Contaminated steroids case from 2012..

[Laryngospasm]

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Specialty lab exec gets 10-year prison term for 11 deaths from tainted steroids in Michigan

A Michigan judge sentenced the former executive of a specialty pharmacy to at least 10 years in prison Friday for the deaths of 11 people who were injected with tainted pain medication, part of a meni...

www.yahoo.com

 

[powermd]

Specialty lab exec gets 10-year prison term for 11 deaths from tainted steroids in Michigan

A Michigan judge sentenced the former executive of a specialty pharmacy to at least 10 years in prison Friday for the deaths of 11 people who were injected with tainted pain medication, part of a meni...

www.yahoo.com

I don't have data to back this up, but to me it seems the risk of infection from compounded steroids would be way greater than the risk of arachnoiditis from whatever timy amount of benzyl alcohol is in the preserved kind. I'll take the latter six ways to Sunday.

 

[pastafan]

I don’t think risk of preservatives drove use; it was $$$$.

 

[Laryngospasm]

There was a documentary about it on tv.. the lab was filthy and contamination issues were common but they were making crazy money so the issues were overlooked and employees were pushed to produce more. There were several deaths and hundreds of infections but due to the nature of the infections and distribution etc it took the investigating agencies quite a while to put together what was happening resulting in further deaths and complications.probably the single biggest cause of medication related morbidity and mortality in the history of pain injections.

New England Compounding Center meningitis outbreak - Wikipedia

en.wikipedia.org

 

[Ducttape]

and the scary part is that this was not the first time where infected steroids caused disease.

there were cases in 2002 and 2011 prior to the NECC debacle that were smaller in scope but should have served as warning.


greedy pharmacy compounding companies combined with, unfortunately, practices wanting to pay dirt cheap prices (pun intended).

 

[specepic]

I think a lot of this was driven by the FDA labeling and some of the inappropriate frenzy about preservatives and spine steroid. As I used to tell patients...you may not want preservatives in some of your food but is not necessarily a bad idea in something going in your spine

When I started at my current job in 2010, this pharmacy was their supplier. Fortunately, I changed suppliers immediately and that was about 1 or 2 years before everything blew up

 

[Ducttape]

um not really.


the FDA did not put out warnings about eliminating preservatives in medications. the FDA focused on the evils of epidural steroids and specifically particulate steroids.

doctors were concerned about preservatives for one main reason - sites like arachnoiditis.co.uk and others blaming preservatives for "causing" a pandemic of arachnoiditis and freaking out pain patients.

 

[specepic]

um not really.


the FDA did not put out warnings about eliminating preservatives in medications. the FDA focused on the evils of epidural steroids and specifically particulate steroids.

doctors were concerned about preservatives for one main reason - sites like arachnoiditis.co.uk and others blaming preservatives for "causing" a pandemic of arachnoiditis and freaking out pain patients.

you misunderstood my post (or I needed to reword)

the compounded steroids did not have the labeling from the FDA saying "not rec'd for epidural use", correct?

The FDA incorrectly labeled some name brand name steroids, which led to docs looking for other options

Some docs also concerned about preservatives

are you asserting it was primarily a cost concern?

 

[Ducttape]

a large part was due to cost concern.

because most docs bought the preservative free formulations from compounding pharmacies as a cost savings measure.

the drug implicated was preservative free methylprednisolone.

previously, you could purchase "preservative free" methylprednisolone directly from the drug company but it was quite expensive. this system did purchase it initially after a similar contaminated steroid scare in 2002.

the contaminated compounded steroids were preservative free. and dirt cheap, pun intended.


(for newbies, as this is a rehash of past posts, you could and can purchase preservative free dexamethasone, but preservative free dexamethasone does have preservatives - namely, citric acid, which is not labeled as a preservative but as a food additive by the FDA).

 

[bedrock]

Wrong. Plenty of docs I know, purchased the preservative free steroid at a higher cost than depo, because they felt it was safer for the patient.

 

[BobBarker]

@bedrock yes, that was my understanding as well from talking to the he physicians who were practicing at that point. Same time frame we were only using preservative free dex for our anesthesia nerve block cocktails.

 

[Ducttape]

so why did they not purchase the even higher cost of the drug company produced preservative free depomedrol?

this system did look at pricing of preservative free depo, and we decided (hugely influenced by "a situation" in 2002) that preservative free depo was too expensive and too risky.

 

[po_boy]

Who here uses preservative free local and steroids for epidural injections?

I have seen some variation...

 

[Painologist]

I only use preservative free meds for epidural use.