NY Times: Counterfeit glycerin killing thousands worldwide

2007-05-10

Richard Moore

Original source URL:
http://www.nytimes.com/2007/05/06/world/americas/06poison.html

May 6, 2007

From China to Panama, a Trail of Poisoned Medicine
By WALT BOGDANICH and JAKE HOOKER

The kidneys fail first. Then the central nervous system begins to misfire. 
Paralysis spreads, making breathing difficult, then often impossible without 
assistance. In the end, most victims die.

Many of them are children, poisoned at the hands of their unsuspecting parents.

The syrupy poison, diethylene glycol, is an indispensable part of the modern 
world, an industrial solvent and prime ingredient in some antifreeze.

It is also a killer. And the deaths, if not intentional, are often no accident.

Over the years, the poison has been loaded into all varieties of medicine ‹ 
cough syrup, fever medication, injectable drugs ‹ a result of counterfeiters who
profit by substituting the sweet-tasting solvent for a safe, more expensive 
syrup, usually glycerin, commonly used in drugs, food, toothpaste and other 
products.

Toxic syrup has figured in at least eight mass poisonings around the world in 
the past two decades. Researchers estimate that thousands have died. In many 
cases, the precise origin of the poison has never been determined. But records 
and interviews show that in three of the last four cases it was made in China, a
major source of counterfeit drugs.

Panama is the most recent victim. Last year, government officials there 
unwittingly mixed diethylene glycol into 260,000 bottles of cold medicine ‹ with
devastating results. Families have reported 365 deaths from the poison, 100 of 
which have been confirmed so far. With the onset of the rainy season, 
investigators are racing to exhume as many potential victims as possible before 
bodies decompose even more.

Panama¹s death toll leads directly to Chinese companies that made and exported 
the poison as 99.5 percent pure glycerin.

Forty-six barrels of the toxic syrup arrived via a poison pipeline stretching 
halfway around the world. Through shipping records and interviews with 
government officials, The New York Times traced this pipeline from the 
Panamanian port of Colón, back through trading companies in Barcelona, Spain, 
and Beijing, to its beginning near the Yangtze Delta in a place local people 
call ³chemical country.²

The counterfeit glycerin passed through three trading companies on three 
continents, yet not one of them tested the syrup to confirm what was on the 
label. Along the way, a certificate falsely attesting to the purity of the 
shipment was repeatedly altered, eliminating the name of the manufacturer and 
previous owner. As a result, traders bought the syrup without knowing where it 
came from, or who made it. With this information, the traders might have 
discovered ‹ as The Times did ‹ that the manufacturer was not certified to make 
pharmaceutical ingredients.

An examination of the two poisoning cases last year ‹ in Panama and earlier in 
China ‹ shows how China¹s safety regulations have lagged behind its growing role
as low-cost supplier to the world. It also demonstrates how a poorly policed 
chain of traders in country after country allows counterfeit medicine to 
contaminate the global market.

Last week, the United States Food and Drug Administration warned drug makers and
suppliers in the United States ³to be especially vigilant² in watching for 
diethylene glycol. The warning did not specifically mention China, and it said 
there was ³no reason to believe² that glycerin in this country was tainted. Even
so, the agency asked that all glycerin shipments be tested for diethylene 
glycol, and said it was ³exploring how supplies of glycerin become 
contaminated.²

China is already being accused by United States authorities of exporting wheat 
gluten containing an industrial chemical, melamine, that ended up in pet food 
and livestock feed. The F.D.A. recently banned imports of Chinese-made wheat 
gluten after it was linked to pet deaths in the United States.

Beyond Panama and China, toxic syrup has caused mass poisonings in Haiti, 
Bangladesh, Argentina, Nigeria and twice in India.

In Bangladesh, investigators found poison in seven brands of fever medication in
1992, but only after countless children died. A Massachusetts laboratory 
detected the contamination after Dr. Michael L. Bennish, a pediatrician who 
works in developing countries, smuggled samples of the tainted syrup out of the 
country in a suitcase. Dr. Bennish, who investigated the Bangladesh epidemic and
helped write a 1995 article about it for BMJ, formerly known as the British 
Medical Journal, said that given the amount of medication distributed, deaths 
³must be in the thousands or tens of thousands.²

³It¹s vastly underreported,² Dr. Bennish said of diethylene glycol poisoning. 
Doctors might not suspect toxic medicine, particularly in poor countries with 
limited resources and a generally unhealthy population, he said, adding, ³Most 
people who die don¹t come to a medical facility.²

The makers of counterfeit glycerin, which superficially looks and acts like the 
real thing but generally costs considerably less, are rarely identified, much 
less prosecuted, given the difficulty of tracing shipments across borders. ³This
is really a global problem, and it needs to be handled in a global way,² said 
Dr. Henk Bekedam, the World Health Organization¹s top representative in Beijing.

Seventy years ago, medicine laced with diethylene glycol killed more than 100 
people in the United States, leading to the passage of the toughest drug 
regulations of that era and the creation of the modern Food and Drug 
Administration.

The F.D.A. has tried to help in poisoning cases around the world, but there is 
only so much it can do.

When at least 88 children died in Haiti a decade ago, F.D.A. investigators 
traced the poison to the Manchurian city of Dalian, but their attempts to visit 
the suspected manufacturer were repeatedly blocked by Chinese officials, 
according to internal State Department records. Permission was granted more than
a year later, but by then the plant had moved and its records had been 
destroyed.

³Chinese officials we contacted on this matter were all reluctant to become 
involved,² the American Embassy in Beijing wrote in a confidential cable. ³We 
cannot be optimistic about our chances for success in tracking down the other 
possible glycerine shipments.²

In fact, The Times found records showing that the same Chinese company 
implicated in the Haiti poisoning also shipped about 50 tons of counterfeit 
glycerin to the United States in 1995. Some of it was later resold to another 
American customer, Avatar Corporation, before the deception was discovered.

³Thank God we caught it when we did,² said Phil Ternes, chief operating officer 
of Avatar, a Chicago-area supplier of bulk pharmaceuticals and nonmedicinal 
products. The F.D.A. said it was unaware of the shipment.

In China, the government is vowing to clean up its pharmaceutical industry, in 
part because of criticism over counterfeit drugs flooding the world markets. In 
December, two top drug regulators were arrested on charges of taking bribes to 
approve drugs. In addition, 440 counterfeiting operations were closed down last 
year, the World Health Organization said.

But when Chinese officials investigated the role of Chinese companies in the 
Panama deaths, they found that no laws had been broken, according to an official
of the nation¹s drug enforcement agency. China¹s drug regulation is ³a black 
hole,² said one trader who has done business through CNSC Fortune Way, the 
Beijing-based broker that investigators say was a crucial conduit for the Panama
poison.

In this environment, Wang Guiping, a tailor with a ninth-grade education and 
access to a chemistry book, found it easy to enter the pharmaceutical supply 
business as a middleman. He quickly discovered what others had before him: that 
counterfeiting was a simple way to increase profits.

And then people in China began to die.
Cheating the System

Mr. Wang spent years as a tailor in the manufacturing towns of the Yangtze 
Delta, in eastern China. But he did not want to remain a common craftsman, 
villagers say. He set his sights on trading chemicals, a business rooted in the 
many small chemical plants that have sprouted in the region.

³He didn¹t know what he was doing,² Mr. Wang¹s older brother, Wang Guoping, said
in an interview. ³He didn¹t understand chemicals.²

But he did understand how to cheat the system.

Wang Guiping, 41, realized he could earn extra money by substituting cheaper, 
industrial-grade syrup ‹ not approved for human consumption ‹ for pharmaceutical
grade syrup. To trick pharmaceutical buyers, he forged his licenses and 
laboratory analysis reports, records show.

Mr. Wang later told investigators that he figured no harm would come from the 
substitution, because he initially tested a small quantity. He did it with the 
expertise of a former tailor.

He swallowed some of it. When nothing happened, he shipped it.

One company that used the syrup beginning in early 2005 was Qiqihar No. 2 
Pharmaceutical, about 1,000 miles away in Heilongjiang Province in the 
northeast. A buyer for the factory had seen a posting for Mr. Wang¹s syrup on an
industry Web site.

After a while, Mr. Wang set out to find an even cheaper substitute syrup so he 
could increase his profit even more, according to a Chinese investigator. In a 
chemical book he found what he was looking for: another odorless syrup ‹ 
diethylene glycol. At the time, it sold for 6,000 to 7,000 yuan a ton, or about 
$725 to $845, while pharmaceutical-grade syrup cost 15,000 yuan, or about 
$1,815, according to the investigator.

Mr. Wang did not taste-test this second batch of syrup before shipping it to 
Qiqihar Pharmaceutical, the government investigator said, adding, ³He knew it 
was dangerous, but he didn¹t know that it could kill.²

The manufacturer used the toxic syrup in five drug products: ampules of 
Amillarisin A for gall bladder problems; a special enema fluid for children; an 
injection for blood vessel diseases; an intravenous pain reliever; and an 
arthritis treatment.

In April 2006, one of southern China¹s finest hospitals, in Guangzhou, Guangdong
Province, began administering Amillarisin A. Within a month or so, at least 18 
people had died after taking the medicine, though some had already been quite 
sick.

Zhou Jianhong, 33, said his father took his first dose of Amillarisin A on April
19. A week later he was in critical condition. ³If you are going to die, you 
want to die at home,² Mr. Zhou said. ³So we checked him out of the hospital.² He
died the next day.

³Everybody wants to invest in the pharmaceutical industry and it is growing, but
the regulators can¹t keep up,² Mr. Zhou said. ³We need a system to assure our 
safety.²

The final death count is unclear, since some people who took the medicine may 
have died in less populated areas.

In a small town in Sichuan Province, a man named Zhou Lianghui said the 
authorities would not acknowledge that his wife had died from taking tainted 
Amillarisin A. But Mr. Zhou, 38, said he matched the identification number on 
the batch of medicine his wife received with a warning circular distributed by 
drug officials.

³You probably cannot understand a small town if you are in Beijing,² Zhou 
Lianghui said in a telephone interview. ³The sky is high, and the emperor is far
away. There are a lot of problems here that the law cannot speak to.²

The failure of the government to stop poison from contaminating the drug supply 
caused one of the bigger domestic scandals of the year. Last May, China¹s 
premier, Wen Jiabao, ordered an investigation of the deaths, declaring, ³The 
pharmaceutical market is in disorder.²

At about the same time, 9,000 miles away in Panama, the long rainy season had 
begun. Anticipating colds and coughs, the government health program began 
manufacturing cough and antihistamine syrup. The cough medicine was sugarless so
that even diabetics could use it.

The medicine was mixed with a pale yellow, almost translucent syrup that had 
arrived in 46 barrels from Barcelona on the container ship Tobias Maersk. 
Shipping records showed the contents to be 99.5 percent pure glycerin.

It would be months and many deaths later before that certification was 
discovered to be pure fiction.

A Mysterious Illness

Early last September, doctors at Panama City¹s big public hospital began to 
notice patients exhibiting unusual symptoms.

They initially appeared to have Guillain-Barré syndrome, a relatively rare 
neurological disorder that first shows up as a weakness or tingling sensation in
the legs. That weakness often intensifies, spreading upward to the arms and 
chest, sometimes causing total paralysis and an inability to breathe.

The new patients had paralysis, but it did not spread upward. They also quickly 
lost their ability to urinate, a condition not associated with Guillain-Barré. 
Even more unusual was the number of cases. In a full year, doctors might see 
eight cases of Guillain-Barré, yet they saw that many in just two weeks.

Doctors sought help from an infectious disease specialist, Néstor Sosa, an 
intense, driven doctor who competes in triathlons and high-level chess.

Dr. Sosa¹s medical specialty had a long, rich history in Panama, once known as 
one of the world¹s unhealthiest places. In one year in the late 1800s, a lethal 
mix of yellow fever and malaria killed nearly 1 in every 10 residents of Panama 
City. Only after the United States managed to overcome those mosquito-borne 
diseases was it able to build the Panama Canal without the devastation that 
undermined an earlier attempt by the French.

The suspected Guillain-Barré cases worried Dr. Sosa. ³It was something really 
extraordinary, something that was obviously reaching epidemic dimensions in our 
hospital,² he said.

With the death rate from the mystery illness near 50 percent, Dr. Sosa alerted 
the hospital management, which asked him to set up and run a task force to 
handle the situation. The assignment, a daunting around-the-clock dash to catch 
a killer, was one he eagerly embraced.

Several years earlier, Dr. Sosa had watched as other doctors identified the 
cause of another epidemic, later identified as hantavirus, a pathogen spread by 
infected rodents.

³I took care of patients but I somehow felt I did not do enough,² he said. The 
next time, he vowed, would be different.

Dr. Sosa set up a 24-hour ³war room² in the hospital, where doctors could 
compare notes and theories as they scoured medical records for clues.

As a precaution, the patients with the mystery illness were segregated and 
placed in a large empty room awaiting renovation. Health care workers wore 
masks, heightening fears in the hospital and the community.

³That spread a lot of panic,² said Dr. Jorge Motta, a cardiologist who runs the 
Gorgas Memorial Institute, a widely respected medical research center in Panama.
³That is always a terrifying thought, that you will be the epicenter of a new 
infectious disease, and especially a new infectious disease that kills with a 
high rate of death, like this.²

Meanwhile, patients kept coming, and hospital personnel could barely keep up.

³I ended up giving C.P.R.,² Dr. Sosa said. ³I haven¹t given C.P.R. since I was a
resident, but there were so many crises going on.²

Frightened hospital patients had to watch others around them die for reasons no 
one understood, fearing that they might be next.

As reports of strange Guillain-Barré symptoms started coming in from other parts
of the country, doctors realized they were not just dealing with a localized 
outbreak.

Pascuala Pérez de González, 67, sought treatment for a cold at a clinic in Coclé
Province, about a three-hour drive from Panama City. In late September she was 
treated and sent home. Within days, she could no longer eat; she stopped 
urinating and went into convulsions.

A decision was made to take her to the public hospital in Panama City, but on 
the way she stopped breathing and had to be resuscitated. She arrived at the 
hospital in a deep coma and later died.

Medical records contained clues but also plenty of false leads. Early victims 
tended to be males older than 60 and diabetic with high blood pressure. About 
half had been given Lisinopril, a blood pressure medicine distributed by the 
public health system.

But many who did not receive Lisinopril still got sick. On the chance that those
patients might have forgotten that they had taken the drug, doctors pulled 
Lisinopril from pharmacy shelves ‹ only to return it after tests found nothing 
wrong.

Investigators would later discover that Lisinopril did play an important, if 
indirect role in the epidemic, but not in the way they had imagined.

A Major Clue

One patient of particular interest to Dr. Sosa came into the hospital with a 
heart attack, but no Guillain-Barré-type symptoms. While undergoing treatment, 
the patient received several drugs, including Lisinopril. After a while, he 
began to exhibit the same neurological distress that was the hallmark of the 
mystery illness.

³This patient is a major clue,² Dr. Sosa recalled saying. ³This is not something
environmental, this is not a folk medicine that¹s been taken by the patients at 
home. This patient developed the disease in the hospital, in front of us.²

Soon after, another patient told Dr. Sosa that he, too, developed symptoms after
taking Lisinopril, but because the medicine made him cough, he also took cough 
syrup ‹ the same syrup, it turned out, that had been given to the heart patient.

³I said this has got to be it,² Dr. Sosa recalled. ³We need to investigate this 
cough syrup.²

The cough medicine had not initially aroused much suspicion because many victims
did not remember taking it. ³Twenty-five percent of those people affected denied
that they had taken cough syrup, because it¹s a nonevent in their lives,² Dr. 
Motta said.

Investigators from the United States Centers for Disease Control and Prevention,
who were in Panama helping out, quickly put the bottles on a government jet and 
flew them to the United States for testing. The next day, Oct. 11, as Panamanian
health officials were attending a news conference, a Blackberry in the room went
off.

The tests, the C.D.C. was reporting, had turned up diethylene glycol in the 
cough syrup.

The mystery had been solved. The barrels labeled glycerin turned out to contain 
poison.

Dr. Sosa¹s exhilaration at learning the cause did not last long. ³It¹s our 
medication that is killing these people,² he said he thought. ³It¹s not a virus,
it¹s not something that they got outside, but it was something we actually 
manufactured.²

A nationwide campaign was quickly begun to stop people from using the cough 
syrup. Neighborhoods were searched, but thousands of bottles either had been 
discarded or could not be found.

As the search wound down, two major tasks remained: count the dead and assign 
blame. Neither has been easy.

A precise accounting is all but impossible because, medical authorities say, 
victims were buried before the cause was known, and poor patients might not have
seen doctors.

Another problem is that finding traces of diethylene glycol in decomposing 
bodies is difficult at best, medical experts say. Nonetheless, an Argentine 
pathologist who has studied diethylene glycol poisonings helped develop a test 
for the poison in exhumed bodies. Seven of the first nine bodies tested showed 
traces of the poison, Panamanian authorities said.

With the rainy season returning, though, the exhumations are about to end. Dr. 
José Vicente Pachar, director of Panama¹s Institute of Legal Medicine and 
Forensic Sciences, said that as a scientist he would like a final count of the 
dead. But he added, ³I should accept the reality that in the case of Panama we 
are not going to know the exact number.²

Local prosecutors have made some arrests and are investigating others connected 
to the case, including officials of the import company and the government agency
that mixed and distributed the cold medicine. ³Our responsibilities are to 
establish or discover the truth,² said Dimas Guevara, the homicide investigator 
guiding the inquiry.

But prosecutors have yet to charge anyone with actually making the counterfeit 
glycerin. And if the Panama investigation unfolds as other inquiries have, it is
highly unlikely that they ever will.

A Suspect Factory

Panamanians wanting to see where their toxic nightmare began could look up the 
Web site of the company in Hengxiang, China, that investigators in four 
countries have identified as having made the syrup ‹ the Taixing Glycerine 
Factory. There, under the words ³About Us,² they would see a picture of a modern
white building nearly a dozen stories tall, adorned by three arches at the 
entrance. The factory, the Web site boasts, ³can strictly obey the contract and 
keep its word.²

But like the factory¹s syrup, all is not as it seems.

There are no tall buildings in Hengxiang, a country town with one main road. The
factory is not certified to sell any medical ingredients, Chinese officials say.
And it looks nothing like the picture on the Internet. In reality, its chemicals
are mixed in a plain, one-story brick building.

The factory is in a walled compound, surrounded by small shops and farms. In the
spring, nearby fields of rape paint the countryside yellow. Near the front gate,
a sign over the road warns, ³Beware of counterfeits.² But it was posted by a 
nearby noodle machine factory that appears to be worried about competition.

The Taixing Glycerine Factory bought its diethylene glycol from the same 
manufacturer as Mr. Wang, the former tailor, the government investigator said. 
From this spot in China¹s chemical country, the 46 barrels of toxic syrup began 
their journey, passing from company to company, port to port and country to 
country, apparently without anyone testing their contents.

Traders should be thoroughly familiar with their suppliers, United States health
officials say. ³One simply does not assume that what is labeled is indeed what 
it is,² said Dr. Murray Lumpkin, deputy commissioner for international and 
special programs for the Food and Drug Administration.

In the Panama case, names of suppliers were removed from shipping documents as 
they passed from one entity to the next, according to records and investigators.
That is a practice some traders use to prevent customers from bypassing them on 
future purchases, but it also hides the provenance of the product.

The first distributor was the Beijing trading company, CNSC Fortune Way, a unit 
of a state-owned business that began by supplying goods and services to Chinese 
personnel and business officials overseas.

As China¹s market reach expanded, Fortune Way focused its business on 
pharmaceutical ingredients, and in 2003, it brokered the sale of the suspect 
syrup made by the Taixing Glycerine Factory. The manufacturer¹s certificate of 
analysis showed the batch to be 99.5 percent pure.

Whether the Taixing Glycerine Factory actually performed the test has not been 
publicly disclosed.

Original certificates of analysis should be passed on to each new buyer, said 
Kevin J. McGlue, a board member of the International Pharmaceutical Excipients 
Council. In this case, that was not done.

Fortune Way translated the certificate into English, putting its name ‹ not the 
Taixing Glycerine Factory¹s ‹ at the top of the document, before shipping the 
barrels to a second trading company, this one in Barcelona.

Li Can, managing director at Fortune Way, said he did not remember the 
transaction and could not comment, adding, ³There is a high volume of trade.²

Upon receiving the barrels in September 2003, the Spanish company, Rasfer 
International, did not test the contents, either. It copied the chemical 
analysis provided by Fortune Way, then put its logo on it. Ascensión Criado, 
Rasfer¹s manager, said in an e-mail response to written questions that when 
Fortune Way shipped the syrup, it did not say who made it.

Several weeks later, Rasfer shipped the drums to a Panamanian broker, the 
Medicom Business Group. ³Medicom never asked us for the name of the 
manufacturer,² Ms. Criado said.

A lawyer for Medicom, Valentín Jaén, said his client was a victim, too. ³They 
were tricked by somebody,² Mr. Jaén said. ³They operated in good faith.²

In Panama, the barrels sat unused for more than two years, and officials said 
Medicom improperly changed the expiration date on the syrup.

During that time, the company never tested the product. And the Panamanian 
government, which bought the 46 barrels and used them to make cold medicine, 
also failed to detect the poison, officials said.

The toxic pipeline ultimately emptied into the bloodstream of people like 
Ernesto Osorio, a former high school teacher in Panama City. He spent two months
in the hospital after ingesting poison cough syrup last September.

Just before Christmas, after a kidney dialysis treatment, Mr. Osorio stood 
outside the city¹s big public hospital in a tear-splattered shirt, describing 
what his life had become.

³I¹m not an eighth of what I used to be,² Mr. Osorio said, his partly paralyzed 
face hanging like a slab of meat. ³I have trouble walking. Look at my face, look
at my tears.² The tears, he said apologetically, were not from emotion, but from
nerve damage.

And yet, Mr. Osorio knows he is one of the lucky victims.

³They didn¹t know how to keep the killer out of the medicine,² he said simply.

While the suffering in Panama was great, the potential profit ‹ at least for the
Spanish trading company, Rasfer ‹ was surprisingly small. For the 46 barrels of 
glycerin, Rasfer paid Fortune Way $9,900, then sold them to Medicom for $11,322,
according to records.

Chinese authorities have not disclosed how much Fortune Way and the Taixing 
Glycerine Factory made on their end, or how much they knew about what was in the
barrels.

³The fault has to be traced back to areas of production,² said Dr. Motta, the 
cardiologist in Panama who helped uncover the source of the epidemic. ³This was 
my plea ‹ please, this thing is happening to us, make sure whoever did this down
the line is not doing it to Peru or Sierra Leone or some other place.²

A Counterfeiter¹s Confession

The power to prosecute the counterfeiters is now in the hands of the Chinese.

Last spring, the government moved quickly against Mr. Wang, the former tailor 
who poisoned Chinese residents.

The authorities caught up with him at a roadblock in Taizhou, a city just north 
of Taixing, in chemical country. He was weak and sick, and he had not eaten in 
two days. Inside his white sedan was a bankbook and cash. He had fled without 
his wife and teenage son.

Chinese patients were dead, a political scandal was brewing and the authorities 
wanted answers. Mr. Wang was taken to a hospital. Then, in long sessions with 
investigators, he gave them what they wanted, explaining his scheme, how he 
tested industrial syrup by drinking it, how he decided to use diethylene glycol 
and how he conned pharmaceutical companies into buying his syrup, according to a
government official who was present for his interrogation.

³He made a fortune, but none of it went to his family,² said Wang Xiaodong, a 
former village official who knows Mr. Wang and his siblings. ³He liked to 
gamble.²

Mr. Wang remains in custody as the authorities decide whether he should be put 
to death. The Qiqihar drug plant that made the poisonous medicine has been 
closed, and five employees are now being prosecuted for causing ³a serious 
accident.²

In contrast to the Wang Guiping investigation, Chinese authorities have been 
tentative in acknowledging China¹s link to the Panama tragedy, which involved a 
state-owned trading company. No one in China has been charged with committing 
the fraud that ended up killing so many in Panama.

Sun Jing, the pharmaceutical program officer for the World Health Organization 
in Beijing, said the health agency sent a fax ³to remind the Chinese government 
that China should not be selling poisonous products overseas.² Ms. Sun said the 
agency did not receive an official reply.

Last fall, at the request of the United States ‹ Panama has no diplomatic 
relations with China ‹ the State Food and Drug Administration of China 
investigated the Taixing Glycerine Factory and Fortune Way.

The agency tested one batch of glycerin from the factory, and found no glycerin,
only diethylene glycol and two other substances, a drug official said.

Since then, the Chinese drug administration has concluded that it has no 
jurisdiction in the case because the factory is not certified to make medicine.

The agency reached a similar conclusion about Fortune Way, saying that as an 
exporter it was not engaged in the pharmaceutical business.

³We did not find any evidence that either of these companies had broken the 
law,² said Yan Jiangying, a spokeswoman for the drug administration. ³So a 
criminal investigation was never opened.²

A drug official said the investigation was subsequently handed off to an agency 
that tests and certifies commercial products ‹ the General Administration of 
Quality Supervision, Inspection and Quarantine.

But the agency acted surprised to learn that it was now in charge. ³What 
investigation?² asked Wang Jian, director of its Taixing branch. ³I¹m not aware 
of any investigation involving a glycerin factory.²

Besides, Huang Tong, an investigator in that office, said, ³We rarely get 
involved in products that are sold for export.²

Wan Qigang, the legal representative for the Taixing Glycerine Factory, said in 
an interview late last year that the authorities had not questioned him about 
the Panama poisoning, and that his company made only industrial-grade glycerin.

³I can tell you for certain that we have no connection with Panama or Spain,² 
Mr. Wan said.

But in recent months, the Glycerine Factory has advertised 99.5 percent pure 
glycerin on the Internet.

Mr. Wan recently declined to answer any more questions. ³If you come here as a 
guest, I will welcome you,² Mr. Wan said. ³But if you come again wanting to talk
about this matter, I will make a telephone call.²

A local government official said Mr. Wan was told not to grant interviews.

A five-minute walk away, another manufacturer, the Taixing White Oil Factory, 
also advertises medical glycerin on the Internet, yet it, too, has no 
authorization to make it. The company¹s Web site says its products ³have been 
exported to America, Australia and Italy.²

Ding Xiang, who represents the White Oil Factory, denied that his company made 
pharmaceutical-grade glycerin, but he said chemical trading companies in Beijing
often called, asking for it.

³They want us to mark the barrels glycerin,² Mr. Ding said in late December. ³I 
tell them we cannot do that.²

Mr. Ding said he stopped answering calls from Beijing. ³If this stuff is taken 
overseas and improperly used. ...² He did not complete the thought.

In chemical country, product names are not always what they seem.

³The only two factories in Taixing that make glycerin don¹t even make glycerin,²
said Jiang Peng, who oversees inspections and investigations in the Taixing 
branch of the State Food and Drug Administration. ³It is a different product.²

All in a Name

One lingering mystery involves the name of the product made by the Taixing 
Glycerine Factory. The factory had called its syrup ³TD² glycerin. The letters 
TD were in virtually all the shipping documents. What did TD mean?

Spanish medical authorities concluded that it stood for a manufacturing process.
Chinese inspectors thought it was the manufacturer¹s secret formula.

But Yuan Kailin, a former salesman for the factory , said he knew what the TD 
meant because a friend and former manager of the factory, Ding Yuming, had once 
told him. TD stood for the Chinese word ³tidai² (pronounced tee-die), said Mr. 
Yuan, who left his job in 1998 and still lives about a mile from the factory.

In Chinese, tidai means substitute. A clue that might have revealed the poison, 
the counterfeit product, was hiding in plain sight.

It was in the product name.
Renwick McLean and Brent McDonald contributed reporting.

Copyright 2007 The New York Times Company
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