Dialysis deaths in Iran reportedly linked to sanctioned drug maker

Despite dozens of deaths among dialysis patients from tainted medication, an Iranian Health Committee spokesperson says that no legal action has been taken against the manufacturer, which has continued producing the substance.

On Monday, Salman Es’haghi confirmed that the deaths of at least 70 dialysis patients were due to aluminum-contaminated medication.

Without revealing the manufacturer's identity, Es’haghi added that production of the medication has not been halted despite contamination reports.

The Ministry of Health said Monday that the deaths were cases from the previous year, and that there is no cause for concern today.

While the Ministry's statement suggested that a legal case was filed at the time, Es'haghi maintained that the judiciary has yet to initiate serious legal action for accountability.

The contamination surfaced in early 2024, initially with reports of fatalities among dialysis patients in Mashhad and Isfahan. Early estimates cited 10 to 12 deaths, but as investigations progressed, the toll quickly climbed to 50, eventually reaching 70 confirmed deaths.

Symptoms included brain dysfunction, seizures, infections, and coma, all consistent with aluminum toxicity.

Es’haghi explained that the initial assumption was low-quality production, but later findings suggested contamination with aluminum, leading to severe complications.

Criticizing the judiciary's slow response, Es'haghi said that months have passed without any significant action.

“If the judiciary continues to neglect its responsibilities,” he warned, “the Health Committee will disclose the name of the company and escalate the matter through other channels.”

Dialysis drug maker linked to sanctioned group

In June, Iran International reported that Samen Pharmaceutical Company, a subsidiary of the influential Astan Quds Razavi, is the sole producer of the medication.

Headquartered in Mashhad and directly overseen by Supreme Leader Ali Khamenei, Astan Quds Razavi has a long and complex history of influence over Iran’s pharmaceutical sector.

Former President Ebrahim Raisi previously served as the head of Astan Quds Razavi, a conglomerate with extensive holdings across Iran’s economy.

Astan Quds Razavi was sanctioned by the US primarily for being owned or controlled, directly or indirectly, by Iran’s Supreme Leader. Raisi’s successor as custodian, Ahmad Marvi, was also sanctioned under this designation.

Ahmad Marvi, the head of Astan Quds Razavi at Samen Pharmaceutical Company

The Iranian Food and Drug Administration first acknowledged issues with the dialysis solution in June, citing reports of adverse reactions linked to the product manufactured by Samen Pharmaceutical Company.

The Food and Drug Administration temporarily halted production, distribution, and use of the company’s peritoneal dialysis solution until further testing could be conducted; however, it remains unclear why production has resumed without confirmed safety improvements.

Samen Pharmaceutical Company, founded in 1984, holds a dominant position in Iran’s pharmaceutical industry as the sole producer of peritoneal dialysis solutions. Its shareholders include Astan Quds Razavi, which controls a 70% stake, along with the Iranian Retirement Fund and Hakim Pharmaceuticals.

Es’haghi said that the company's head admitted a lack of oversight on raw materials used in manufacturing, with aluminum-contaminated ingredients apparently slipping through quality control.

Iran’s dialysis patients, estimated at around 800,000, rely heavily on peritoneal dialysis solutions like those produced by Samen Pharmaceutical. Peritoneal dialysis involves using the abdominal lining as a membrane for filtering blood, and contamination of the solution can have severe, even fatal, consequences. Patients affected by the contaminated batch, distributed between December 2023 and May 2024, suffered irreversible damage.

Efforts to uncover details of the contamination have faced obstacles.

In June, when deaths were first reported, Samen Pharmaceutical reportedly informed journalists it was barred from commenting on the matter by a superior organization, believed to be Astan Quds Razavi.

This restriction has fueled public concern, as Astan Quds Razavi has previously been implicated in various allegations of corruption and misconduct.