Mohamed Nasri Mohamed Hatta




Hatta MN1, Wong KD1, Tan JG1, Jusoh M1, Wong SY1, Gani F1, Samad NS1

1 Emergency and Trauma Department, Penang General Hospital, Penang, Malaysia



A video footage of two security guards who behaved insanely after consuming a certain brand of durian white coffee had gone viral over social media, drawing local and international attention and speculations. Emergency and Trauma Department (ETD) of Penang General Hospital was in the spotlight, challenging our healthcare personnel to provide accurate information whilst executing our social responsibility. We faced difficulties to take concrete action due to the lack of substantial laboratory evidence during the initial phase.


Case Presentation:

A series of seven cases presented to ETD over the period of one week. They shared similarities in presentation, most cases presented in pairs and all affected patients have consumed coffee of a similar packaging. All patients exhibited severe sympathomimetic toxidromes. When this suspicious pattern was discerned, a multi-agency corporation was quickly formed to identify the root of the problem, encompassing ETD, Medical Department, Clinical Forensic Department and the Food Safety and Quality Division under Penang State Health Department.



When the various agencies were involved actively, quick laboratory analysis was made and the results confirmed our clinical suspicion. It showed that the coffee packages from the patients have been tempered. Preliminary report was informed to the State Health Director, Director General of Health and Health Minister to dissipate this updated information. The Police also took over to further investigate the incidents. We were able to successfully mitigate the issue quickly without further breech to patients’ discretion.



Tempered food product that roused societal health concerns is unusual in Malaysia. This occurrence provided valuable experiences to our healthcare providers and awareness to our community. We learned to quickly mitigate the spread of information and harness multiple agencies to strike a balance of providing safe patient treatment and protecting the integrity of the manufacturer of the said product.






































EMAS Meeting 2018 Abtracts