Minister says injection that affected vision in Punjab patients was contaminated during transportation

Punjab Interim Health Minister Dr Javed Akram on Monday said the Avastin eye injection, allegedly responsible for causing vision loss in diabetic patients across the province, was contaminated during transportation.

Several diabetic patients in Lahore, Kasur and Jhang districts were administered Avastin injections to address retinal damage, but the doses led to severe infections. The issue first surfaced when several cases of the drug’s reaction were reported from the Kasur district.

According to doctors, the patients developed a life-threatening disease, endophthalmitis, an inflammation of the inner coats of the eye, which led to loss of vision.

Subsequently, the Punjab government slapped a ban on the eye drug for an indefinite period across the province, besides launching a portal to collect data on the patients affected by the drug and provide them with treatment.

A high-level inquiry was also initiated to find out the prime factors leading to vision loss among patients administered the injection in Punjab. Later a criminal case was registered against the manufacturers of the drug and two men were arrested in connection with the scam.

In a press conference in Lahore today, Dr Akram, flanked by Punjab caretaker health and population welfare minister Dr Jamal Nasir, said heavy rainfall and public transportation proved to be the reason behind the contamination.

“We think this batch was shifted when there was heavy rainfall in Lahore and the samples given that day weren’t properly packed or checked,” he said.

Dr Akram revealed the medicine was transported in a Daewoo bus, which is not allowed under the standard operating procedures.

He explained that after a forensic analysis of the vehicle was carried out, it was found that the distance between the lower compartment of the bus and the ground was less which led to rainwater entering the part of the vehicle where luggage/cargo was stored.

“Rain and sewage entered the compartment and contaminated the medicines. This is how the infection was caused,” he said.

“We also interviewed the driver who said he could not access the motorway due to water and went via the Multan road which took longer to reach.”

Dr Akram further stated that officials had also obtained previous records that confirmed that medicines were being transported in public vehicles without any temperature control.

Meanwhile, Dr Nasir recalled that the Punjab health department had sprung into action after the vision loss outbreak.

“We held meetings with the health commission and drug inspectors and visited 48 centres that conduct eye operations,” he said. “Services of around 26 centres were suspended and many operation theatres and labs were sealed.”

DG Drug Control (Primary and Secondary Healthcare Department of Punjab) Mohammad Sohail said the vision loss incident had to be looked at through a scientific lens.

“There was a media hype regarding this. We received 66 patients. Some were affected in one eye, others in both eyes,” he said.

“Nearly 85 per cent of patients were from outside Lahore. This was one clear indication. The pathogen that was discovered was pseudomonas.”

He added that these two indications led the department to study the route of transportation. “Then we got evidence that pre-filled syringes were transported through public transport and that too in the cargo department and not a temperature-controlled environment.”

DG Sohail said all the vision loss incidents were the outcome of transportation. “It is imperative to fix the problem and not malign the injection or some company,” he added.