A discarded coagulant, long past its expiry date, is being used by India’s paramilitary forces, jeopardising the lives of troops in the Maoist-affected areas of central India and the insurgency-prone Northeast states and Jammu and Kashmir.
The item in question is the first-generation version of a coagulant—QuikClot—and HT has at least one government tender specifically asking for this product. It is also reported that such items are being supplied to paramilitary troops in Chhattisgarh, Bihar, and Jharkhand as well.
The coagulant is used to seal serious bleeding in wounds caused by bullets and bomb splinters till the injured soldiers receive proper medical treatment.
Such situations are normally encountered in Maoist and militancy prone areas where battles are fought in areas far off from places with proper medical facilities. QuikClot was first introduced in the US in 2002 and came in the form of a granular product made from zeolite, a naturally-occurring mineral.
The granular product was phased out of production in 2007 since it caused burns to both the patient and the person administering it. Besides the danger of causing tissue injury to the wounded, the zeolite granules were often washed away by blood, leading to messy application. Better versions—in beanbag form and gauze strips—were also developed.
“QuikClot granular has not been manufactured since 2007 and carried a shelf life of five years. If there are any remaining QuikClot granular products in the market, they are past their expiration date,” said Jos Kerstens, vice-president, International Sales, Z-Medica, the company that manufactures the product.
Kerstens added that the new generation products (gauze strips) are currently the only coagulant recommended for use by the US Department of Defense through the Committee for Tactical Combat Casualty Care (TCCC). TCCC sets the standard for management of combat casualties throughout the US military.
The supplied item—HT has a sample—has an unusual packaging. In spite of it being such a vital item during emergency situations, the packaging has no mention of the manufacturer’s name or any address.
“No drug can be marketed in India without mentioning the name of the manufacturer as well as the name and address of the importer,” said GN Singh, Drug Controller General of India.