October 13, 2025 : Following reports of suspected adverse drug reactions (ADRs) from various government health facilities across the state, the Punjab health department has ordered an immediate withdrawal and banned the use of at least eight intravenous (IV) fluids and antibiotic injections.
An ADR is a harmful, unintended reaction to a medicinal product that occurs at doses normally used for treatment, prophylaxis, or diagnosis. ADRs range from minor side effects to serious life-threatening events and are a significant cause of hospital admissions and patient harm.
The directive, issued by the director, health and family welfare, issued on Friday, has instructed all civil surgeons, medical superintendents, and district hospital authorities to stop the use, issue, and procurement of specific batches of Normal Saline, Dextrose, Ciprofloxacin, DNS, and other IV fluids until further orders.
Punjab health minister Dr Balbir Singh said a committee has been formed and action will be taken against the suppliers based on the report submitted by it.
“Our stand is clear that patient care is our topmost priority; therefore, we have stopped the usage of these IV fluids as a precautionary measure. The health department is maintaining strict vigil to ensure that only quality medicines and fluids are supplied to hospitals. No compromise will be tolerated when it comes to the safety of patients,” he added.
Kumar Rahul, principal secretary, health department, said the samples are being sent to the laboratory for further testing.
“There have been sporadic cases in various parts of the state. Consequently, we have decided to stop the usage immediately. This is a precautionary measure. We are going to test samples of these batches in our lab,” he said, while refusing to comment on the number of ADRs reported across the state.
The circular also calls for a committee to be formed by the Punjab health systems corporation (PHSC) to evaluate the suspected ADRs linked to the batches that were procured this year and have expiry dates ranging from 2026 to 2028.
As per the orders, a copy of which is with HT, the suspension covers eight items manufactured by different pharmaceutical firms, including Swaroop Pharmaceuticals Private Limited, Otsuka Pharmaceutical India Private Limited, and Health Biotech Limited. The IV fluids and injection list includes normal saline (Sodium Chloride Injection IP 0.9%); Dextrose Injection IP 5%; Ciprofloxacin Injection IP 200 mg; DNS 0.9%, N/L + Dextrose 5% IV Fluid; and Bupivacaine HCL with Dextrose Injection.
All government health institutions have been directed to ensure strict compliance and immediately halt the usage of the mentioned drugs, the order further added. “The step was taken as a precautionary measure to ensure patient safety and to prevent further cases of adverse reactions,” the order further reads.
Previous recalls raise concern
This is not the first time Punjab has faced issues related to IV fluid quality.
In May this year, the Punjab health department recalled an IV fluid from all health centres following reports of contamination.
In an SOS message, the department issued directions to immediately halt the usage of Ringer’s Lactate, manufactured by Albert David. Ringer’s Lactate, also known as lactated Ringer’s solution, is a type of intravenous fluid used to replace fluid and electrolyte losses. It is especially used for restoring blood volume in situations like trauma, burns, and sepsis, as well as in cases of hypovolemia (low blood volume). Additionally, it can be used as an alkalinising agent to help correct metabolic acidosis.
In March last year, Normal Saline (NS) — a commonly used IV fluid — was pulled from circulation after 20 pregnant women fell ill at a government health centre in Sangrur.
Need to fix procurements: Docs’ body
An emergency medical officer at the Patiala Health department, pleading anonymity, said repeated incidents of suspected contamination or substandard quality have raised concerns about the drug procurement and quality monitoring mechanisms in the state’s public healthcare system.
“These are very basic IV fluids that are given to almost all admitted patients in the emergency department. If we can’t ensure the quality of such basic medicines, then patient care goes for a toss,” he said.
Reacting to the development, Dr Akhil Sarin, state president, Punjab civil medical services association (PCSMA), said that there is a need to strengthen the procurement procedures.
“Although the regulatory mechanisms are in place, both at the Centre and state levels, these need to be strengthened further to ensure that the highest levels of quality and standards are ensured,” he said.
Summary:
Following reports of adverse reactions, the Punjab Health Department has recalled eight batches of IV fluids and antibiotics to ensure public safety and prevent complications.