LAHORE, Nov 26: Sixteen people have died after drinking a toxic cough syrup here over the past three days. The first death was reported on Saturday and the toll rose to 16 when six people died in Mayo Hospital on Monday.

It was the second major drug-related ‘tragedy’ in Lahore over the past year. Earlier, reaction to a heart drug had claimed the lives of more than 150 cardiac patients and affected the health of thousands of others. A report on the scam is yet to be made public.

On Monday, initial investigations by police by other state-run departments suggested that the people who had lost lives or developed serious health complications after drinking the spurious syrup were ‘drug addicts’.

They had either added narcotics to the cough syrup to increase its sedation or directly consumed the syrup manufactured and marketed by some unregistered local companies under the same brand name, Lahore’s Executive District Health Officer Dr Inamul Haq said.

He said the original price of the syrup was Rs42 but some samples of the product retrieved during a crackdown were carrying the price tag of Rs19 which showed the possible involvement of some ‘swindlers’.

Investigation in-charge Inspector Muhammad Jameel of the Shahdara Town Police Station confirmed the death toll at 16. Most of the deceased were aged between 16 and 30 years. An FIR has been lodged under sections 302 and 34 of Pakistan Penal Code.

He said police had arrested the owner of Ricko Pharma, a distributor and owners of two medical stores.

A senior official told Dawn that according to the first laboratory analysis, samples of the cough syrup, Tyno, retrieved from medical stores, office of the distributor and the company were not spurious.

Health and medical experts finalised a report on the basis of the laboratory analysis and statements of relevant people, including the survivors, owners of medical stores and the government officials concerned.

According to the report, Tyno was manufactured by Ricko Pharma, a local pharmaceutical company situated on Multan Road. The syrup contains active ingredients — Dextromethorphan+chlorpheniraminemaleate.

“This combination is registered in Pakistan for years. As per the laboratory analysis contamination does not exist in the product as it fulfils the Active Pharmaceutical Ingredient (API) qualitative and quantitative tests,” the report said, adding that the most popular belief was that the affected people had used this combination as part of their addiction practices.

The report said: “It is being suspected that they might have mixed this syrup with some mixture (narcotics) to increase its sedation property. Upon intake of intoxicating cough syrup they all fell sick and their condition worsened. The symptoms include hypotension (abnormally low blood pressure), constriction of pupil, irritability of person and pinpoint vision.”

I said: “One thing we need to focus is that the issue is not product but drug use and also registration of combination,” it added.

The report also highlighted the sale of the drug without prescription and the issue of dispensing of the drug by qualified personnel (pharmacists) who could counsel the patients about the use and its potential harmful effects.

“In the light of the Drug Sales Rule 2007 and the DRAP Act 2012 which has now become a law, its practical enforcement needs to be reflected so that such serious accident could be avoided,” the report concluded. EDO Dr Inamul Haq said two teams of senior government officials were investigating the incident. He said the Punjab chief minister’s inspection team was also investigating the incident.