‘Cough syrup deaths’: Why did children fall sick, even die, after taking dextromethorphan?

Sixteen children fell sick, allegedly after taking the medication prescribed at Delhi’s mohalla clinics.

ByShivangi Saxena
‘Cough syrup deaths’: Why did children fall sick, even die, after taking dextromethorphan?
Kartik Kakar
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On December 23, the National Commission for the Protection of Child Rights issued a notice to the Delhi government. The commission highlighted that 16 children had fallen sick after consuming dextromethorphan, a cough suppressant.

The children were all aged between one and six. Three children died in September and October.

“...ensure to stop the usage of syrup Dextromethorphan and also ensure that no syrup of this batch is left at any of the dispensing units,” the commission said, and “send a factual action taken report regarding the action taken against respective officers, doctors and pharma company along with all the relevant documents to the Commission within 15 days.”

The matter first came to light through a letter dated December 7, stating that the children "were prescribed the dextromethorphan drug by mohalla clinics of Delhi government and the drug is strictly not recommended for paediatric age children".

The letter flagging the 'poisoning' due to dextromethorphan.

The letter flagging the 'poisoning' due to dextromethorphan.

A mohalla clinic in Delhi.

A mohalla clinic in Delhi.

According to the Indian Express, officials are probing two possible causes: contamination of a specific batch of medicine, or a higher dose given. The syrup in question was manufactured by Omega Pharmaceuticals, and was prescribed to the children at Delhi’s mohalla clinics.

Each mohalla clinic has four staffers: a medical officer or doctor, a pharmacist, a mohalla clinic assistant, and a multi-task worker. Medicines at the mohalla clinics are supplied by different hospitals.

Newslaundry met with the families of some of the children.

Dying weeks before her birthday

In July, Garima Saay, 6, had a cough and cold. Her mother, Hema, 27, took her to a mohalla clinic in Amrit Vihar in Delhi’s Burari, where Garima was administered dextromethorphan, according to her mother.

Hema took her daughter home. Garima fell asleep. After some time, Hema said she noticed Garima was running a temperature and her belly was swollen. With her husband, she rushed Garima to a local doctor, who referred them to a local hospital. The hospital in turn referred Garima elsewhere, and so did the next.

Garima died, while she was enroute from Hindu Rao hospital to Kalawati Saran hospital.

Weeping, Hema told Newslaundry her daughter had survived a paralytic attack at the age of six months, only to die weeks before her seventh birthday.

“She was intelligent. She used to try walking herself after the treatment,” said Hema, talking about Garima’s recovery from the paralytic attack. “She always used to tell me, ‘Mummy, I can go to the toilet myself, read a book.’ She used to jump around the whole day. I reminisce about her doing all this.”

Laxmi Devi, 32, has similar memories of her two-year-old daughter, Ananya.

Laxmi lives in a one-room chawl in Jawahar with her husband and three children. Her husband works as a labourer in a factory.

On October 10, she went out to fetch water. While she was away, Ananya drank half a bottle of dextromethorphan syrup – Laxmi’s medicine. Laxmi had been suffering from a cold and cough, and a mohalla clinic in Patel Nagar had given her the syrup.

“When I returned home, I saw Ananya was drinking my medicine,” Laxmi said. “I snatched the bottle and threw it away immediately. But she got a high fever after half an hour.”

After 7 pm that evening, with Ananya not seeming any better, Laxmi took Ananya to a local doctor. The doctor told them to take Ananya to Kalawati Saran hospital. After three days of treatment, Laxmi said, Ananya died on October 13.

“October 10 was Ananya’s birthday,” said Laxmi, crying. “I had bought her a frock by saving money. She was very happy. But this accident happened on her birthday.”

Survived, with side-effects

Several families in Delhi’s Prem Nagar told Newslaundry their children allegedly fell ill after consuming dextromethorphan syrup.

On August 4, for instance, Soni Devi, 28, took her four-year-old son, Yash, to a mohalla clinic in Amrit Vihar. Yash had been unwell for a few days but hadn’t improved.

“The doctor gave my son medicine, dextromethorphan,” said Soni. “I made him drink the medicine before sleeping.”

The following morning, Soni and her husband, Pramod, woke at 5 am. Yash, lying next to them, was cold to the touch and breathing with difficulty. As his pulse rate dropped, Pramod took him to Kapil hospital.

“I reached Kapil hospital at 7.20 am,” said Pramod. “There, the doctors refused to treat him after looking at him. We hired an ambulance and took him to Muni Maya Ram Jain hospital in Pitampura, and got him admitted.”

Yash’s treatment at Muni Maya Ram Jain hospital went on for a week, but he never improved. During that period, Pramod received a phone call from the Amrit Vihar mohalla clinic.

“My son was in the ICU when I received the call,” Pramod said. “On the other end, a female worker at the clinic asked me to return the medicine to the clinic because it needed to be examined.”

Pramod recorded the call, and shared the recording with this reporter.

On August 9, Pramod took Yash to Kalawati Saran hospital, where doctors told him his son’s illness was a reaction to dextromethorphan cough syrup. Yash was sent home on September 1, but his health has never been the same. His parents said he suffers from “fits”, “weakened” memory, slower responses, poor eyesight, and a poor appetite.

“My savings of eight years was spent on his treatment,” said Pramod. “Now, I am borrowing money to treat him.”

Also in Prem Nagar is Rita Singh, 25, whose two-year-old daughter Arpita suffered from a cough in November.

On November 20, Rita went to the mohalla clinic. She said Arpita was given dextromethorphan syrup to treat her symptoms.

“I got the medicine at 8.30 am,” Rita explained. “I gave her a spoonful of it at night. She became unconscious, her limbs contorted. We rushed her to Sanjay Gandhi hospital where she was referred to Kalawati Saran hospital. They kept her in the ICU for two days and discharged her on November 25.”

Newslaundry found several similar cases in the area. Near Rita’s home was the house of Shabana Khatun, 25, who has a two-year-old son, Rahim. Rahim had a cold in the last week of November and Shabana got dextromethorphan syrup for him from the mohalla clinic.

“I brought the medicine home at noon. Not long after giving him the medicine, his eyes rolled up, body went cold, and he couldn’t walk properly,” Shabana said. “I ran to my husband, who has a stitching job in a factory. We immediately took our son to a local doctor and he received a week’s treatment.”

Rahim’s story, though, has a happy ending – his health is fine now, his parents said.

‘All blame is assigned to doctor’

The Delhi government suspended three doctors from the mohalla clinics following the outcry over children falling ill after consuming dextromethorphan.

One of the three doctors is Kunal Gupta, 30, who was posted at the Sheesh Mahal mohalla clinic.

“I haven’t been given any information about which child has died,” Kunal told Newslaundry. “The government has only told me that my name is in dextromethorphan poisoning which is why I’m being removed. No medicine was checked at the backend. All the blame is assigned to the doctor.”

Several doctors at mohalla clinics told Newslaundry about instances of the government recalling batches of dextromethorphan. In August, for example, two batches – GL0015 and GL0016 – were recalled from the mohalla clinics for examination.

“Dextromethorphan has been examined for quite some time now,” Kunal said. “We were told to throw away the medicine from the batch GL0023. But I didn’t have that batch; I had the batch GL0060.” He alleged that after a child fell sick, he “didn’t give the medicine to any other kid and put the batch aside”.

None of this past history about dextromethorphan has been revealed by the Delhi government.

Suraj Kumar, a pharmacist at Mangolpuri Kurd mohalla clinic, told Newslaundry and “every year, one or the other batch of dextromethorphan turns out to be bad”.

“We ask for different medicines,” said Sunil, 26. “But they frequently give us only dextromethorphan, saying it’s the only available one.”

Newslaundry also reached out to one Ritika, a doctor at the Amrit Vihar mohalla clinic who had been suspended. She refused to speak.

Unsurprisingly, the illnesses, and deaths, have resulted in a political storm.

Even as the BJP took out posters on the issue, its East Delhi MP, Gautam Gambhir, said Aam Aadmi Party chief minister Arvind Kejriwal must “take responsibility” especially after “going gaga over mohalla clinics”.

Manoj Tiwari, the BJP’s MP for Northeast Delhi, also pulled up the Kejriwal government in a press note, saying, “Due to bad medicine being given in Delhi’s mohalla clinics, three children have died and 13 are sick. The Delhi government should take action immediately. One who cannot even manage the two crore people of Delhi has gone to dream about Punjab and UP.”

This piece was first published in Newslaundry Hindi. It was translated to English by Shardool Katyayan.

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