Clipping Board » Medical Harm ─ Unnecessary or inappropriate medical procedures can also cause harm.
【By Liu Changsong and Liu Zhiyuan / Taipei Report】
Dr. Wang Yunkai, a traditional Chinese medicine (TCM) practitioner, had long been taking two Chinese herbal medicines produced by Koda Pharmaceuticals—"Longdan Xiegan Tang Powder" and "Longdan Xiegan Tang Tablets." A decade ago, he was diagnosed with uremia and required lifelong dialysis. Subsequent testing revealed that both medicines contained aristolochic acid, a compound known to cause kidney failure. The Supreme Court ruled that Koda failed to clearly label the ingredients and potential side effects, constituting negligence. Yesterday, the court finalized a judgment ordering Koda to compensate Wang over NT$15 million in medical expenses and punitive damages, setting a record for the highest compensation in a pharmaceutical harm case.
Taiwan has the highest dialysis rate in the world, which some suspect is linked to the historical sale of TCM containing aristolochic acid.
Reporters were unable to reach Wang Yunkai yesterday. His lawyer, Li Yiguang, responded on his behalf: "Dr. Wang’s life was once full of color, but now it has turned black and white. Yet, Koda has still not compensated him."
### Self-Diagnosis and Medication
Wang, 47, graduated from Fu Jen University’s Department of Textiles before becoming a licensed TCM practitioner. He has operated a clinic in Xizhi to this day. He claimed that due to a busy schedule and symptoms such as hepatitis B, hyperlipidemia, and a bitter taste in his mouth, he self-diagnosed with "damp-heat syndrome" and began taking "Longdan Xiegan Tang" in 1996. He purchased the powder and tablets produced by Koda, labeled as containing "Akebia" herb, under his clinic’s name for personal use.
### Long-Term Use Led to Kidney Failure
In July 2002, Wang was rushed to Shin Kong Hospital due to kidney failure. Even during his hospitalization, he continued taking the tablets until doctors intervened and had them tested. The results showed the presence of aristolochic acid, which is known to cause kidney damage with prolonged use. Wang accused Koda of using "Aristolochia manshuriensis" (guan mu tong), a rare variant containing aristolochic acid, in their products despite listing other safer Akebia species as ingredients. This led to his lifelong dependence on dialysis, prompting him to sue for over NT$28 million in damages.
At the time, Taipei Veterans General Hospital was conducting research on the effects of aristolochic acid on the human body. The Department of Health (now the Ministry of Health and Welfare) had also mandated that medicines containing aristolochic acid must clearly label potential side effects. Following the incident, the department banned all TCM containing aristolochic acid in November 2003. The Supreme Court ruled that Koda failed to fulfill its duty to inform consumers of the risks, holding the company liable for Wang’s condition.
### Shared Responsibility
However, the court also found that Wang, as a licensed TCM practitioner, should have recognized that his symptoms—such as unresolved damp-heat syndrome and subsequent stomach pain and diarrhea—indicated adverse effects. His continued use of the medication contributed to his condition, resulting in a 50% shared liability. Thus, Koda was ordered to pay Wang over NT$14 million in medical expenses and an additional NT$1 million in punitive damages under the Consumer Protection Act.
Huang Linhuang, Director of the Committee on Chinese Medicine and Pharmacy under the Department of Health, advised the public to consult pharmacists or check the committee’s website for information on TCM ingredients and usage. Those experiencing adverse reactions should report them to hospital drug safety monitoring centers.
### Aristolochic Acid Fact Sheet
- **Source**: Found in Aristolochia plants and other Chinese herbs.
- **Effects**: Reduces internal heat, aids weight loss, protects the liver, and promotes diuresis.
- **Uses**: Treats kidney, rheumatism, joint, and skin diseases.
- **Toxicity**: Prolonged use can cause kidney failure, nephropathy, and increase the risk of bladder, kidney, and ureter cancers.
- **Herbs containing aristolochic acid**: Aristolochia (various species), Akebia (guan mu tong), Fangji (guang fang ji), Qingmuxiang, Tianxianteng, Zhushalian, Xungufeng, Qingxiangteng, Nanmuxiang, Tongchenghu, Jiadashu, Huaitong, Guannanxiang, Bixuelei, Baijingulan, Asarum (xi xin), Huangxixin, Hualianxixin, Shaoyexixin, Duheng, Jin'erhuan, etc.Source: http:/ / www. appledaily. com. tw……e/ headline/ 20120602/ 34272153
Doctor Awarded 15 Million for Drug-Induced Kidney Damage
Dr. Wang Yunkai, a traditional Chinese medicine (TCM) practitioner, had long been taking two Chinese herbal medicines produced by Koda Pharmaceuticals—"Longdan Xiegan Tang Powder" and "Longdan Xiegan Tang Tablets." A decade ago, he was diagnosed with uremia and required lifelong dialysis. Subsequent testing revealed that both medicines contained aristolochic acid, a compound known to cause kidney failure. The Supreme Court ruled that Koda failed to clearly label the ingredients and potential side effects, constituting negligence. Yesterday, the court finalized a judgment ordering Koda to compensate Wang over NT$15 million in medical expenses and punitive damages, setting a record for the highest compensation in a pharmaceutical harm case.
Taiwan has the highest dialysis rate in the world, which some suspect is linked to the historical sale of TCM containing aristolochic acid.
Reporters were unable to reach Wang Yunkai yesterday. His lawyer, Li Yiguang, responded on his behalf: "Dr. Wang’s life was once full of color, but now it has turned black and white. Yet, Koda has still not compensated him."
### Self-Diagnosis and Medication
Wang, 47, graduated from Fu Jen University’s Department of Textiles before becoming a licensed TCM practitioner. He has operated a clinic in Xizhi to this day. He claimed that due to a busy schedule and symptoms such as hepatitis B, hyperlipidemia, and a bitter taste in his mouth, he self-diagnosed with "damp-heat syndrome" and began taking "Longdan Xiegan Tang" in 1996. He purchased the powder and tablets produced by Koda, labeled as containing "Akebia" herb, under his clinic’s name for personal use.
### Long-Term Use Led to Kidney Failure
In July 2002, Wang was rushed to Shin Kong Hospital due to kidney failure. Even during his hospitalization, he continued taking the tablets until doctors intervened and had them tested. The results showed the presence of aristolochic acid, which is known to cause kidney damage with prolonged use. Wang accused Koda of using "Aristolochia manshuriensis" (guan mu tong), a rare variant containing aristolochic acid, in their products despite listing other safer Akebia species as ingredients. This led to his lifelong dependence on dialysis, prompting him to sue for over NT$28 million in damages.
At the time, Taipei Veterans General Hospital was conducting research on the effects of aristolochic acid on the human body. The Department of Health (now the Ministry of Health and Welfare) had also mandated that medicines containing aristolochic acid must clearly label potential side effects. Following the incident, the department banned all TCM containing aristolochic acid in November 2003. The Supreme Court ruled that Koda failed to fulfill its duty to inform consumers of the risks, holding the company liable for Wang’s condition.
### Shared Responsibility
However, the court also found that Wang, as a licensed TCM practitioner, should have recognized that his symptoms—such as unresolved damp-heat syndrome and subsequent stomach pain and diarrhea—indicated adverse effects. His continued use of the medication contributed to his condition, resulting in a 50% shared liability. Thus, Koda was ordered to pay Wang over NT$14 million in medical expenses and an additional NT$1 million in punitive damages under the Consumer Protection Act.
Huang Linhuang, Director of the Committee on Chinese Medicine and Pharmacy under the Department of Health, advised the public to consult pharmacists or check the committee’s website for information on TCM ingredients and usage. Those experiencing adverse reactions should report them to hospital drug safety monitoring centers.
### Aristolochic Acid Fact Sheet
- **Source**: Found in Aristolochia plants and other Chinese herbs.
- **Effects**: Reduces internal heat, aids weight loss, protects the liver, and promotes diuresis.
- **Uses**: Treats kidney, rheumatism, joint, and skin diseases.
- **Toxicity**: Prolonged use can cause kidney failure, nephropathy, and increase the risk of bladder, kidney, and ureter cancers.
- **Herbs containing aristolochic acid**: Aristolochia (various species), Akebia (guan mu tong), Fangji (guang fang ji), Qingmuxiang, Tianxianteng, Zhushalian, Xungufeng, Qingxiangteng, Nanmuxiang, Tongchenghu, Jiadashu, Huaitong, Guannanxiang, Bixuelei, Baijingulan, Asarum (xi xin), Huangxixin, Hualianxixin, Shaoyexixin, Duheng, Jin'erhuan, etc.Source: http:/ / www. appledaily. com. tw……e/ headline/ 20120602/ 34272153