2008 Chinese heparin adulteration

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2008 Chinese heparin adulteration, refers to heparin adulteration incidents that occurred in the United States of America in 2008. Pharmaceutical company Baxter International subcontracted the creation of precursor chemicals of heparin to Scientific Protein Laboratories, an American company with production facilities located in China. Scientific Protein Laboratories then used counterfeit precursors to create the chemicals ordered. Baxter then sold this adulterated heparin in the US, which killed 81 people, and left 785 severely injured. This caught the attention of the media and the USA Food and Drug Administration leading to numerous ongoing lawsuits.

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Overview

The raw material for the recalled heparin batches was processed in China from pig's intestines by the American pharmaceutical firm Scientific Protein Laboratories. [1] [2] [3] The U.S. Food and Drug Administration was quoted as stating that at least 81 deaths were believed to be linked to a raw heparin ingredient imported from the People's Republic of China, and that they had also received 785 reports of serious injuries associated with the drug's use. [4] According to The New York Times , "problems with heparin reported to the agency include difficulty breathing, nausea, vomiting, excessive sweating and rapidly falling blood pressure that in some cases led to life-threatening shock." [2]

In March 2008, due to contamination of the raw heparin stock imported from mainland China, major recalls of heparin, a substance widely used as an injectable anticoagulant, were announced by the U.S. Food and Drug Administration (FDA). [5] [6] [1]

Upon investigation of these adverse events by the FDA, academic institutions, and the involved pharmaceutical companies, the contaminant was identified as an "over-sulfated" derivative of chondroitin sulfate, a closely related substance obtained from mammal or fish cartilage and often used as a treatment for arthritis. [1] [7] Since over-sulfated chondroitin is not a naturally occurring molecule, costs a fraction of true heparin starting material, and mimics the in-vitro properties of heparin, the counterfeit was almost certainly intentional as opposed to an accidental lapse in manufacturing. [8] The raw heparin batches were found to have been cut from 2–60% with chondroitin and motivation for the adulteration was attributed to a combination of cost savings and a shortage of suitable pigs in mainland China.

When the FDA conducted an inspection of Baxter's Chinese heparin supplier, it found serious deficiencies at the facility, which the FDA detailed in a warning letter. [9] [10]

The warning letter detailed that the company failed to monitor changes in the impurity profile of incoming heparin active raw material, to adequately investigate out-of-specification results, to document actual processing steps in batch records, to validate all critical steps in the process, to qualify all suppliers, and to use valid methods to test products.

The FDA has stated that it does not have the funds nor bear the responsibility to inspect on a regular basis overseas upstream processors of finished active pharmaceutical ingredients such as heparin. However, according to the internationally harmonized guideline, ICH Q7, API manufacturers are fully responsible for qualifying their suppliers through on-site audits, testing, and regular communications.

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<span class="mw-page-title-main">Heparin</span> Anticoagulant

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A counterfeit medication or a counterfeit drug is a medication or pharmaceutical item which is produced and sold with the intent to deceptively represent its origin, authenticity, or effectiveness. A counterfeit drug may contain inappropriate quantities of active ingredients, or none, may be improperly processed within the body, may contain ingredients that are not on the label, or may be supplied with inaccurate or fake packaging and labeling. Counterfeit drugs are related to pharma fraud. Drug manufacturers and distributors are increasingly investing in countermeasures, such as traceability and authentication technologies, to try to minimise the impact of counterfeit drugs. Antibiotics with insufficient quantities of an active ingredient add to the problem of antibiotic resistance.

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References

  1. 1 2 3 "Heparin's Deadly Side Effects". Time magazine . 2008. Archived from the original on 21 November 2008. Retrieved 2008-11-16.
  2. 1 2 Harris, Gardiner; Walt Bogdanich (March 6, 2008). "Drug Tied to China Had Contaminant, F.D.A. Says". The New York Times. Archived from the original on December 11, 2008. Retrieved 2008-03-19.
  3. ↑ Harris, Gardiner; Walt Bogdanich (March 7, 2008). "German Authorities Report Problems With Blood Thinner". The New York Times. Retrieved 2008-06-11.
  4. ↑ Harris, Gardiner (April 22, 2008). "U.S. Identifies Tainted Heparin in 11 Countries". The New York Times. Archived from the original on December 11, 2008. Retrieved 2008-06-11.
  5. ↑ CBS News. "Blood-thinning drug under suspicion". Archived from the original on 2012-10-23.
  6. ↑ FDA informational page with information and links about FDA investigation.
  7. ↑ Zawisza, Julie (2008-03-29). "FDA Media Briefing on Heparin" (PDF). U.S. Food and Drug Administration . Retrieved 2008-04-23.
  8. ↑ Bogdanich, Walt (March 20, 2008). "Heparin Find May Point to Chinese Counterfeiting". The New York Times. Retrieved 2008-03-20.
  9. ↑ "Warning Letter: Changzhou SPL Company, Ltd (a/k/a "Kaipu")". FDA Warning letter. FDA. Retrieved 28 July 2010.
  10. ↑ Harris, Gardiner (February 14, 2008). "Chinese Factory Linked to Drug Under Inquiry in U.S." The New York Times. Archived from the original on December 9, 2008. Retrieved 2008-02-18. Public health officials noticed a problem with heparin supplies late last year when children undergoing dialysis at a Missouri hospital had severe allergic reactions. As officials investigated, they discovered hundreds of similar cases. Baxter initially recalled some of the product, but the problems persisted.
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