a chemical importing company remain either in jail or on bail facing continued criminal proceedings and a self-investigation by the Social Security Fund found no fault with itself or any of its managers, a steady drumbeat of new revelations, mainly in the PRD-aligned daily newspaper La Prensa but also in other media, increasingly points to negligent supply managment that allowed outdated and degraded glycerin into the medicines distributed by Seguro Social.

Speaking shortly after the referendum on the RCM television news channel, Torrijos had discounted the possibility that Health Minister Camilo Alleyne or Seguro Social director René Luciani would lose their jobs as the result of the mess. But that was before La Prensa revealed, based on documents from prosecutors, that Seguro Social knew that there was some sort of an unexplained deadly health problem in early August, yet didn't do anything about it until information about it was leaked to a reporter in early October. At that point international assistance was brought in, and within a couple of weeks DEG poisoning was identified and the source of that was three-year-old barrels marked pure glycerine that had decomposed into a toxic brew. The delay in informing the public about the problem, most probably to avoid bad publicity for the government ahead of the canal expansion referendum, now appears to be one of the proximate causes of several patients' deaths.

According to the document La Prensa obtained from prosecutors, the first person known to have been affected by the symptoms later identified as being those of DEG poisoning became ill in mid-July and died on August 2. However, more recent revelations raise suspicions that the string of deaths and illnesses began earlier, in May.

The barrels of glycerine, obtained by Seguro Social in the summer of 2003 from a Panamanian importer which bought from a chain of dealers that ran through Spanish and Chinese wholesalers to a Chinese factory, were supposed to have been about a three-month supply for the lab that makes medicines for Panama's public health system. The trail becomes murky rather immediately, however: conflicting records variously quantify the lot as 45 or 55 barrels. And why was a three-month supply around three years later to mix into the nation's medicines?

Prosecutors are alleging altered expiration date tickets, and one theory is that the importing company did it. However, even while the Seguro Social medicine production lab was closed and under police custody the warehouse where the barrels of bad glycerin were kept was open enough such that somebody could have had access to alter the labels. Thus the question of when any alterations were made, which ought to be readily determinable by a competent document examination lab, becomes a key factor in the criminal investigation.

By several reports prosecutors are now looking at the conditions and practices by which the raw materials for Panama's medicine supply were stored and processed, and that probe is finding a serious lack of professionalism, much of which had nothing to do with causing the deaths and some of which probably did.

Based on these reports the president has said that the situation is unacceptable and that changes will be made in the health care system.

Social Security Fund Employees Association leader Priscilla Vásquez told The Panama News that her union, which represents some of the employees at the lab, is on a "state of alert" for the possibility that low-level workers will be blamed for a management problem. "We won't accept scapegoats," she said. "We are demanding due process for all union members" who are or might be accused of any wrongdoing. The medicine processing lab has been closed and not all of the workers there have been assigned to other duties. Vásquez expressed concern that instead of cleaning up the medicine processing facilities and procedures, the poisoned medicines scandal might be used as an excuse for privatization.