Hyderabad Paediatrician Receives Legal Notice Over ORS Product Criticism
HYDERABAD: A Hyderabad-based paediatrician, Dr Sivaranjani Santosh, has been served with a legal notice by pharmaceutical companies following her critical remarks about certain ORS-like products on social media platforms. This development comes several months after the Food Safety and Standards Authority of India (FSSAI) implemented restrictions on using the "ORS" prefix or suffix in product names unless they meet specific formulation standards.
The Legal Notice and Its Demands
The legal notice, dated March 16, 2026, accuses Dr Sivaranjani of making "false, misleading and defamatory" statements about the companies' products. The document demands that she remove her social media posts and reels within seven days and refrain from making any future comments about their products. The notice alleges that her remarks constitute "spreading unscientific myths" and running a "malicious campaign" against their products.
Doctor's Longstanding Concerns About ORSL Products
Dr Sivaranjani has been raising concerns about ORSL products for nearly eight years, arguing that these products were often sold alongside genuine Oral Rehydration Salts (ORS) despite not matching the formulation recommended by the World Health Organization. According to her analysis, ORSL contained higher sugar content and lower electrolyte levels compared to WHO-approved ORS formulations, while its name closely resembled "ORS," potentially confusing parents and caregivers.
Specific Allegations About Sucralose Content
The legal notice specifically addresses Dr Sivaranjani's comments about sucralose in a product marketed as ERZL. The doctor had claimed that sucralose could potentially worsen gut inflammation, disrupt the microbiome, and increase the risk of diabetes and cardiovascular disease, particularly in children under two years of age. She emphasized that sweeteners like sucralose should not be consumed regularly without awareness of potential long-term health concerns.
Companies' Defense and Regulatory Compliance
The pharmaceutical firms maintain that sucralose is an approved sweetener under both Indian and international regulatory frameworks, including those established by FSSAI and the Indian Pharmacopoeia. The notice cites a February 2026 review by the European Food Safety Authority that reaffirmed the safety of sucralose for consumption.
The companies strongly dispute Dr Sivaranjani's claim that ORSL products are still being sold or that ERZL is being presented as a substitute for Oral Rehydration Solution. They describe such allegations as "baseless and malicious" and emphasize that their new brand name ERZL does not contain the term "ORS," making confusion with WHO-approved ORS products "beyond reasonable comprehension."
Rebranding Following FSSAI Regulations
Following the October 2025 FSSAI directive that prohibited products from using the term "ORS" in their names or labels unless they complied with WHO formulation standards, the company discontinued the ORSL branding and launched ERZL around November 2025. The companies claim that ERZL is not a therapeutic ORS product but rather a reformulated electrolyte beverage containing "87% less sugar" than its predecessor.
The firms assert that the earlier ORSL branding has been revised in compliance with regulatory directions and that the new product name and packaging are clearly distinct from ORS products. They maintain that older stock is being withdrawn or relabelled according to the advisory and that there has been no attempt to mislead consumers.
Doctor's Response and Professional Duty
Dr Sivaranjani maintains that her comments were part of her professional duty as a practising paediatrician to raise legitimate public health concerns. She argues that presenting ERZL as a replacement for ORSL could potentially violate the FSSAI advisory and mislead consumers. The doctor alleges that companies rebranded ORSL as ERZL by placing new stickers over existing packs, essentially creating the same product with a different label.
"In my post, I clearly explained that this is essentially the same ORSL product that has been relabelled legally," Dr Sivaranjani stated. She emphasized that her criticism focused on the earlier branding being misleading rather than the product being unsafe or adulterated.
Marketing Concerns and Public Health Implications
According to Dr Sivaranjani, companies can market ERZL as a regular drink but not as a health drink. She expressed concern that if people believe it is a health drink, they might think it is safe for daily consumption, particularly for children. The paediatrician stressed that it is her responsibility to inform parents not to mistake such drinks for health products and to avoid giving them to children every day.
The doctor pointed out that the company's advertisements claim ERZL is "the new ORSL," which she believes contradicts the government order that prohibits such claims. She included images in her social media posts showing ORSL with an arrow pointing to ERZL to illustrate how the product was repositioned in the market.
Regulatory Background and Industry Response
The October 2025 FSSAI directive specifically required companies to revise branding and packaging to prevent consumer confusion between genuine ORS products and similar-looking alternatives. The regulatory action aimed to ensure that only products meeting WHO formulation standards could use the "ORS" designation, protecting consumers from potentially misleading product claims.
This case highlights the ongoing tension between healthcare professionals raising public health concerns and companies defending their products and marketing practices within regulatory frameworks. The outcome may have significant implications for how medical professionals can discuss commercial health products on public platforms while balancing their duty to inform the public about potential health considerations.
