environmental health investigations branch

Investigation Spotlight: Death Linked to Lead-Tainted Ointment from Vietnam

Problem

In 2024, the California Department of Public Health (CDPH) investigated a report of a woman in Sacramento who developed severe lead poisoning and died after using a hemorrhoid ointment from Vietnam called, Cao Bôi Trĩ Cây Thầu Dầu. The woman purchased the ointment on Facebook, and a relative in Vietnam mailed it to her in the U.S.

Investigation

Sacramento County and CDPH’s Childhood Lead Poisoning Prevention (CLPP) Branch investigated the incident to try to figure out how the woman may have been exposed to such high levels of lead. Sacramento County visited the home to perform lead screening tests of various products. The lead screening of the Cao Bôi Trĩ Cây Thầu Dầu ointment showed an immediate and strong reaction.

Three Cao Bôi Trĩ Cây Thầu Dầu ointment jars collected from the home were sent to CDPH’s Environmental Health Laboratory for further analyses (one opened jar, two unopened jars). The results showed that samples from all three jars contained about four percent lead (39,000 ppm), which is a highly dangerous amount of lead.

The Investigations Unit at CDPH’s Environmental Health Investigations Branch was notified about the hazardous ointment and asked to support the investigation. Our team provided technical assistance to Sacramento County. We interpreted the product lab results and assisted the county with public health messaging. CDPH’s CLPP Branch also alerted county CLPP programs throughout the state about the ointment.

Communications

The Investigations Unit alerted the public, medical providers, and public health professionals about the dangers of the lead-contaminated Cao Bôi Trĩ Cây Thầu Dầu ointment. Specifically, our team:

Published a webpage alert in English and Vietnamese, which included factsheets for the public and medical providers.
Issued a press release, which resulted in broad media coverage of the alert in English and Vietnamese.
Posted on social media.
Disseminated an advisory via the California Health Alert Network (CAHAN) to county public health officers, hospitals, and all licensed physicians in California.
Alerted the California Poison Control System to be on the lookout for illnesses that might be associated with the ointment.
Sent an advisory via the CDC’s Epidemic Information Exchange (Epi-X) to inform other states about the incident in order to prevent additional illnesses.
Coordinated with counties in California that have large Vietnamese American populations. The counties notified residents, medical providers, and small businesses in their areas.
CDPH worked with Meta to remove Facebook ads, videos, posts, and private groups which promoted the Cao Bôi Trĩ Cây Thầu Dầu ointment.

Implications

This tragic incident underscores the risks of purchasing health or herbal remedy products online from international sellers or from unfamiliar/unknown sellers—even if the products are recommended by other people. Consumers cannot be certain what these products contain and how or where they were made. The products may contain hazardous ingredients that are not listed on the packaging.