According to the authorities, Slim 10, the weight-cut import from China, was adulterated after it was tested and cleared for sale in Singapore.

It was subsequently found to contain fenfluramine – a chemical which is prohibited in the United States and many other countries, including Singapore. The pills on sale in Singapore did not list this substance or another harmful chemical, nicotinamide, among the ingredients.

At least 16 Singaporeans who took it developed hyperthyroidism and liver failure. One victim, Selvarani Raja, died of liver failure, and another, TV star Andrea De Cruz, survived after a liver transplant from her boyfriend.

Both the importing company, Health Biz Pte Ltd, and its president and director, Semon Liu, face eight counts of contravening the Poisons Act. The maximum penalty is a fine of S$10,000 (M$21,000) and a jail term of two years for each of the eight charges.

The summons for the company was served on one of its directors, while the one for Liu was served on a member of his family as he is in China.

It is also cracking down on all 45 Chinese slimming products to ensure they have not been adulterated.

The sad story has received extensive coverage in the Singapore media for a month. It has raised doubts on China’s control – and ethics – of its traditional health-care products, which are popular among the mostly Chinese-educated here.

China agreed last month to begin regulating its multi-billion dollar traditional medicine industry, including tightening controls on pesticide residues and heavy metal levels in herbs.

Everyone is rushing to consult lawyers. The authorities are also considering whether to charge the distributor of Slim 10, TV Media.

At least one victim is preparing to take legal action against the importer.

Several victims are watching closely the outcome of the criminal charges against Liu before deciding whether or not to take civil action themselves.

One lawyer said the case was open for action against other people, including manufacturers, distributors and retailers who carried Slim 10 on the shelves.

This could potentially be the largest product litigation in Singapore.

The whole thing is raising Singaporean distrust on a whole range of traditional pills from China that promise to cure a wide range of illnesses, reduce weight, promote female beauty and male potency and grow hair.

The question is which products are safe – and which are dangerous? If the approved ones are adulterated subsequently without control or being discovered, what products are safe – and who are responsible?

It will likely lead to more safeguards for these products. Since its launch in late November till it was withdrawn in April, about 20,000 bottles of Slim 10, each containing 120 pills, have been sold.

On the action being taken against the importer, a spokesman of Health Sciences Authority said: “It is a warning to anyone who deals in medicinal products that they have to take care to ensure their products are not adulterated.

“We will not hesitate to press for strong and deterrent sentences to ensure the message gets through because this is very important to ensure public health and safety.”

Usually efficient on such matters, the authorities have been criticised for not being fast or firm enough once it realised the extent of the threat. On April 15, the HSA, for example, gave the importer four days to comply – instead of an immediate ban. Officials had not quickly followed up to ensure that all sales had stopped.

Although the importer was given till April 19 to stop selling the pills, at least one woman said she was able to buy them on April 20.

Mrs Elaine Tan said the distributor, TV Media at a Beach Road shop, sold her two bottles when she had wanted only one, one day after the ban took effect.

Dr Clarence Tan, the HSA’s chief executive officer, said he knew of similar incidents and is investigating them.

The death of 43-year-old Selvarani Raja, after an emotional appeal for a liver donor failed, raised another issue – rules governing living organ donation.

Critics blame it partly on the Ministry of Health’s refusal to allow living organ donation from someone not related or emotionally attached to the patient. This is aimed at preventing organ trading.

One letter writer accused the Ministry of playing the role of God by deciding who can live and who cannot.

“It should approve the transplant and save a life because it is more important than the integrity of the system,” he added.

Others said the authorities had tied up the case in unnecessary red tape when “a distant cousin” had turned up with a matching organ – until it was too late.

The Indian national met Miss Raja’s family for the first time four days before he was presented as a cousin, although he had been working in Singapore for more than a year as a daily-rated worker.

Still, he was not ruled out as a donor, a ministry spokesman said. But his would be a case of a non-related donor, so he had to prove that the act was altruistic and that he had not been offered any incentive. If he had, it would be a case of organ trading, which is not allowed here.

Another significant factor in Miss Raja’s case was her infection, which put paid to her hopes of a transplant.

The chances of a seriously-infected person dying on the operating table is high. If she survived the operation, the drugs she would need after the transplant would suppress her immune system, the ministry explained, so she would likely have died of infection. But without the drugs, her body would reject the new liver.

The biggest obstacle facing a transplant is not the number of people who are prepared to donate their organs. It is finding the right match. Being a transplant patient myself, I know about such things.

Seah Chiang Nee is a veteran journalist and editor of the information website littlespeck.com

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