HMA WGEO – Rapid Alert Form same batch and 1 counterfeit bottle with a white (newer and currently

Counterfeit or illegal product found in the illegal supply chain

available on the market) label. An inspection of Medi-market showed no
evidence of diversion from the legal chain of supply. The sources of the
Reference: counterfeit ketamine vials were not disclosed by the suspects.
Date: 12.08.2018 Time: Initials:
Please complete sections 1 to 5 providing as much information as possible. Analysed: YES NO
1. REPORTING PERSON If yes, result of analysis: Des-chloro-ketamine, N-Ethyl-ketamine (one
Name: Position: substance in each of counterfeit vials)
Organisation:

Address:
3. DISTRUBUTION METHOD
Telephone No: office:
e-mail address:
2. PRODUCT DETAILS Internet: YES / NO

Product name: KETAMIN MEDIMARKET 10% VETERINARY Internet:

Manufacturer: BREMER PHARMA GMBH, GERMANY URL:

Supplier/MAH: MEDI-MARKET LTD (official chain) Website address:

Legal status: Banned Counterfeit Unlicensed Stolen Other details:

Dosage form/pack size: single glass vials/bottles for injection i.v./i.m. – Currency of payment:

10ml (only 25ml is licensed) Has product reached patients/consumers? Yes. Seized from drug

Strength: 100 MG/ML (counterfeit products did not contain ketamine, dealers/drug users

instead contained analogues of ketamine) 4. RISK TO PUBLIC HEALTH

Batch / lot no: 26637 (PP26668)-2 samples of green label, on one sample Adverse reactions: YES / NO Unknown

with white label batch was not printed. Is batch number genuine: Yes If yes, please advise details:

No Medical assessment details:

If yes to the above, advise batch destination country: Israel (maybe others) 5. NEED FOR PUBLICITY

Expiry date: not printed on any of counterfeit products Are you making a public statement? YES / NO

Language of packaging: English Are you issuing a press release? YES / NO

Date of discovery: 27.06.2018 and 2 more dates within 2-3 weeks Are you recalling product? YES / NO

Details of discovery: If yes to any of the above, when do you intend to take action? April 2018
In three different police seizures, each included a small number (1 or 2) 6. DISSEMINATION
vials of counterfeit ketamine and other illicit club drugs. 2 counterfeit Are you content for this Rapid Alert to be shared outside WGEO membership?
bottles with a green label (older version of Medi-market label) of the YES / NO (please see below)
If yes, please specify which of the below you are content for this to be shared
with (you may tick more than 1 box)
Law Enforcement Industry Security Trade Associations
Traders Other Please specify_______________________
7. PHOTOGRAPH
If possible, please attach a photograph of the product.