Kerala Probes Remdesivir Procurement And Inventory Records Following Nipah Treatment Questions

By Elizabeth Urbanek, Executive Editor

Kerala health officials have ordered an investigation into whether expired batches of remdesivir were administered to patients, including those treated for Nipah virus infection, after questions emerged about pharmaceutical procurement, inventory records, and drug expiry controls at government hospitals.

The issue came before the Kerala Legislative Assembly on Oct. 29, when Health Minister K. Muraleedharan said records from Kozhikode Medical College Hospital raised concerns that remdesivir purchased in 2021 may have been administered after its expiration date. The government subsequently appointed a medical board headed by Dr. Aravind Reghukumar, head of the Department of Infectious Diseases at Government Medical College in Thiruvananthapuram, to investigate.

According to the minister, the Kerala Medical Services Corporation Limited (KMSCL), the state's government pharmaceutical procurement and distribution agency, purchased 3,000 vials of remdesivir on June 3, 2021, for ₹42 lakh. The batch carried an expiration date of May 30, 2023.

Records from Kozhikode Medical College indicated that 102 vials were used during fiscal year 2023-24, 34 during 2024-25, and 10 during 2025-26. The figures prompted questions about whether some of the medication came from the 2021 batch. However, the available records have not established that every vial administered during those periods came from that particular purchase.

The minister said the investigation would examine whether expired medication was administered, whether any patients experienced adverse effects, and whether procurement or distribution procedures were breached. The Directorate of Medical Education and Directorate of Health Services were also instructed to collect information about patients who received remdesivir through government healthcare institutions.

A Separate Inquiry Into Clinical Trial-Labeled Vials

Questions have also emerged about a separate shipment of 690 vials of remdesivir manufactured by Gilead Sciences.

According to reporting by Onmanorama on Oct. 31, Kozhikode Medical College's records show that the hospital received the vials on Jan. 1, 2022. The packaging was labeled "For clinical trial use only" and listed an expiration date of September 2025, but did not include a manufacturing date.

KMSCL officials reportedly have not located records identifying the supplier, the quantity purchased, or when the shipment reached the corporation. Hindustan Lifecare Limited (HLL), which had been speculated to be involved in the procurement, told Onmanorama that it did not purchase or supply Gilead's remdesivir.

KMSCL will conduct a separate internal inquiry into the procurement and distribution of these vials.

The clinical trial designation also raises questions about the authorization and documentation governing the product's use. Available reporting does not establish whether the shipment was part of a registered clinical trial, an expanded-access arrangement, or another investigational-use pathway.

The two inquiries concern different reported supplies. The 3,000 vials purchased by KMSCL in 2021 had an expiration date of May 2023, while the separate Gilead-manufactured shipment carried an expiration date of September 2025. The two should not be treated as the same inventory.

What This Means For Clinical Supply

The investigation highlights the importance of maintaining traceable procurement and inventory records throughout a pharmaceutical product's life cycle.

For clinical supply teams, product accountability extends beyond confirming that medication is available when needed. Records must establish where a product originated, who authorized its procurement, when it was received, how it was stored, which batches were distributed, and where the product was ultimately administered or otherwise dispositioned.

Investigational products introduce additional documentation considerations. Their intended use, applicable authorization, labeling, distribution, and administration must be supported by records that allow sponsors and other responsible parties to reconstruct the product's movement and use.

The Kerala case also illustrates why inventory systems must connect batch-level information with expiry controls. A procurement record, hospital receipt log, and dispensing record serve different purposes, but together they should provide an auditable account of product movement and use.

The allegations remain under investigation, and the circumstances surrounding the reported administration of expired medication are disputed.

On Nov. 2, Onmanorama reported that former health officials and treating physicians questioned the suggestion that expired remdesivir had been administered to Nipah patients. A former state Nipah research official said multiple remdesivir batches procured in 2021 carried different expiration dates, including 2023 and 2025, and that KMSCL's inventory system flags expired medicines before distribution. A physician who treated a Nipah patient also told the publication that he was confident the medication administered to him was within its expiration period.

The New Indian Express separately reported that critical care specialist Dr. A.S. Anoop Kumar said none of the six Nipah fatalities between 2023 and 2025 had received remdesivir from Kozhikode Medical College. The investigation has not established a causal connection between the medication and any patient deaths.

For clinical supply organizations, the questions extend beyond this particular drug or procurement agency: Can every batch be traced from its source through receipt, storage, distribution, and final disposition, and can the records substantiate that the product remained authorized and within its usable period throughout that process?

The Supply Question

How can sponsors and clinical supply teams strengthen batch-level traceability, procurement documentation, and expiry controls when investigational products move through multiple procurement and healthcare distribution channels?

Related Clinical Supply Leader Editorial:

• Segregation of Duties: Drug Accountability Needs Three Separate Roles
• Regulatory Readiness in Clinical Supply: Building a Culture of Compliance, Part 1
• Clinical Supply Systems Need IT General Controls

About The Author:

Elizabeth Urbanek is executive editor of Clinical Supply Leader, where she works with clinical trial supply and logistics professionals across pharma and biotech to bring real-world perspectives, operational challenges, trends, scientific insights, and regulatory strategy to the field.

Before joining life sciences media, Elizabeth spent more than 15 years in broadcast, digital, and live-event storytelling, helping highly technical teams communicate complex ideas with clarity and impact. She brings that same approach to clinical supply, creating editorial space for experts to share what is happening across clinical trial operations.

Elizabeth is passionate about connecting people and ideas, identifying emerging themes, and showcasing work that can move the clinical supply field forward.