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Coldrif Row Explained: How A Cough Syrup Led To 14 Child Deaths And A Nationwide Crackdown

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What began as routine prescriptions for cough and cold in Chhindwara ended in 14 child deaths, leading to licence cancellations, and a multi-state crackdown on toxic syrups

Coldrif cough syrups (Photo: Social Media)

Coldrif cough syrups (Photo: Social Media)

A paediatric cough syrup made by Sresan Pharmaceuticals, a Chennai-based company, is at the centre of a grave drug-safety failure. In Madhya Pradesh’s Chhindwara district, 14 children treated for routine colds later developed acute kidney failure and died. Subsequent testing found that the cough syrup they had consumed—Coldrif—contained 48.6 per cent diethylene glycol (DEG) by volume, with ethylene glycol also detected.

Both chemicals are industrial solvents and are prohibited for medicinal use because even tiny amounts can be lethal, particularly for children.

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Once laboratory results were confirmed, Tamil Nadu banned the product and ordered stocks off shelves. The Central Drugs Standard Control Organisation (CDSCO) recommended cancellation of Sresan’s manufacturing licence, which has been revoked, and criminal proceedings have begun against the company.

In parallel, the Union Health Ministry advised all states and Union Territories that cough and cold syrups should not be prescribed to children under two years of age.

How Was The Contamination Discovered?

The pattern emerged slowly, then all at once. In the first half of September, Chhindwara recorded a string of paediatric deaths from suspected renal failure. Families described an identical arc: a minor respiratory illness, a prescription that included Coldrif, a brief improvement, and then a sudden drop in urine output followed by kidney shutdown.

By 18 September, the district authorities were treating it as an emergency.

Investigators traced prescriptions to Dr Praveen Soni, a government paediatrician who also practised privately in Madhya Pradesh’s Parasia. Police have arrested and suspended him. The FIR names both the doctor and Sresan Pharmaceuticals, invoking Section 276 of the Bharatiya Nyaya Sanhita (sale of adulterated drugs) and Section 27A of the Drugs and Cosmetics Act, 1940, which can attract imprisonment up to life when adulteration causes death.

In a related order, the Controller, Food and Drugs Administration, Madhya Pradesh, instructed drug inspectors across the state on 4 October to halt Coldrif distribution immediately, reflecting the seriousness of the findings from Tamil Nadu’s laboratory.

The chemical evidence is stark. Analysis from the Government Analyst at the Drug Testing Laboratory in Chennai declared the syrup “not of standard quality”, recording 48.6 per cent (w/v) diethylene glycol, a level that renders the medicine dangerous to health.

The trail led to Batch SR-13, manufactured in May 2025 and carrying an expiry of April 2027.

To rule out broader contamination, a central expert team drawn from the National Centre for Disease Control (NCDC), the National Institute of Virology (NIV) and the CDSCO visited Chhindwara and Nagpur. Samples were tested at NIV Pune, the Central Drug Laboratory, Mumbai, and NEERI, Nagpur.

The findings were narrow but decisive: nine of 10 medicines met quality standards, while Coldrif alone failed for DEG far beyond permissible limits.

Out of caution, the administration also suspended sales of Nextro DS, another cough syrup some of the children had taken; its final test results are awaited.

What Are Diethylene Glycol And Ethylene Glycol, And Why Are They Deadly?

Diethylene glycol and ethylene glycol are clear, syrupy liquids widely used in industry, such as in antifreeze, brake fluids, paints, dyes and resins. They are not fit for ingestion. In the body, they can trigger metabolic acidosis and cause rapid renal and hepatic failure, neurological damage, and death. Children are particularly vulnerable because smaller doses can overwhelm developing organs.

Part of the danger lies in how easily these solvents can masquerade as legitimate pharmaceutical excipients if procurement and testing are lax.

The World Health Organisation has linked similar contaminations to mass casualties in several countries.

After The Gambia reported seventy child deaths in 2022, the WHO issued a series of global alerts; it now estimates more than 300 child deaths worldwide since 2022 from DEG/EG poisoning.

How Have States Responded?

The Chhindwara tragedy has prompted action across multiple states, from bans and seizures to precautionary advisories.

Madhya Pradesh has imposed a blanket ban on Coldrif and all products by Sresan Pharmaceuticals. Chief Minister Mohan Yadav called the deaths “extremely tragic” and said the state would ensure that “the guilty are not spared.” He also announced financial assistance of Rs 4 lakh each to the families of the children who died due to consumption of the cough syrup.

In Tamil Nadu, the state government banned its sale and distribution with effect from 1 October after laboratory tests detected 48.6 per cent diethylene glycol. The manufacturer’s licence has been cancelled, criminal proceedings have begun, and the Drugs Control Department has issued a public notice warning against sale or consumption of the syrup.

Maharashtra’s Food and Drug Administration has halted sales and seized stock of the implicated batch, while Kerala has suspended distribution “out of an abundance of caution.” Health Minister Veena George said the flagged batch was not distributed in the state but confirmed that all eight distributors and pharmacies were directed to clear shelves. Telangana has issued a public alert instructing hospitals, retailers, and wholesalers to stop use immediately.

In Uttarakhand, Health Secretary Dr R. Rajesh Kumar directed district officials to ensure that no cough or cold medication is given to children below two years of age.

Rajasthan, which also reported four child deaths during the same period, said its inquiry has not established any link between those deaths and Coldrif’s quality, though precautionary monitoring continues.

What Officials Have Said

Union Health Secretary Punya Salila Srivastava convened all states and Union Territories in an emergency meeting on Sunday to tighten compliance and surveillance. States were directed to enforce Revised Schedule M, India’s upgraded Good Manufacturing Practices code, and to flag non-compliant units for immediate action.

Drug Controller General of India Dr Rajeev Raghuvanshi said manufacturers must align with the revised norms by December 2025, noting that risk-based inspections are already underway in 19 units across six states.

ICMR Director General Dr Rajiv Bahl and Director General of Health Services Dr Sunita Sharma emphasised that most paediatric coughs are self-limiting and do not require medication, and indicated that national guidelines on the rational use of paediatric syrups will be issued shortly.

What Happens Next?

The priority for investigators is to identify precisely how a toxic solvent entered a paediatric formulation. The CDSCO and Tamil Nadu Drug Control Department are tracing Sresan’s procurement and production chain for Batch SR-13. In Madhya Pradesh, Dr Praveen Soni remains under investigation for alleged negligence and for prescribing the syrup despite reported adverse effects.

Policy-wise, the Union Health Ministry has ordered states to audit paediatric syrup manufacturers and submit compliance reports within 30 days. Surveillance through the Integrated Disease Surveillance Programme (IDSP–IHIP) has been intensified, and inter-state coordination strengthened so that unusual clusters are flagged and tested rapidly.

About the Author

Karishma Jain
Karishma Jain

Karishma Jain, Chief Sub Editor at News18.com, writes and edits opinion pieces on a variety of subjects, including Indian politics and policy, culture and the arts, technology and social change. Follow her @kar…Read More

Karishma Jain, Chief Sub Editor at News18.com, writes and edits opinion pieces on a variety of subjects, including Indian politics and policy, culture and the arts, technology and social change. Follow her @kar… Read More

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