news

Also in this section:
Women's groups on alert over Penal Code proposals
Heavy rains, storm surges batter Colon, part of Interior
Shannon visits Panama to talk about bilateral and UN issues
Poisoned medicine probe looks toward Spain and China
Former "Patriot" radio host charges The Panama News editor with defamation
Hobnobbing at a Mexican presidential inauguration
Panama News Briefs

Prosecutor cites death toll of 221 in the metro area alone

Poison medicine scandal probe grows in scope and cases

by Eric Jackson, mainly from other media

Although prosecutors have been cautious not to conduct their investigation of the poisoned government medicines case through the press, a few leaks and one bombshell announcement indicate that it’s much larger than had been known --- much larger in the number of cases and larger in geographical scope. The Torrijos administration’s reactions to events indicate that it is not at all happy with the turn of events.

The sugar-free cough syrup and benadryl elixir that were tainted with toxic diethylene glycol (DEG) came to public attention in October, many weeks after a mysterious string of deaths and illnesses led doctors, nurses and pharmacists to raise an alarm with the Seguro Social Fund (CSS) and Ministry of Health management. The information was withheld from the public until October 2, when direct questions from a La Prensa reporter led the government to declare a health emergency and call for international assistance. Within a few days investigators from the US Centers for Disease Control determined that the problem was DEG poisoning and shortly thereafter it was found that the substance was found in plastic jugs labeled as glycerin and bought by Seguro Social for its medicine production lab from a Panamanian import company, Medicom SA. Three people with various ties to that company were ordered arrested.

Medicom SA cried foul on several counts. Two of those arrested had nothing to do with the ordering or handling of materials --- one was a fonda operator and paper director and the other was the attorney who did the company’s incorporation papers. The company president, who went into hiding for several weeks before his arrest, admitted to putting new labels with a new expiration date on the containers but denied that he or his company had anything to do with the DEG. Medicom sued a Spanish chemical wholesaler, Rasfer Internacional, from whom it had bought the supposed glycerin.

Here the investigation gets into the stuff of conflicting reports and questions of chemistry. Some reports had it that the tainted glycerin containers held a brew of about one-quarter DEG and various other unidentified substances, while lawyers for Medicom alleged that the toxic glycerin jugs contained essentially pure DEG. Medicom’s defense also asserted that DEG is not one of the chemicals that results when glycerin decomposes after its expiration date. Hazardous materials warnings say that when glycerin breaks down under high heat it gives off carbon monoxide and other noxious chemicals, but not DEG, but these don’t say what happens if glycerin breaks down by aging, exposure to moisture or other causes. The presumption, if the Medicom lawyers’ version of pure DEG rather than the mixture earlier reported is true, is that the problem was mislabeling rather than mishandling.

Working on the possibility that it was a problem along the supply chain rather than handling at the CSS warehouse, prosecutors went to courts and the Foreign Ministry to get their Spanish counterparts to investigate Rasfer. That company panned Medicom as deadbeats and claimed that it had never possessed the material in question, but rather had ordered it from a Chinese chemical wholesaler, CNSC Fortune Way Company, which shipped the stuff directly to Panama. CNSC Fortune Way, for its part, bought the chemicals from the Taixing Glicerin Factory, another Chinese company. So far there have been no reports of formal requests to authorities in China to take depositions from figures in either of those two companies --- and that process could be complicated by the lack of formal relations between Panama and the Peoples Republic of China --- but surely the Panamanian investigation will cross the Pacific to look at the manufacturer and wholesaler.

Meanwhile the Public Ministry charged four people at Seguro Social --- the head of the now-closed medicine production lab, the head of quality control at that facility and two lab technicians. The allegation is that they negligently failed to test the purity of the chemicals put into the cough syrup and benadryl elixir, thus causing the poisonings. Those charges led CSS director René Luciani to summarily fire the four, and someone in his institution’s management to unethically release the medical records of one of the suspects to the press. Meanwhile, President Torrijos ordered the definitive permanent closing of the CSS medicine production lab, which amounts to the privatization of procurement for 24 different medications.

These moves led to protests by labor unions, public health advocates and the Panamanian Committee Against Racism. The charges were that CSS and Health Ministry management knew for years about problems at the lab yet ignored its director’s and employees’ pleas for a budget and equipment that would allow them to properly do their jobs; that low-level employees were being made scapegoats for a high-level political problem; and that not only does the president not have the legal authority to make decisions about the autonomous CSS and its lab but that to buy the two dozen items that had been produced at that facility on the private market will drive the public health care systems costs way up. Most Panamanians did think that blame that accrued to high-level officials was being assigned to low-level people, but the public protests were small because most people also believed that there was negligence at all levels and that all who had a hand in putting poisonous medications into public circulation should suffer the consequences.

Case almost closed? That’s what Luciani and Health Minister Camilo Alleyne, both of them resisting popular demands for their resignations, apparently hoped.

Then, on December 5, the prosecutor for the metro area’s fourth district, Dimas Guevara, announced that his office had received many complaints about poisoning from the medicines in question and upon investigation found that 241 people and become sick after taking the medicines, 221 of whom had died.

In all of cases there was evidence that the medicines in question had been taken, but Guevera added that to conclusively prove the link between DEG and the deaths it will be necessary to exhume and examine the bodies for toxic residues. Some of the bodies have been cremated and in some cases relatives may not authorize exhumations, and in any case the sheer volume of the work will exceed the budget and staffing capacities of the Legal Medicine Institute that does such investigations.

Guevara added that the death count of 221 in his office was for the metro area only, and that there were likely other cases outside of Panama province. This observation was underscored by complaints from Kuna Yala that there had been poisonings there which did not count among the Torrijos administration’s official figure of 49 deaths. It may have been hinted at weeks earlier, when the Ministry of Health conducted a campaign to recover the 20,000 or so flasks of tainted Seguro Social medicines that had been produced, but said it had only collected about 3,000.

The prosecutor’s announcement was followed by frantic information control maneuvers by the Torrijos administration and those news media aligned with or subservient to the government. The PRD-aligned La Prensa buried the story, repeated the official figure of 49 in its headline and reported the 221 number as “complaints” received by the prosecutor. At a hastily convened meeting between prosecutors and the presidential commission appointed to support the CSS investigation of itself. At that meeting, at which Torrijos administration figures grumbled about prosecutors not coordinating their statements with the government, Seguro Social admitted that it was investigating 21 deaths beyond its official list of 49. The commission’s Dr. Néstor Sosa complained that more than 20,000 sets of medical records had been examined and that the symptoms listed would not support the numbers alleged by prosecutors, but Public Ministry’s secretary general Rigoberto González shot back that citizens who believe that their relatives died from poisoned medicines chose to take their cases to the prosecutors, rather than to the health authorities.

González added that the Public Ministry will keep the public informed as its investigation continues. Meanwhile the criticism of the Torrijos administration and its information control strategies spread its previous circles, with the ultra-establishment National Private Enterprise Council (CoNEP) issuing a call for more transparency from the government about the health crisis.