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Theft of deadly medicine prompts 'catastrophe' concerns

Peter Vinthagen Simpson · 24 Feb 2010, 12:06

Published: 24 Feb 2010 12:06 GMT+01:00

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Skåne University Hospital in Lund on Monday reported the theft of several bottles of the drug remifentanil - a powerful ultra short-acting anaesthetic with one ampoule enough to kill 50 men, according to the police.

"We could not imagine that anyone outside of the hospital could be interested in the substance which was stolen," Doctor Bengt Roth at the intensive care clinic told the newspaper.

Roth, who discovered the missing bottles and informed the police, warned that the drug is very dangerous and said that it would be a "catastrophe" if the bottles found their way to the street, as even the smallest inhalation can cause a cessation of lung function.

The drug is used during surgery and normally only when the patient is connected to a respirator in the event of breathing problems.

The bottles of Ultiva branded remifentanil were stolen from a locked room requiring three pass card checks to enter.

Bengt Roth is at a loss to explain how somebody could have gained access and stated that the hospital logs shed no light on where the drugs have gone.

Story continues below…

Malmö police confirmed to the newspaper that they were not aware of the drug being commonly in use among drug addicts.

"We urge those that have taken this not to use it, either themselves or on somebody else. One ampoule is enough to to stop the breathing of 50 men weighing 100 kilogrammes a piece - it is that strong," said Mikael Persson at Skåne police.

Peter Vinthagen Simpson (news@thelocal.se)

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Your comments about this article

14:11 February 24, 2010 by Audrian
The hospital would need to lock such type of medicine in special cupboard that is fitted with an alarm system and CCTV.
14:16 February 24, 2010 by Twiceshy
"We could not imagine that anyone outside of the hospital could be interested in the substance which was stolen,"

Yes because people are never interested in things which kill others, right?
15:21 February 24, 2010 by krrodman
Remifentanil is diluted for use, even in the operating room setting. The person who stole the medicine would know this - since this was obviously an inside job.

In our hospital to remove narcotics requires a computer PIN so that every narcotic distribution can be traced to a particular doctor or nurse.

The strange thing about this theft is that Remi is not a great drug to abuse. The ideal drug to abuse would create a light plane of narcosis that lasted a long time. Remi is very potent but disappears within minutes. Makes no sense to me.
15:30 February 24, 2010 by J Jack
Here we go again!.. this is what happens when you give students responsibilities they haven't earned... of course I'm only speculating.
20:23 February 24, 2010 by kenny8076
twiceshy thats so great, i was thinking the same thing when i was reading and when i saw you made the comment i laughed out loud!! Are Swedes really that naive? As soon as i read it can take out 50 men by one ampoule and they have ''several'' bottles i immediately suspected possibly good weapon for a terrorist, or is that just the realistic American coming out of me?!?!
20:58 February 24, 2010 by krrodman
hej guys,

Remifentanil has to be injected intravenously. not practical for terrorism. Most drug thefts in hospital are done by drug users/abusers. The only thing that makes this event interesting is that Remi is not a drug that it commonly abused.

As for narcotic drugs as terror weapons, they already exist. Fentanyl, another very potent narcotic, can be aerosolized. It was originally designed for crowd control. The plan was to aerosolize fentanyl to sedate large crowds of people. Unfortunately, some in the crowd will die a narcotic death, so it is not a practical sedative agent.

If you recall, several years ago in Russia, Chechians held hostages in a theater. The Russians tried to sedate everyone with aerosolized Fentanyl. Unfortunately, some of the Chechians were undersedated and were able to fight back, while many hostages died from narcotic overdose. In large enough doses aerosolized fentanyl could be used as a terror weapon.
03:22 February 25, 2010 by Davey-jo
How many is "several"? Is it 2 or 3 or 150? Is there enough gone to kill a small roomful or a town the size of Lund? What is the real threat not the journalistic hype that is in this report?
12:36 February 25, 2010 by krrodman

Seems like your question should be easy to answer but it is not. I will assume that the thief stole the largest vial of Remifentanyl(5mg). And, to make things easier I will assume that the person taking the Remi weighs 100kg.

Here is where things get difficult. The actions of Remi are related to many factors including the speed of administration and coincident use of other sedatives or central nervous system depressants. And, even in large doses, the actions of Remi will disappear in a few minutes, so it might be possible to survive a large overdose.

All of that said, 5 mcg/kg as a rapid intravenous bolus should be enough to kill a person. In our 100kg victim 5mcg/kg equals 0.5mg. A single vial of Remi would then be able to kill 10 people.
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