Efroze Chemical Industries is responsible for 213 deaths caused by a batch of its Isotab drug, a judicial inquiry in Lahore, Pakistan has said.

The Defective Drug Inquiry Tribunal said batch number J093 of Isotab 20mg, manufactured by Efroze and distributed at the Punjab Institute of Cardiology‘s free pharmacy, contained higher concentrates of pyrimenthamine.

As a result, 213 cardiac patients died and another 1,000 became ill but survived.

The inquiry report stated that Efroze had "miserably failed to fulfil its obligations" and that legal action should be taken.

"We recommend strict legal action against the company, its management and others involved under the law," the report said.

The report also said the Punjab Institute of Cardiology had major failings.

Stating that; "The mode and manner in which medicines are procured, received and stored, and documented and dispensed is not in consonance with the requirements of running an organised and efficient hospital."

"The Defective Drug Inquiry Tribunal said batch number J093 of Isotab 20mg, manufactured by Efroze and distributed at the Punjab Institute of Cardiology’s free pharmacy, contained higher concentrates of pyrimenthamine."

The patients who died after taking the J093 batch of Isotab started feeling symptoms in December 2011, and symptoms included bone marrow suppression, darkening of the skin and reduction of white blood cells, which caused excessive bleeding that eventually lead to death.

The report said that Umar Trading Co, distributor of the drug, should also be held responsible.

They provided incorrect documentation to the Punjab Institute of Cardiology by not mentioning batch number J093 was in the delivery.

The report also recommended that a taskforce of pharmaceutical experts should be set up to carry out current good-manufacturing practice compliance audits, with any companies found lacking to be suspended.

Drug regulation in the province had deteriorated considerably, the report said.

It added that the Health Department’s response to the unfolding crisis was unstructured and the police investigation lacked adequate experts.