The imported ethylene glycol is from a Chinese manufacturer,under the name TD glycerine which means glycerine substitute, but after dealing from Spanish middleman in filling the customs declaration in Panama, the name was changed to glycerine.
In Panama, at least 365 deaths were believed to be linked to the cough syrup.
Tracing the toxic syrup to its source has been difficult for health care providers and governmental agencies due to difficult communication between First World and Third World governments. For example, Dr. Michael L. Bennish--an American pediatrician who works in developing countries. Dr. Bennish had been volunteering in Bangladesh as a physician and had noticed a rash of deaths that seemed to coincide with the distribution of the government issued 'cough syrup'. The government rebuffed his attempts at investigating the medication. In response Dr. Bennish smuggled bottles of the syrup in his suitcase when returning to the United States, allowing pharmaceutical laboratories in Massachusetts to identify the poisonous ethylene glycol, which can appear very similar to the less dangerous glycerine. Dr. Bennish went on to author a 1995 article in the New England Journal of Medicine about his experience, writing that, given the amount of medication prescribed, death tolls "must [already] be in the tens of thousands."
Media coverage of the recent poisonings in Western media has been limited, which some editors have ascribed to the fact that the majority of the victims have been in Third World countries.