Skip to comments.Drugs For Critically Ill In Short Supply; Some Hospitals Consider Rationing
Posted on 05/19/2011 1:45:34 AM PDT by The Magical Mischief Tour
NASHVILLE, Tenn. -- Michael O'Neal is a pharmacist. He purchases drugs for Vanderbilt University Medical Center. He often deals with drug shortages, but this one is bad. O'Neal is concerned about the availability of electrolytes. They are critical to a babies in neonatal intensive care and seriously ill adults.
Electrolytes are administered to a critically ill patient for nutritional support intravenously. They are given to patients who cannot get their nutrition any other way.
O'Neal said he's concerned that as supplies shrink, measures will have to be taken.
"We are dangerously close, we believe, when we will have to ration care to the critically ill. I would say within days or weeks," said O'Neal.
Vanessa Kumpf has her doctorate in pharmacy. She's also a clinical specialist. She supervises patient nutritional support at Vanderbilt. She knows how important the correct cocktail of electrolyte drugs are to a patient.
"If one of the drugs is missing, it can be a very potentially life threatening situation. Your heart, your muscles, your lungs, every organ system has to have the right component of electrolytes," said Kumpf.
There are so few makers of electrolytes that when one drug company, American Regent, stopped production because of quality issues, it sent supplies in a tail spin nationwide.
Kumpf told Channel 4 News that if you have a loved one in the hospital you should ask a very important question.
"Are there shortage issues in the institution, and how are clinicians dealing with it?" said Kumpf.
Both Kumpf and O'Neal said even after production of electrolytes speeds up, it will take months before supplies return to normal.
How come babies were given sterile water in years gone by??
you don’t start with death panels right off...
how’s that change working out for you?
“...stopped production because of quality issues, it sent supplies in a tail spin nationwide.”
Yeah, I’ve got enough Gatoraide and Pedialyte around here to last awhile. However, it probably is off by 0.01% of the requirements of the gov’t. And not that it would be bad for anyone, but sure might lend itself to a lawsuit. I imagine that was the same place the manufacturer found themselves in when they stopped production.
“Are there shortage issues in the institution, and how are clinicians dealing with it?” said Kumpf.”
And you will be told, “WE don't have any such problems but if you feel you can get better care elsewhere........”.
There are insane shortages of drugs in almost every category that the public isn’t hearing about. I guess the manufacturers got tired of being sued.
I think they’re talking electrolytes for IV fluids for critically ill patients - quite different from fluids that you take by mouth.
I know. But I wonder how far off I am on my speculation of them dumping a batch and stopping to avoid a lawsuit because they weren’t quite up to par on the government standards?
But, I guess that is what happens when you leave the manufacture of important drugs and medicines up to private industry. They are only in it for the profit you know. If the government took over these companies and the manufacture of critical drugs and medicines we wouldn’t have this problem!
(I’m probably getting ahead of myself. A few folks need to die first in order for it to become a new(?) liberal talking point.)
I don’t think you can buy IV fluids at Wal-Mart. And no one would get sterile water via IV unless their sodium is critically elevated.
Folks, the hospital I work in has had shortages of various drugs in the operating room for about a year now. I don’t recall this ever happening in my 14 year-career before. Once, we had some sterile saline recalled because it was found to be contaminated. This was in 2000 or 2001, but it was quickly resolved. Now, there are always some medications on “national backorder” that requires us to alter how we practice.
Does anyone remember the shortage of flu vaccine a few years ago, too?
Going Galt? Shrugging like Atlas?
paging...John Galt...paging John Galt....
This wouldn’t have anything to do with encroaching Obamacare, would it?
The nation has suffered through economically stupid presidents before (Jimmy Carter) without these kinds of consequences.
Would be interesting to interview those who got out of the game and ask them why. Trying to set up overseas and having quality problems? Totally unrealistic price caps? (Bulk medication prices are way less than the delivered cost of a unit at a hospital.)
Dr. Atlas, code blue
I wonder if more incoming patients are getting the IV hookup in order to ward off lawsuits in the event they conk and it takes a moment too long to administer a drug. If it was just electrolytes, many of these people could swallow them.
Maybe it has to do with the FDA. The FDA is just as bad as the IRS or the BATF. Dealing with the FDA is almost impossible for a small company, so the landscape is reduced to big companies that have departments of staff who just prepare for and deal with the FDA. They regulate huge swathes of the economy, and would like to regulate it all! At least, that's my opinion.
Better built some more space ships, as those drugs are only available on other planets like Canada. Europe, and Asia.
Oh the horror, you are all going to die.
They have enough money to advertise on the Obama Networks ABCBSNBCNN morning and evening “News” shows about 6 times every half hour.
But, I guess that is what happens when you leave the manufacture of important drugs and medicines up to private industry. They are only in it for the profit you know. If the government took over these companies and the manufacture of critical drugs and medicines we wouldnt have this problem! [</sarcasm>]
Reminds me of the story (told by Thomas Sowell IIRC) of the shortage of pumps for mines in the USSR. It seems that mining production was crippled by the lack of the necessary water pumps. At the same time, the pumps were in being at the the pump factory, taking up space and not being shipped.
The reason was that the spec for the pump required a specific green paint to be applied before shipment, and the pump manufacturer was simply unable to obtain that specific paint. And while failure to ship was a problem for the pump manufacturer, you could be shot for shipping the pumps without the correct coat of paint!Which illustrates the basic point that criticizers, whether in government or in journalism, can paralyze economic activity. It takes a lot of "yes" - in the form of knowhow, equipment, workmen, supervision - to make the pump. It only take a little bit of "no" - in the form of armed enforcers with arbitrary power to execute rule breakers - to cancel all that "yes" out. Result: no pumps. And low production from mines. Maybe, the lack of mine production ultimately had some indirect influence on the supply of green paint?
***Does anyone remember the shortage of flu vaccine a few years ago, too?***
I do! It was caused by Hillary putting the vaccine manufacturers out of business. We had to get the vaccine from Canada.
...”Does anyone remember the shortage of flu vaccine a few years ago, too?”...
A family member was diagnosed with the flu last week and the PA who saw her said, “You are lucky..We have been out of Tamiflu and just got some in today.” Folks, this should not be happening..Has the demand suddenly outstripped our usual supply or are we trying to treat the whole world or is it something else..Just wait until the severe shortage of doctors and nurses comes around..If we really want to survive, we will get government out of our lives and begin to place value where it is real and that is with people who have REAL skills and REAL experience running things..The politicians are, for the most part, money hungry lawyers who mostly view doctors, our medical establishment and our private companies as targets for lawsuits. I suspect those issues are feeding into these shortages.
my ex is a transplant surgeon. Say what you want about that but my point is that he often treats SEVERE rejection woth a drug called OKT3. Just this year....no more OKT3. The drug company stopped making it because “no one uses it”. yeah, right. I know transplant centers all over the U.S. that use this drug. The handwriting on the wall says this is just a way to eliminate critically ill patients who consume alot of time & money in healthcare. Scary.
I think what smart hospital administrators who want to take a stand against government health control should be doing is to determine areas where they can be self-sufficient. That is, find out what critical medical items you can manufacture yourself and start doing it so that you do not have depend on outside supply. Electrolytes are a good example of what I mean. It is not difficult to mix these and fill IV bags.
The Death Panels opt for the "Staples" approach.
Yes, my son’s ADHD meds are on a hit-or-miss availability these days
This is bad news for kids who need daily meds to function normally :-(
I wonder what is really going on????
a family member recently had to remove his elderly mother from a nursing home. They were told - you have to either be very very rich to afford the $7,000/month tab, or very very poor to receive it “free”.
They were unwilling to sign over all their assets.
So now they have to figure out how they’re going to take care of her plus her elderly husband who is in better shape, but unable to handle the responsibility.
She went in there because the daily visit from a nurse wasn’t cutting it.
As far as I know - Paul Ryan had nothing to do with any of this either.
The drug company stopped making it because no one uses it. yeah, right.Why would a drug company stop selling a drug that makes them money? I mean, how do they benefit by halting production? Scary story, regardless.
It makes me suspect the drug companies are taking their orders from gov officials because it does defy logic to stop production of these meds. Very scary, indeed.
sad sad story
It really makes sense to bond with a church or fraternal or affinity group, while you are still young and healthy, that has nursing homes or special communities for its members- usually the costs are less and the care is a bit more compassionate
If they were “unwilling to sign over all “their” (her?) assets then they are paying themselves to attend to her.
I hope they spend it on her care instead of trying to hoard their inheritance
“Does anyone remember the shortage of flu vaccine a few years ago, too?”
Yes, and I remember obama’s czar rationing it, giving it to “underserved” communities of black middle school kids, when people over 50 could not get a flu shot even from our family doctors. Luckily the pandemic fizzled.
And no outcry from the MEdia
I’m not sure how much inheritance there is to hoard.
They’re a typical middle class couple - probably have modest savings, and then their house.
He was still living in their house (which, I think is deteriorating)
She needs round the clock care - and he can’t do it.
.Just wait until the severe shortage of doctors and nurses comes around..
There will be plenty of doctors and nurses who will get 3 month vacations and cushy pensions. Unfortunately they will have the same SAT, ACT, and GRE scores of our nation’s “dedicated” government indoctrination teachers. /s
When it rains it pours
Na+, K+, buffers, sterile water -- how are oral electrolytes different from IV ones?
There was some serious backroom dealing with the pharma companies to get them onboard with Obamacare, and some serious money changing hands. Follow the money, if you can. The "most transparent administration in history" will attempt to thwart that endeavor at ever turn.
It makes me suspect the drug companies are taking their orders from gov officials because it does defy logic to stop production of these meds. Very scary, indeed.What a world we live in! Does the surgeon know ahead of time if his patient is more likely to have a *severe* rejection to their organ?
I think the difference is the preparation. IV ‘lytes would need to be prepared in a solution whose pH is compatible w/ blood pH (7.4). Also, they’d have to be completely dissolved so that no particulate matter would be accidentally injected. I think preparation of medication to be administered intravascularly is more complex than most think.
I can only speak for my ex. He had no idea the drug was out of production. He called all over the place & found one vial somewhere that had to be shipped in. Now, he has to treat the kids who reject with large doses of steroid. He had no warning or notice ahead of time.
I went to our OR pharmacy to get drugs for a liver transplant that I was doing one day (I give anesthesia). One of the drugs, called THAM, was not available. To make a long story short, it’s a drug we use in highly specialized & critical surgeries. I was told it’s on “national backorder” because the pharm company is limiting it’s production. Hmmmmm
I think a lot of companies are looking at the profit/loss of the new requirements, and choosing not to play.
My company has seen it, and it hurts the consumers but if the red tape is to much we don’t make money. And we don’t really interact with the FDA to much (we don’t make drugs).
I have been in and out of the hospital and have had 14 surgeries. When they told me I would be on TPN because I do not have enough small intestine to absorb nutrients, I never thought that I would have to worry about missing ingredients such as electrolytes.
I know that the FDA has messed around with other drugs and making relatively common drugs scarce. Any drug maker that had grandfathered status with the FDA was told to cease making those drugs until the FDA gave them the go ahead.
Many of these were pain meds such as Roxinal.
The other drug companies couldn’t increase making Roxinal because they were only cleared for a certain amount of raw products from the DEA.
Another beaurcratic mess.
Cost of maintaining compliance has skyrocketed in the last 5-6 years. I work medical devices and have watched as margins have shrunk while the police state has ramped. There is safety and then there is ‘safety’. The two aren’t always the same.
If the govt won’t pay beyond a certain amount (remember there were changes ~4 years ago on reimbursements even before obamacare) and imposes additional costs through regulations then the margins decrease - for pharma it doesn’t take much for the risk/benefit equation to turn so that one bad batch bankrupts the entire company. Devices has been hit as well but the margins are different so it’s not quite as bad as pharma where the risks are also much higher.
As with a lot of small businesses they are making the decision to get out with what they have and shut it down rather than risk losing everything or running in the red.
Atlas is shrugging hard folks.
If medical supplies became unavailable to all politicians and their families, the shortage problems would be resolved. They must become the victims of the crises they create.
This point is worth pushing on those Congress critters capable of understanding it. We don't want some RINO reflexively attacking the drug companies. IIRC, the Tea Party elected a few physicians last fall who may be capable of carrying this ball. They need to understand the drug companies are the victims as much as their no longer served customers. They need to point out that while not being able to get insurance is a problem, not being able to get a needed medicine, at any price, regardless of one's insurance status, is a much bigger problem. And that the solution isn't more government, but less government.
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