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Meningitis Outbreak Ripples Through Hospitals

BOSTON — The meningitis outbreak that has already sickened 247 people and killed 19 is forcing patients to question whether the drugs they receive are safe.

So far, investigators have tied the outbreak to at least one injectable steroid from the Framingham-based New England Compounding Center.

It does not appear that any patients in Massachusetts received the tainted medication which is often used for pain and swelling from arthritis or joint disorders.

Dr. Padma Gulur, director of inpatient pain services at MGH, joined WBUR’s Morning Edition host Bob Oakes to discuss how doctors and patients are handling the outbreak.

Bob Oakes: What are patients saying to you about the outbreak? Are they raising concerns about the safety of these treatments?

Dr. Padma Gulur: They’re definitely concerned. Patients who have received the treatment especially are concerned, given the national level of this outbreak.

They do call us, they express their concern and we are quick to reassure them, thankfully we have not been using any of the contaminated steroids from that particular facility — we don’t purchase it — so we are able to give them some quick reassurance. Other hospitals are doing the same as best as they can.

Has the outbreak raised questions for you about the safety of some of these medications, especially from compounding pharmacies? When you pick up a vial that you’re about to inject in a patient seeking relief from pain, do you take a double take of that vial now?

I must admit we’ve always, as part of the process. We do check the vial of medication before we administer the drug and this was well before [the outbreak], this was part of our universal check that we do before any procedure. We check the expiration date that is put on the drug, we look at the particular matter in there. But, again, those are checks that work if the process before has been meticulous in the preparation of that vial. We rely on the information printed on the label.

So in some way you’re at the mercy of the system?

We are, we are. Unfortunately there’s no test that you can preform on site in a time efficient manner that would assure us that that drug was completely safe.

In terms of who supplies you with the drugs that you do use, is it necessary to use compounding pharmacies? Are compounding pharmacies sometimes the only places where you can get particular drugs?

That is correct. While we have a lot that is manufactured there are certain dosages and certain strengths to provide optimal patient care that are not available on the open market and do require some compounding.

Do you think that federal and state regulators have done enough to ensure the safety of these medications?

Hindsight is 20/20. At this point I would say obviously more needs to be done and more regulations needs to be in place to allow the authorities to inspect and ensure the safety of our population.

Have any patients canceled their appointments because of this? Has anyone said, you know, “I’ll skip that pain injection this time around”?

I have to admit I’ve been pleasantly surprised by the fact that our patients have shown a lot of confidence in the care that we deliver and our focus on patient safety. We’ve had patients come, almost all of them have asked us about this, but they have gone through with their procedures. They’re in pain, they recognize they’re in need of help. These injections do help and they’re looking to be functional in life. I’m sure there are concerns but no, I would say at this point we have not seen any significant change in our practice.

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