Page 11 of 31 FirstFirst ... 91011121321 ... LastLast
Results 101 to 110 of 309

Thread: Anesthesia Shortage

  1. #101
    Administrator Heidi's Avatar
    Join Date
    Oct 2010
    Posts
    33,217
    Buy some from Nebraska!

  2. #102
    Senior Member Member Slayer's Avatar
    Join Date
    Jul 2011
    Posts
    200
    LOL! anyway are you worried about this Heidi?

  3. #103
    Administrator Heidi's Avatar
    Join Date
    Oct 2010
    Posts
    33,217
    Nope, They have 6 doses and 6 executions scheduled. Texas will change the protocol if it comes down to it.

  4. #104
    Senior Member Member Diggler's Avatar
    Join Date
    Jan 2012
    Location
    Peckham Rye London
    Posts
    112
    India pays no attention to copyright of drugs so they could order from there.
    Or Thailand,
    Or South Africa.
    Its not a problem unless you need an excuse.

    And whats wrong with the Chinese method. No shortage of drugs there.

    Diggler

  5. #105
    Banned TheKindExecutioner's Avatar
    Join Date
    May 2011
    Location
    Missouri
    Posts
    1,277
    Quote Originally Posted by Heidi View Post
    Nope, They have 6 doses and 6 executions scheduled. Texas will change the protocol if it comes down to it.
    Texas will always do what it takes to get the job done!

  6. #106
    Administrator Heidi's Avatar
    Join Date
    Oct 2010
    Posts
    33,217
    Getting the newbies up to speed.

    A Convict's Lethal Injection Challenge - A Short(age) Story

    Capital punishment, also known as death penalty, is a highly sensitive and controversial issue around the world. The history of this practice dates as far back as the sixteenth century B.C., and according to reports, the first recorded death penalty occurred in Egypt.

    Although death penalty has been laid to rest in more than two thirds of countries as a barbaric legacy of the past, it is still retained in some of the developed countries like the U.S. and Japan.

    The first known infliction of death as a punishment in American colonies was reportedly that of Captain George Kendall, which occurred in Jamestown Colony (present day Virginia near Williamsburg) in 1608. In the U.S, the death penalty was suspended for a brief period in the 1970s. However, it was reinstated in 1976.

    Ever since the reinstatement, a total of 1,281 executions have been carried out in the U.S. so far, including 4 in 2012. In the U.S., the death penalty is in place in 34 of the 50 states.

    According to Death Penalty Information Center, the number of new death sentences issued in the U.S. in 2011 were down to 78 from 112 in 2010. Over the past decade, the number of executions in the country declined by half - from 85 in 2000 to 43 in 2011.

    Lethal injection, electrocution, gas chamber, hanging and firing squad are the methods of execution authorized in the U.S. Lethal injection is the common mode of execution in the country as it is considered a more humane alternative to other methods like electrocution or firing squad.

    The lethal injection is a series of three drugs - Sodium thiopental or Pentobarbital, Pancuronium bromide and Potassium chloride, administered one after the other in the same order.

    Sodium thiopental, often referred to as "truth serum", and belonging to the family of barbiturate, acts as an anesthetic. Pancuronium bromide is a muscle-relaxant that stops breathing by paralyzing the diaphragm and lungs. Potassium chloride causes death by inducing cardiac arrest.

    Before Pentobarbital, which is also an anesthetic agent, became a part of the lethal injection, the sole anesthetic that was a part of the three-drug regimen was Sodium thiopental. It was only from December 2010 that Pentobarbital became a part of the lethal three drug protocol, and that too was for a reason.

    The only company in the U.S. that was the source of FDA-approved Sodium thiopental was Hospira Inc. Due to manufacturing issues at its North Carolina plant, the company suspended production of Sodium thiopental in 2009. It was around the same time that the European Union also blocked the export of Sodium thiopental to the U.S. on ethical grounds. Since the end of the 1960s, all the European Union Member States have absolutely abandoned the death penalty in law.

    Hospira had planned to resume production of Sodium thiopental after shifting production from its North Carolina plant to its plant in Liscate, Italy, in the first quarter of 2011. But in January 2011, Hospira announced its decision to cease production and exit the Sodium thiopental market altogether because it couldn't assure Italian authorities that the company's Italian-made Sodium thiopental wouldn't be used as a part of the lethal injections.

    With supplies of Sodium thiopental drying up, there was a dire shortage of the drug in the U.S., which delayed executions, and even resulted in postponement of signing death warrants in several states. It was during this time that correctional facilities in several states switched to Lundbeck-made Pentobarbital, sold under the name Nembutal, from Sodium thiopental. Lundbeck is a Danish pharmaceutical company and the manufacturing plant for Pentobarbital is based in Kansas, U.S. Late last December, Lundbeck divested a portfolio of products, including Pentobarbital to US-based pharmaceutical company Akorn Inc.

    Pentobarbital is commonly used to euthanize dogs, cats, and horses, and its approved use in the humans is for controlling seizures. Many medical and legal experts have been opposing the use of Pentobarbital for the purpose of capital punishment since there is no assurance for the drug's associated safety and efficacy profiles in such instances. Lundbeck has also been objecting to the use of Pentobarbital for lethal injection in the U.S. and has placed strict restrictions on the distribution of the drug.

    In order to carry out the executions without delay, the correctional facilities in some states like Arizona, Arkansas, California, Georgia, Nebraska and Tennessee obtained a new supply of Sodium thiopental from foreign sources. To ensure that the new supplies of Sodium thiopental are not counterfeit, only those states that had properly registered with federal regulators before importing the anesthetic were allowed to retain the stockpiles while supplies of Sodium thiopental illegally imported were confiscated by Drug Enforcement Administration, or DEA.

    Amid this background, last week, a Supreme Court stayed the execution of a death row inmate based on the legality of purchase of Sodium thiopental, the first of three drugs used in the lethal injection protocol.

    The stay of execution was granted by Nebraska Supreme Court for the condemned prisoner Michael Ryan.

    Ryan, who was convicted in two murders, has been on death row since 1985. His execution had been set for March 6, 2012. Ryan had appealed that his death sentence should not be enforced, and his lawyers had challenged the manner in which Sodium thiopental was obtained by Nebraska Department of Correctional Services, or NDCS, to carry out the execution.

    And here is how the Sodium thiopental fiasco in NDCS has played out...

    In December 2010, India-based Kayem Pharma Pvt. sold a 500-gram consignment of Sodium thiopental to the Nebraska Department of Correctional Services, reportedly for $2,056, a deal which was brokered by the Indian company's representative Chris Harris. Kayem is not registered with either the DEA or FDA as a foreign pharmaceutical manufacturer or distributor.

    Soon Kayem was in the eye of storm as international human rights and anti-capital punishment campaigners took up cudgels against the company. In April 2011, Kayem announced its decision to halt sales of Sodium thiopental to U.S. jails on humanitarian grounds. The company also claimed that it was not aware of the real purpose for which Sodium thiopental was bought, and sacked Harris for breach of trust as he failed to reveal the intended purpose of the drug.

    In November 2011, the Nebraska Department of Correctional Services announced that it had purchased 485 grams of Sodium thiopental in two batches with expiration dates of May 2013 and December 2013, manufactured by Swiss pharmaceutical company Naari AG to be used in capital punishment procedures in Nebraska.

    When this news came to the notice of Naari, its CEO wrote to the Chief Justice of Nebraska Supreme Court clarifying that his company did not supply Sodium thiopental directly to the NDCS. Naari said that it had supplied samples of the drug to a middleman named Chris Harris with the intention of getting the product registered in Zambia and then begin selling it there, since Sodium thiopental is used very widely as an anesthetic in the developing world.

    But instead of providing the drug to Zambian officials, Harris sold it to the NDCS for $5,411. Enraged by the diversion from the drug's intended purpose, Naari in its letter had requested that the drug be returned to it.

    Unless a lower court challenge over how Nebraska obtained Sodium thiopental is resolved, the execution of Michael Ryan cannot take place, according to the Supreme Court's order dated February 23, 2012.

    Aside the fact that there have been dicey procedural missteps in procuring Sodium thiopental by some states, they are also perilously close to running out of Pentobarbital - the substitute for Sodium thiopental, given the restrictions placed on its distribution.

    If Pentobarbital inventory also dries up, the states will have to find an alternative drug, and for now, little is said about what other drugs the prison officials are considering.

    But for anti-death penalty campaigners, who want capital punishment to be replaced by life without parole, dwindling supplies of Pentobarbital are very welcome news.

    http://www.rttnews.com/1828645/a-con...=fdr&pageNum=3

  7. #107
    Banned TheKindExecutioner's Avatar
    Join Date
    May 2011
    Location
    Missouri
    Posts
    1,277
    Scientists agree nitrogen asphixiation is the best execution method since 78% of our atmosphere is already nitrogen! States need to look into that!

  8. #108
    Member Newbie allfourjacks's Avatar
    Join Date
    Mar 2012
    Location
    Southern California
    Posts
    42
    Crushed_by_elephant.jpg

    Here is one I think would work!!!!
    "It's ok to do for others knowing they won't do anything for you"

  9. #109
    Passed away. Rob's Avatar
    Join Date
    Nov 2010
    Location
    Far away from you...
    Posts
    151
    Quote Originally Posted by Diggler View Post
    India pays no attention to copyright of drugs so they could order from there.
    Or Thailand,
    Or South Africa.
    Its not a problem unless you need an excuse.

    And whats wrong with the Chinese method. No shortage of drugs there.

    Diggler
    The problem with getting drugs from other countries is that the FDA would intervene. Especially when you're talking about third world countries where anything and everything from Propfol to Viagra can basically be bought over the counter. Of course, most of it is faked or brewed in underground labs anyway.

  10. #110
    Administrator Heidi's Avatar
    Join Date
    Oct 2010
    Posts
    33,217
    Survey: 7 Deaths From Anesthesia Drug Shortage

    Seven U.S. anesthesiologists have reported that drug shortages resulted in deaths of their patients, according to a new survey from the American Society of Anesthesiologists.

    Although the online survey completed by 3,063 of the organization's 28,000 practicing anesthesiologists cannot be considered scientific, it opens a window to the growing shortage of anesthetics and painkillers used before, during and after surgery, and the potentially fatal consequences when those are unavailable.

    Seven doctors responded to the question "How has a drug shortage impacted your patients?" by checking the option, "Has resulted in death of a patient," according to survey results exclusively obtained by ABCNews.com.

    "We have a warning here. We are bound to trace this warning down and find out the extent of it," American Society of Anesthesiologists President Dr. Jerry A. Cohen said in an interview. "Are these the canary in the mine? I don't know. I worry that they are."

    Because the survey was anonymous, Cohen said he couldn't determine where the reported deaths occurred, how the patients died, or be sure all seven reports were reliable. "Six we're absolutely sure were reported," Cohen said.

    ASA had questions about "data points" in one responder's answers that cast doubts on one of the death reports, he explained. "It's unusual to have anybody report a death due to a drug shortage," Cohen said.

    Responses to a similar ASA survey in 2011 included two reports of patient deaths, but those weren't made public, Katherine Looze, an ASA spokeswoman, revealed in response to a question from the ABC News Medical Unit.

    Going forward with surgeries when they're short of needed drugs can put anesthesiologists in a legal bind, Cohen said. "We are at risk," he added. "If I proceed, if I don't have the drug I need -- and know I don't have the drug I need -- and I have a bad outcome, I'm responsible."

    Among survey respondents (3,033 Americans and 30 from abroad), 97.6 percent reported being currently short of at least one drug and 96 percent said shortages forced them to use substitutes for particular patients and procedures. When they used alternatives to their top-choice drugs, some of their patients experienced nausea and vomiting, spent longer in surgery or took longer to recover from sedation or anesthesia, the survey revealed.

    The drugs survey respondents most often couldn't get were the workhorses of local and general anesthesia, such as propofol, a milky white intravenous sedative and anesthetic that works in just 40 seconds. It's best known as the drug that led to the death of pop superstar Michael Jackson. Another is succinylcholine, a quick-acting paralytic agent frequently given to help insert a breathing tube into a patient's airway. There's also fentanyl, a powerful synthetic opioid used to knock patients out and to treat operative and post-op pain.

    Anesthesiologists also reported problems getting thiopental, also known as sodium penthothal, an ultra-short acting barbiturate that's used less frequently today in hospitals, but remains in demand for the lethal cocktail many states use in executions. The shortage has left some prisoners longer on death row.

    Shortages Lead to Substitutions, Delays, Canceled Surgeries

    If supply problems force anesthesiologists to switch from shorter-acting to longer-acting drugs, it can be harder to bring some patients out of anesthesia. More than half of doctors who answered the ASA survey questions said they'd altered procedures to accommodate shortages. Those changes could have included switching from general anesthesia to epidural or regional anesthesia. Among survey respondents, 7 percent said shortages forced them to postpone a procedure; 4 percent said they had to cancel procedures.

    Sometimes, second-choice drugs have unwanted side effects, said Cohen, an associate professor emeritus at the University of Florida in Gainesville. If fentanyl isn't available, he can substitute morphine, but "morphine causes nausea and vomiting systemically. If I use morphine in an epidural, it creates itching."

    He might try Dilaudid, but "it doesn't quite have the same safety margin" and it lasts longer, he said. "I will have a delay in waking the patient up."

    The association undertook the survey, in part, to have something to share with the Congress and other policymakers grappling with a nationwide crisis that has sent hospitals scrambling for antibiotics and anesthetics and brought them to the brink of being unable to treat some childhood cancers. Other medication shortages have forced parents to drive among pharmacies looking for medications to help their hyperactive children sit still and pay attention in class

    President Obama issued an executive order in the fall that, among other things, gave the Food and Drug Administration power to respond more quickly to drug shortages. The FDA has since begun allowing overseas imports of key drugs for leukemia and cancer, and approved new suppliers to alleviate shortfalls.

    But no one has yet determined how to alleviate a perfect storm of manufacturing problems, shrinking numbers of generic drug makers and increasing demand.

    "One solution I think is to have a supply of drug that is not going to go away if we have several days of delay in a component for a drug reaching the manufacturer," Cohen said. "The only way to get around that is to stockpile."

    "I've seen a lot more of this that I never dreamed would happen," said Cohen, who completed his residency in 1977. "When I started practicing, I thought whatever drugs I needed would always be there. Now I open the drawer and occasionally something isn't there."


    http://abcnews.go.com/Health/abc-new...2#.T4wkfNlX_T4
    An uninformed opponent is a dangerous opponent.

    "Y'all be makin shit up" ~ Markeith Loyd

Page 11 of 31 FirstFirst ... 91011121321 ... LastLast

Thread Information

Users Browsing this Thread

There are currently 1 users browsing this thread. (0 members and 1 guests)

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •