Heparin fix leads to new concerns

Shortage after recall has led to rationing, fear of dosing errors

The hospitals, which were using 5,000 of these syringes a month before the recall, have been able to meet their needs by buying the larger vials, Fox said, but nurses must draw individual doses into syringes and sometimes refrigerate them before administering the drug.

"Smaller hospitals may not be equipped with the right sterile area to prepare batches of syringes. They may not have the manpower either," Fox said. Her hospitals and clinics are training nurses in drawing the right dose and posting reminders to prevent medication errors.

Pharmacists and industry officials proposed a variety of explanations for the heparin shortages, starting with hospitals' need to replace most of the existing supply from scratch. Also slowing the path to market, pharmacists and officials said, is a new requirement that heparin products must undergo sophisticated testing for the contaminant before being sold.

As supplies are replenished, industry officials see the high demand weakening. U.S. Pharmacopeia, a private group that sets the standards for drug production and quality in the United States, is helping heparin makers prepare to conduct in-house testing for the contaminant soon to speed up production, said Dr. Darrell Abernathy, chief science officer.

Johns Hopkins Hospital has already seen improvement, said Brian Pinto, a drug information specialist at the Baltimore hospital.

After the recall, Hopkins was getting less than half of its normal heparin supply, Pinto said. Within the past few weeks, its supply has returned to almost pre-recall levels, but the hospital is not getting the drug in the form it had normally used. "Those are in short supply," he said.

[e-mail]