Kerala Health Minister K. Muraleedharan on Thursday, 29 October 2026, informed the state Assembly that Remdesivir vials that expired in May 2023 were administered to patients — including those being treated for the deadly Nipah virus — at hospitals across Kerala in subsequent years. The minister ordered a formal investigation into whether the use of the expired antiviral drug contributed to patient deaths, in what is shaping up as one of the most serious drug-management failures in the state's recent medical history.

How the Expired Stock Entered Patient Care

According to details placed before the Assembly, the Kerala Medical Services Corporation Limited (KMSCL) purchased 3,000 vials of Remdesivir for ₹42 lakh on 3 June 2021. The entire stock carried an expiry date of 30 May 2023. Despite this, records tabled in the House showed that expired vials continued to be drawn from storage and administered to patients well beyond that date.

Specifically, 102 vials were used in 2023–24, 34 vials in 2024–25, and a further 10 vials in 2025–26 — all after the stock's expiry. Among those who received the drug were Nipah-infected patients at Kozhikode Medical College Hospital, one of Kerala's frontline referral centres for high-risk infectious disease cases.

Medical Board Constituted; Departments Directed to Audit

A medical board has been constituted under Dr Aravind, Head of the Infectious Diseases Department, to examine the circumstances surrounding the continued use of the expired stock. The Health Department has separately directed the Director of Medical Education and the Director of Health Services to compile a comprehensive list of all patients who received the drug through the implicated supply channels.

The investigation is specifically tasked with determining whether the expired Remdesivir had any role in the deaths of Nipah patients and whether other recipients suffered adverse effects. Notably, the ministerial disclosure explicitly states that no causal link between the expired medicine and any death has yet been established.

Nipah Deaths in Kerala: The Backdrop

The revelation arrives against a grim epidemiological record. Kerala reported six Nipah cases in 2023, of whom two died. Both patients detected in 2024 died, while two of three cases in 2025 were fatal. Remdesivir, an antiviral used in experimental Nipah treatment protocols, was among the drugs deployed during these outbreaks. The fact that some of those doses may have been drawn from an expired batch raises acute questions about the efficacy of the treatment received.

The minister also confirmed that 50 vials used during the current financial year had been specially procured from Bahrain on 12 June for a Nipah patient — a separate procurement that underscores how critical supplies were being sourced on an emergency basis even as an expired domestic stock apparently remained in circulation.

Systemic Questions on Drug Storage and Monitoring

The disclosure lays bare what critics argue are structural gaps in Kerala's drug lifecycle management — specifically in expiry monitoring, cold-chain storage oversight, and the hospital-level checks required before controlled antivirals are administered to critically ill patients. This is not the first time India's public health system has faced scrutiny over expired drug administration, but the Nipah link lends the Kerala case exceptional urgency.

The findings of the medical board are expected to clarify whether the lapses originated in procurement, warehousing, distribution, or bedside protocol — and to assign accountability accordingly. With the Assembly now on record, pressure on the Health Department for a time-bound report is likely to intensify.