Another drug recalled over contamination

The Hospital Authority ordered the recall of a diuretic drug yesterday after it was found to be contaminated by fungus, further shaking public confidence in the drug industry after a series of blunders. The drug, sold as Diurex and produced by Hong Kong company Vickmans Laboratories, had been prescribed to 43,000 patients. Director of Health Lam Ping-yan said at least two batches had been found to be contaminated with the fungus Aspergillus. He said the fungus was dangerous only to those whose immune systems were suppressed and efforts were being made to track down at-risk patients. The Department of Health said the company had been ordered to stop production immediately until further notice and the department was considering prosecution. Vickmans is a sister company of Europharm, which was involved in an earlier blunder connected to the deaths of six patients from a rare fungal infection, which were linked to a tainted drug, allopurinol. The Hospital Authority meanwhile came under fire for taking a week to disclose the contamination after it was discovered by staff of the Kennedy Town general outpatient clinic last Wednesday. But the authority's director of cluster services, Cheung Wai-lun, said the authority had obtained a sample for testing only on Monday because of what he termed 'problems on traffic arrangements'. Department of Health consultant medical microbiologist Kam Kai-man said granules of Diurex had been stored for up to 10 days before they were turned into tablets, which might have caused the contamination. He said the fungus was commonly found in the environment. Diurex, chemically known as frusemide, was taken by heart, hypertension and kidney patients to encourage urination, he said. It was also prescribed to 90 leukaemia patients in public hospitals. Dr Cheung said the fungus was found in the stool culture of an elderly lymphoma patient in February but he had now recovered. It was very common for patients with suppressed immune systems to have fungal infections, he said. About 630,000 pills have already been prescribed and the Hospital Authority has 150,000 in storage. Dr Cheung said Vickmans supplied 63 types of drugs to the authority. Samples had been taken from the factory on Tuesday for tests and the authority would stop using the drugs if any abnormalities were found. Meanwhile, alternative suppliers were being sought, he said. The blunder was discovered weeks after the department finished inspecting 25 local drug makers in the wake of the previous blunders. Dr Lam said it was 'impossible' to spot storage problems in a brief inspection. 'It's like searching for a needle in an ocean,' he said. Health Secretary York Chow Yat-ngok said the drug maker should bear the greatest responsibility, adding that he was very disappointed in the local drug industry. Medical sector legislator Leung Ka-lau said the delay in publicising the case was 'ridiculous' and totally unacceptable. Medical Association president Tse Hung-hing was also shocked by the delay. 'Were they travelling around the world?' he asked, adding that it was very unprofessional. Dr Tse was also disappointed by the drug manufacturer. 'It shows how poor the regulation is and how neglectful the drug maker is. After a spate of incidents, we assumed they would pay more attention to their products but obviously they don't,' Dr Tse said. He noted that Vickmans' products were commonly used by private doctors across the city. 'We will inform doctors to stop using Diurex and other drugs produced by the company,' he said, adding that it was easy to find replacements. Practising Association of Pharmacists president Iris Chang said drug makers should not allow any tainted products to leave their plants. Vickmans said it was recalling Diurex. 'We are also following up the case with the Department of Health closely,' a spokeswoman said. Bad medicine March 6 Allopurinol produced by Europharm is found to contain 100 times the allowed level of fungus. It is later confirmed to be linked to a fungal infection that killed six patients March 10 It is revealed that several types of over-the-counter drugs made by local company MPL Holdings have been quietly recalled in the previous two weeks because of wrong labelling, including labels with incorrect expiry dates March 16 The Hospital Authority decides to recall 38,000 diabetes tablets made by Christo Pharmaceuticals because they are not registered for use in Hong Kong March 20 More than 3 million Cosalgesic painkiller tablets, imported by Unipharm Trading from Britain, are found to have a fabricated expiry date March 22 Almost 93,000 bottles of sterile water used to dilute anaesthetics for surgery are found to contain 30ml more than on the label March 25 Another batch of drugs imported by Unipharm is found to be labelled with the wrong expiry date March 27 Medipharma sodium chloride tablets for mouth cleaning are found to have the wrong expiry date April 2 Two batches of solutions used in dialysis for kidney patients imported by Fresenius Medical Care Hong Kong are recalled due to suspected contamination April 3 Some 70,000 boxes of the US-made drug Baraclude, imported by Bristol-Myers Squibb Pharma (HK) for patients with hepatitis B, are recalled because they carry the wrong registration number April 4 Viscotears eye drops, made in Germany by drug giant Novartis, are recalled because they are not registered for sale in the city April 6 Novartis is ordered to recall a batch of Swiss-made Cortiphenol H eye ointment after its registration is found to have expired April 7 The Department of Health orders drug wholesaler Main Life Corporation to recall five products found to have unregistered sales packs April 11 One of six patients given excessive doses of an epilepsy drug dies at Tung Wah Hospital. Some bottles of 60-milligram phenobarbital tablets had been mislabelled as 30-milligram tablets April 17 Up to 63 diabetes patients are feared at risk of taking the wrong medicine after drug dispensers at the Lady Trench General Outpatient Clinic in Tsuen Wan mix up their tablets with drugs for controlling high blood pressure