Chhindwara, India — The heartbreak in Chhindwara district, Madhya Pradesh, deepened as reports confirmed the deaths of at least 23 children linked to a toxic cough syrup. The affected children reportedly consumed Coldrif syrup, produced by Sresan Pharmaceuticals based in Tamil Nadu. In response to the devastating incidents, authorities have shuttered the manufacturing facility and revoked its license indefinitely.
Initial reports of the deaths surfaced in early September, but the exact cause remained shrouded in uncertainty for weeks, as families denied post-mortem examinations. However, testing later revealed alarming levels of diethylene glycol (DEG) in the syrup—a compound known to cause severe damage to the kidneys, liver, and nervous system. Many affected children exhibited signs of acute kidney failure.
An inquiry led by Tamil Nadu’s drug control officials in early October uncovered serious violations at Sresan Pharmaceuticals. Investigators discovered that the company sourced industrial-grade propylene glycol from local traders instead of legitimate pharmaceutical suppliers. While propylene glycol is typically safe for consumption, the industrial versions often contain harmful contaminants, including DEG. The absence of qualified chemists overseeing production further compounded the risk, as none of the raw materials underwent rigorous testing.
Biopsy samples from the deceased children confirmed high concentrations of DEG, with one batch of Coldrif reportedly containing over 48% of the toxic substance—far exceeding permissible limits by hundreds of times. Inspections revealed 39 critical violations of the Drugs and Cosmetics Act at the facility, including pest infestations, inadequate ventilation, and broken equipment.
A report from the Comptroller and Auditor General of India from 2024 highlighted ongoing deficiencies in drug inspections across Tamil Nadu, citing that only two-thirds of mandatory inspections were completed from 2016 to 2021. This lack of oversight raises critical questions regarding the safety of pharmaceuticals produced in the region.
In the aftermath of these tragic events, immediate actions were taken against several health officials in Madhya Pradesh. The doctor who prescribed Coldrif syrup faced scrutiny, leading to suspensions of multiple regulatory figures, including the district drug inspector and the deputy director of the state Food and Drug Administration. Notably, the owner of Sresan Pharmaceuticals, who had been evading authorities since September, has since been apprehended and charged with serious offenses, including culpable homicide.
Elsewhere, another cough syrup manufactured by Kaysons Pharma has also been tied to child fatalities and hospitalizations, leading to state investigations and distribution freezes. Initial denials of connections by the state government were later reversed, resulting in accountability measures. The Kaysons syrup, previously failing quality tests multiple times, raised further concerns when authorities attributed the deaths to overdosing, alleviating the company of some responsibility.
In light of these tragedies, several Indian states have moved to ban the sale of cough syrups designed for children, intensifying scrutiny of pharmaceutical practices nationwide. The Supreme Court was approached to force a comprehensive national inquiry into the safety of such products, but the petition was ultimately dismissed.
The Indian pharmaceutical industry has come under heightened scrutiny following previous incidents tied to cough syrup contamination that caused a wave of fatalities in other countries, including The Gambia and Uzbekistan. The World Health Organization has acknowledged India’s notification regarding several contaminated syrup batches, although none had been officially exported. The organization continues to work with Indian authorities to address public health risks stemming from these developments, ensuring accountability and safety for vulnerable populations.