Cough Syrup Tragedy: Death Toll in MP Hits 22, Tamil Nadu Faces Severe Criticism

The death toll from contaminated cough syrup in Madhya Pradesh has climbed to 22, with two more children from Chhindwara district succumbing to suspected renal failure during treatment in Nagpur, Maharashtra, on Wednesday night. The victims, both under 10 years old from the Parasia block, bring the total to 19 from Chhindwara, two from Betul, and one from Pandhurna. Three other children who consumed the syrup remain in critical condition at a Nagpur hospital, where Chief Minister Mohan Yadav visited them earlier this week. Additional Collector Dhirendra Singh confirmed the latest fatalities, noting that medical documents are being verified to establish definitive causes. This outbreak underscores ongoing challenges in India's pharmaceutical regulation, echoing the 2022 global scandal where diethylene glycol-tainted syrups killed over 300 children across Indonesia, Gambia, and Uzbekistan, prompting stricter Central Drugs Standard Control Organisation (CDSCO) guidelines.

The implicated product, Coldrif cough syrup, is manufactured by Sresan Pharmaceuticals in Kancheepuram, Tamil Nadu. Drug inspectors from both Madhya Pradesh and Tamil Nadu have confirmed the syrup contains over 45% diethylene glycol (DEG), a sweet-tasting but highly toxic industrial solvent used as a cheap substitute for propylene glycol in formulations. DEG, banned in pharmaceuticals since the 1937 Elixir Sulfanilamide disaster in the US that claimed 107 lives, causes acute kidney failure, especially in children. The CDSCO has responded by demanding a nationwide list of all cough syrup manufacturers and launching joint audits to prevent similar adulterations.

In a parallel development, Tamil Nadu Health Minister Ma. Subramanian announced the suspension of two senior drug inspectors for lapses in oversight. Sresan Pharmaceuticals, a small-scale unit operating from a modest facility, received its drug licence and renewal without on-site inspection, raising red flags about enforcement gaps in southern India's pharma hub, which produces 30% of the country's formulations.

Chief Minister Yadav has sharply criticised Tamil Nadu authorities for allegedly stonewalling the investigation, accusing them of lacking cooperation despite arrests made in the manufacturing hub. "Our police have made arrests where the medicine was manufactured, but the Tamil Nadu government is not cooperating the way it should," Yadav stated during a press briefing, flanked by officials. He demanded an immediate regulatory probe by the Tamil Nadu Drug Controller into Sresan's licensing and operations, questioning, "Who were the people responsible for granting this company a drug license? How was the licence renewed without inspection? How was this pharmaceutical company granted an industry licence again?" Yadav highlighted anomalies like the firm's cramped 500-square-foot space, ill-suited for GMP-compliant production. The Madhya Pradesh government has invoked the Drugs and Cosmetics Act, 1940, to pursue negligence charges, while urging the Center for a unified national framework to curb substandard drugs.

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In a joint operation with Chennai police, a Special Investigation Team (SIT) from Madhya Pradesh arrested G. Ranganathan, the 52-year-old proprietor of Sresan Pharmaceuticals, from his residence late Tuesday. Chhindwara Superintendent of Police Ajay Pandey revealed that documents on company ownership and operations were seized, with interrogations underway to identify accomplices in the supply chain. The six-member SIT, dispatched to Tamil Nadu, plans to seek transit remand for Ranganathan to facilitate deeper questioning in Bhopal.

As the probe intensifies, experts call for forensic analysis of batch records and raw material sourcing to trace contamination origins. This tragedy not only exposes regulatory silos between states but also amplifies calls for AI-driven pharmacovigilance and mandatory third-party testing, ensuring such lapses do not recur in a $50 billion industry vital to public health.

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