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Big no no, but is it prohibited by the FDA, or recommended against by the manufacturer? Is there a black box warning against multi use? Maybe there should have been.
Read that article. I'll ask a couple more questions?
Why the propofol shortage? Is it to drive up prices, because a drug company could definitely do that. Does that lead to multi use because clinics can't afford to throw away?
[LEFT]When DIPRIVAN 2% is to be aspirated, it must be drawn aseptically into a sterile syringe or
giving set immediately after opening the vial seal. Administration must commence without
delay. Asepsis must be maintained for both DIPRIVAN 2% and infusion equipment throughout
the infusion period. Any infusion fluids added to the DIPRIVAN 2% line must be administered
close to the cannula site. DIPRIVAN 2% must not be administered via a microbiological filter.[/LEFT]
Any container or syringe containing DIPRIVAN 2% is for single use in a single patient only.
The issue is here is that the jury is very vindictive. Try were "angry.". That's not how the law should work. That's not how our justice system civil or criminal should not work. Emotions need to be set aside.
It's like the Las Vegas Jury with the OJ Simpson trial. Most people agree that the only way OJ Was convicted was "payback" for the 1994 double murder aquittal. I hope justice doesn't work that way but sadly a lot of jurors are so blinded by emotions.
In this propofol case, all the blame needed to be directed at the healthcare providers and facility. Since they filed for bankrupcy, the jurors emotions shifted towards Big Pharma.
We use Diprivan at my facility. It's clearly labeled "for single patient use". Diprivan is the trade name for propofol. But we only have 20 cc vials. We stopped carrying 50cc vials 4 years ago.
The price differece between 20 and 50 cc vials is not much. We are talking about $10-12 per 20 cc vial vs $15-20 for 50cc vial.
Plus propofol is off patent now so TEVA who manufactures the generic version propofol doesn't make "billions" of propofol. They make most money off other generic drugs. This is what's wrong with the juror system in America. You need to walk away from emotions and look at the big picture. The providers misused the propofol. The drug has been around for more than 25 years. It's not like it's new.
Yes there should definitely be a warning against the re-use of this drug and such. My information comes form the state board of nursing (let me tell you, answer to reuse or not change and discard vial after 6 hours you get a big red X on that question ) So anyone in the medical profession with the training required to administer these drugs should know this. Vials of certain meds are reused all the time (insulin for example) but protocol says a new needle used with every withdraw and that the top of the vial be wiped with alcohol before drawing up the medication.
As for the shortage I don't know but if there is such a shortage with propofol, given the risk for infection and the "urge to reuse", why not employ other sedatives like versed? That's what I would like to know.
I'm not disputing that someone really screwed up reusing the vial. Thats an obvious one. I just want to know if there are other causes that lead to this screw up or is it simply provider incompetence/laziness? Correct all causes, not just the most obvious one. Without reading through the entire trial transcript, I don't know if you can readily place all blame on any one specific party.
With regards to propofol vs. midazolam (versed):
Whats the standard of practice? What is the cost of versed by comparison? Which is more effective? What do they have on hand? Whats dictated by the people running the practice? Is using one vs. another opening you up as a target for lawyers due to side effects or if something goes south during the procedure?
Why not stop protecting incompetence in health care, then maybe the lawyers wouldn't be necessary.
I don't try to protect incompetence in medicine. I review for our state board and medicare as well as a large insurer. We ding guys all the time.
Apparently you like expensive healthcare, as YOU pay for all the litigation (as a consumer). You must be very fond of lawyers and I am sure that thier families thank you for your support.
Why not stop protecting incompetence in health care, then maybe the lawyers wouldn't be necessary.
Protecting consumers is not what a lot of them are after, they are interested in the big cash award. There's a reason you see lawyer commercials asking if you got hit by a truck, they know trucking companies have some very hefty policies. Try walking into the lawyers office advertising that and tell them you were hit by an underinsured motorist or one without insurance, they'll laugh you right out of the office.
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) So anyone in the medical profession with the training required to administer these drugs should know this. Vials of certain meds are reused all the time (insulin for example) but protocol says a new needle used with every withdraw and that the top of the vial be wiped with alcohol before drawing up the medication.
