The preparation of sulfanilamide with diethylene glycol (as it was more soluble in this solvent compared to ethanol), with a sweet syrup for palatability, was labeled an “elixir.” Many patients, most of whom were children, died of acute kidney failure resulting from metabolism of the glycol to oxalic acid and glycolic acid. The drug and its metabolites crystallized in the kidney tubules, leading to renal failure. This tragedy led to the passage of the 1938 Food, Drug, and Cosmetic (FD&C) Act, also known as the Copeland Bill, which contained provisions for both misbranding and adulteration