According to its web site, U.S. Pharmacopeia is an official public standards-setting authority for all prescription and over-the-counter medicines and other health care products manufactured in the United States. It is a non-governmental, not-for-profit public health organziation staffed by independent, volunteer experts.

USP Chief Executive Officer Roger L. Williams, M.D., was quoted as saying, “Stronger methods for detecting contaminants have been thoroughly assessed and incorporated into the new test methods, and the new physical reference standards are specific to these methods.”

According to the Huliq News report, these newest changes in standards were the topic of discussion at the third International Heparin Workshop, which was held at USP headquarters in Rockville, Maryland, this summer. The Workshop was co-sponsored by USP, the British National Institute of Biological Standards and Control (NIBSC), and the European Directorate for the Quality of Medicines (EDQM).

It is hoped the upgraded standards will improve patient and physician confidence in heparin products.

More information is available at http://www.usp.org/hottopics/heparin.html.

SOURCE: Heparin Recall › USP updates standards for heparin

POGO is an independent nonprofit group that investigates and exposes corruption and other misconduct in order to achieve a more effective, accountable, open and ethical federal government. The organization has spoken out previously about the FDA and its handling of contaminated food and drugs, such as the tainted heparin scandal of 2007. Now it is asking questions about the contaminated pre-filled heparin and saline syringes manufactured and sold by AM2PAT.

In a letter to FDA commissioner Margaret A. Hamburg, the organization said the FDA missed chances to act before a contaminated lot of 74,000 syringes were shipped by AM2PAT to hospitals and health care centers. Earlier this year, two officials with AM2PAT were sentenced to prison after pleading guilty to crimes related to the contamination.

“Why did the FDA fail in its duty to keep a dangerous medical product, AM2PAT’s syringes, off the market?” asks POGO in its letter. “We believe that part of the reason is a culture within the FDA that habitually maintains a relationship with manufacturers that is too collegial and too tolerant. There is a reluctance by the FDA to take corrective action stronger than a Warning Letter, even when stronger action is clearly indicated, as it was at several points in the history of the AM2PAT case. There is an additional reason for the FDA’s failure: the grossly inadequate resources available to the FDA for inspection and enforcement. This is mainly a budgetary problem that can, of course, be solved only by the White House and Congress.”

POGO says that the FDA knew of AM2PAT’s failures for more than a year but has issued no public statement about the failures. “The silence on the part of the FDA officials would by itself indicate the need for an investigation and report by the Inspector General.”

SOURCE: Heparin Recall › Watchdog group pressures FDA about contaminated syringes

Investigators now know that the pre-filled heparin and saline syringe Fullerton used was part of a contaminated lot that has since been linked to at least four deaths and 162 illnesses. And that lot could have and should have been prevented from being shipped to hospitals by the Food and Drug Administration (FDA).

Months before the syringes were shipped out, the FDA received reports about debris in syringes filled with heparin and saline distributed by drug manufacturer AM2PAT, yet the agency didn’t follow up on the complaints until 2007 after the reports of deaths and illnesses following use of the syringes. Reports from 2007 inspections show that investigators found a “gummy brown” substance on the syringe-filling machine. The plant was closed in January 2008.

Consumer advocates say the FDA should have acted faster and more aggressively to prevent the contamination of the pre-filled syringes at AM2PAT. Congress, too, has been critical of the agency for not properly or adequately inspecting food and drugs that are distributed to American hospitals and health care centers, and are pushing for better inspection standards within the agency.

Source: Pro Publica

SOURCE: Heparin Recall › FDA should have acted faster to prevent contamination

Bian Zhenijia, director of the drug safety supervision department of the State Food and Drug Administration (SFDA), urged companies to be more responsible when dealing with foreign suppliers.

“The problem lies in the fact that some overseas companies have an implicit deal with underground factories or illegal manufacturers in China, so the product involved has problems,” Bian said at a press conference.

China’s pharmaceutical industry is poorly regulated and several deaths and illnesses have been blamed on contaminated medications produced there. Last year, heparin manufactured in China was linked to more than 80 deaths and hundreds of illnesses in the United States. The blood thinner was later found to have been contaminated with a heparin-mimicking substance called oversulfated chondroitin sulfate, or OSCS. Heparin is derived from pig intestines, which are often produced by unregistered China businesses.

“I do not agree with what the foreign media say. The Chinese government has always paid a lot of attention to cracking down on fake drugs,” Bian told a news conference. “If the international community can give us information on fake drugs, we will resolutely investigate. There is no ambiguity about this.”

More than 300,000 cases of unlicensed drugs and medical products were distributed in 2007, according to SFDA.

Sources:
Associated Press
Reuters

SOURCE: Heparin Recall › China says tainted drug blame should fall on foreign suppliers

“As orthopedic surgeons, we look very critically at safety; we look very critically at efficacy. I think it is fair to say, if we consider those to be equal and the dosing schedule is equal, (and) they are both once-a-day, then it comes down to cost,” Richard J. Friedman, M.D., was quoted in the publication. “But we are looking (at) safety first and efficacy afterward.”

The topic, spurred by positive Food and Drug Administration (FDA) advisory committee reviews of rivaroxaban, was discussed recently at the 76th annual meeting of the American Academy of Orthopaedic Surgeons. Rivaroxaban, made by Bayer and marketed in other countries as Xarelto, is just one of many anticoagulants in development and expected to be on the market in the next one to three years.

Heparin is an injectible used in hospitals because it is easier to control than Coumadin, also known as warfarin, which requires close monitoring and frequent blood tests. Rivaroxaban is an attractive alternative because it comes in a pill and doesn’t require constant monitoring. If approved by the FDA, Rivaroxaban will be marketed by Ortho-McNeil Pharmaceuticals.

“Often in orthopedics, even the best of folks take a long time to incorporate and change practice patterns,” said Fred D. Cushner, M.D. “The big question is, who is going to switch? … This is debatable, but my personal opinion is the injectables will probably be the first to go.”

SOURCE: Heparin Recall › Surgeons hopeful about new alternatives to heparin

Announcement of the deaths and illness at Beebe Medical Center in Lewes, Delaware, raised immediate concern at the hospital, which promptly notified the FDA and Baxter. The incidents were far too similar to the 2007 heparin scandal in which more than 80 Americans died and hundreds more became ill after receiving doses of Baxter’s heparin. An investigation found some lots of heparin manufactured in Baxter’s China factory were contaminated with a heparin-like substance called over-sulfated chondroitin sulfate, or OSCS.

Both Baxter and the FDA investigated the Beebe incidents. Earlier this week Baxter announced its investigation found no OSCS contaminate in the heparin supplied to Beebe. It also said the heparin used by Beebe was manufactured in its Ohio plant, not the China facility.

But the mystery about the deaths and illness at Beebe still remains. A Baxter spokesperson said that following the national guidelines for drugs like heparin does not guarantee that there will be no problems with the medication.

“Even when those protocols are followed, bleeding at a site, including intercranial bleeding, can occur – especially in high-risk patients, which is an established side effect of all anticoagulant therapies,” said Erin Gardiner with Baxter. “Our responsibility is for the safety of the product.”

Source: Delmarva Media Group

SOURCE: Heparin Recall › FDA clears Baxter in deaths following heparin injections

Two deaths and one illness earlier this month following the injection of heparin in patients at a Lewes, Delaware, hospital sent chills through the nation. Could this be a repeat of the deadly contamination that harmed so many in 2007? The vials of heparin were traced back to Baxter, however these doses were manufactured in Ohio, not China, the drug maker contends.

Last year’s OSCS contaminant caused victims to suffer severely low blood pressure. This new reaction involves intracranial bleeding. Investigations by both Baxter and the Food and Drug Administration (FDA) followed and early findings indicate there is no trace of OSCS in the heparin used. Now Baxter says it is confident that the events at the Delaware hospital were “isolated, institution-specific issues, unrelated to the quality of Baxter’s heparin premix product,” a Baxter spokesperson told the Reuters news organization.

According to Baxter, it obtained samples from the lot in question as well as lots produced before and after the lot in question. Testing on those lots confirmed that the product’s formulation was within specifications and met all requirements. The FDA backed up Baxter’s contention: “We don’t see a quality problem with the product,” an FDA spokesperson said.

SOURCE: Heparin Recall › Baxter says it’s not responsible for recent heparin deaths, illness

All three incidences occurred at the Beebe Medical Center in Lewes, Delaware, and all three were given heparin supplied by Baxter, the same drug company at the center of last year’s contaminated heparin scandal. That heparin, which killed more than 80 people and injured hundreds more, was manufactured in China. The latest batch was manufactured in Ohio.

The heparin in question involves premixed intravenous bags of heparin whereas the previous heparin, which was later found to have been contaminated with a heparin-mimicing substance called over-sulfated chondroitin sulfate (OSCS), involved vials of the medicine and drug-coated medical devices.

The symptoms suffered from the newest victims involved intracranial bleeding; the previous deaths and illnesses were caused by severely low blood pressure. Immediately following the adverse reactions, the hospital contacted Baxter, which immediately contacted the FDA.

Both Baxter and the FDA sent medical teams to Delaware and the FDA took samples of the heparin for testing. “As far as we can determine at this point, it appears to be an isolated incident,” says FDA spokewoman Karen Riley.

Baxter has tested for but not found the contaminant OSCS to be in the batches of heparin taken from Beebe Medical Center. Baxter insists the heparin used on the patients who became ill at Beebe was not manufactured in China but in North America.

SOURCE: Heparin Recall › New deaths, illness following heparin use spark FDA investigation

She already has Senator Edward M. Kennedy’s support. “Her expertise is valuable for problems we now face, such as combating food-borne illness, cooperating with other agencies to address the new flu outbreak and drug-resistant diseases, and protecting our food and drug supplies,” Sen. Kennedy said in a statement for the Health, Education, Labor, and Pensions Committee hearing.

If confirmed, one of Dr. Hamburg’s many priorities will be to detangle the mess left behind from last year’s contaminated heparin scandal, in which batches of tainted heparin manufactured in China made their way into the United States. Those bad batches killed more than 80 people and sickened hundreds more. An investigation resulted in the FDA’s admission that it did not have the resources or the funding to adequately inspect foreign food and drug manufacturing companies.

The agency’s handling of the heparin scandal is currently under review by the Government Accountability Office, and congressional leaders are not letting up on their insistence that the FDA make better provisions to ensure the food and drugs imported into the US are safe.

“It is abundantly clear that the agency needs strong, new leadership to improve morale and make it once again the world class agency that Americans can trust to protect the health of their families,” Sen. Kennedy wrote. “I’m very pleased, therefore, that President Obama has nominated Dr. Margaret Hamburg to lead the FDA as its new Commissioner.”

SOURCE: Heparin Recall › Obama’s pick for FDA commissioner wants to restore trust in agency

Anticoagulants are often administered to patients before undergoing some surgeries and medical procedures to reduce the risk of life-threatening blood clots. Lovenox has been touted as an effective replacement for the blood thinner heparin in patients undergoing abdominal surgery.

Heparin carries a laundry list of side effects such as nausea, vomiting, abdominal pain, diarrhea and low blood pressure. Concerns about heparin flooded the media last year with cases of accidental overdoes and shipments of tainted batches of the blood thinner imported from China. Both incidences caused patients serious injury or death.

The contaminated heparin scandal in particular created an urgency among consumers, the medical community and pharmaceutical companies to find safer alternatives to the commonly used blood thinner.

Momenta chief executive officer Craig A. Wheeler said in the conference call that the FDA continues to review its Abbreviated New Drug Application (ANDA) process for M-Enoxaprin. ANDA is the FDA’s Center for Drug Evaluation and Research Office of Generic Drugs review and ultimate approval process of a generic drug.

Once approved, an applicant may manufacture and market the generic drug product to provide a safe, effective, low cost alternative to the American public. “We are in regular communication with the agency and responding to their questions as they arise,” Wheeler said.

Wheeler referred to the “global contamination issue” with the heparin supply and the FDA’s plant inspections of Chinese suppliers of heparin, adding that the companies who supply heparin to Momenta’s partner distributor Sandoz for the manufacture of M-Enoxaprin have all been inspected by the FDA.

While the company has no indication that the inspections raised concerns with the FDA, Wheeler said “Any disruption in the heparin supply has the potential to impact our supply chain.” As a result, the company will diversify its sources of heparin and closely monitor the supply chain.

Momenta hopes to launch M-Enoxaparin in 2009 provided the ANDA is readily approved by the FDA.

Source:
Seeking Alpha

SOURCE: Heparin Recall › FDA approval for marketing generic Lovenox expected

Rep. Joe Barton

The FDA has previously claimed the raw heparin originated from a manufacturing company in China and was purposefully contaminated with a man-made chemical, over-sulfated chondroitin sulfate, OSCS. The Chinese government disagrees.

Barton, a ranking member of the House Energy and Commerce Committee, has long championed the effort to resolve the heparin scandal by scrutinizing the FDA’s investigation into the case and the subsequent recall. He has previously argued that the agency misrepresented deaths tied to the heparin and didn’t thoroughly investigate the matter. He also has demanded answers on why the FDA took six months to seize lots of the contaminated heparin from an Ohio agency that still had the tainted drug in stock.

In his latest inquiry, Barton wants to know if the FDA has tracked the contamination back to the source. He also asked what action the Chinese government has taken in the matter and whether anyone in China has been held accountable.

Products imported from China have been in the spotlight in recent years as reports of more tainted foods, drugs and toys have entered the U.S. and injured people. The FDA has been working to expand its inspections of foreign imports in part by opening offices overseas. The first of these offices opened late last year in China.

SOURCE: Heparin Recall › Congressman demands answers on tainted heparin scandal

Letters sent by the FDA to Qingdao Jiulong Biopharmaceuticals Co. Ltd. and Shanghai No. 1 Biochemical & Pharmaceutical Co. Ltd., says that during inspection of the plants in 2008, the agency “uncovered untrue statements and information by your firm to the agency.”

In late 2007 the FDA began receiving reports of patients experiencing severe reactions after receiving injections of the blood thinner heparin. An investigation found that batches of heparin manufactured in China had been contaminated with oversulfated chondroitin sulfate (OSCS), a material that is difficult to immediately identify as it mimics heparin. The tainted blood thinner killed more than 80 Americans and sickened hundreds more before batches of the medication were recalled.

In the letters to the Chinese drug suppliers, the FDA said that although some shipments of heparin were quarantined, the drug companies did allow 19 lots to be shipped to the U.S. The agency warned that it can refuse to grant new drug applications or allow shipments to unload.

The FDA, which later admitted it did not have sufficient resources to fully inspect foreign food and drug manufacturers, has come under fire for its handling of the contaminated heparin scandal. As a result, the FDA has stepped up its efforts by opening inspection offices in foreign countries to oversee the quality of goods imported into the U.S. The first offices were placed in China with plans to have four permanent inspectors in China by mid summer.

SOURCE: Heparin Recall › FDA accuses Chinese companies of lying about role in heparin scandal

It wasn’t until then that Martin learned the syringe he had used on his young son was part of a recalled batch that was found to have been contaminated at the manufacturing plant AM2PAT. The tainted syringes killed five people and sickened at least 100 more before the Angier plant was closed. The company’s “clean room” was found to be a frightful mess.

Last month, two AM2PAT managers pleaded guilty to federal fraud and a warrant is out for AM2PAT president Dushyant Patel, who is still at large.

Knowledge of the recall did little to put Martin’s mind at ease. He wants answers from the company, the distributor of the syringes, and the Food and Drug Administration (FDA).

“I just felt, why? Why didn’t somebody stop this?” he told media. “Not only did they hand me a loaded gun, they enabled me to pull the trigger on my own son.”

An FDA warning letter to the plant in 2005 reported no major safety violations. However, an FDA spokesperson says in August 2007 the company began producing the syringes at a “dramatic rate” and that was when quality began to slip.

The FDA was notified by the Centers for Disease Control and Prevention about the adverse events reported, and within five days the FDA had closed down the plant for manufacturing violations. The FDA also contends that “evidence of a casual link between the AM2PAT product” and the infections was “never conclusively established.”

The FDA’s claims don’t sit well with Martin, who says he will pursue legal action.

Source: WRAL

SOURCE: Heparin Recall › Father blames FDA for not taking precautions to protect son

Blood tends to pool in the atrial chamber of individuals with atrial fibrillation, which can lead to clotting and an increased risk for strokes. Patients with atrial fibrillation are generally treated with blood thinners to help prevent blood clots from forming.

However, blood thinners like heparin can cause serious bleeding episodes and allergic reactions. Alternatives to long-term use of blood thinners has many cardiologists taking notice.

“The findings from this clinical trial are very impressive,” said Dr. Gregg C. Fonarow, professor of cardiology at the University of California, Los Angeles. “Treatment with this novel device will be very attractive and provide patients with atrial fibrillation effective, long-term protection from stroke and systemic embolization without the bleeding risks associated with (blood thinners).”

The PROTECT-AF Trial, which involved 707 patients with a type of atrial fibrillation, showed that patients who had the device had a 32 percent lower risk of stroke and cardiovascular death compared with those on blood thinners. The study also found fewer complications with the implanted device compared to the use of blood thinners.

A Food and Drug Administration (FDA) advisory panel will meet in April to consider the sale of the device in the United States.

Source:
Eflux Media News

SOURCE: Heparin Recall › Heart device may eliminate need for heparin, warfarin

The label changes include modifications to the Warnings, Precautions and Adverse Reactions sections of Heparin Sodium in 5% Dextrose Injection and Heparin Sodium in 0.9 % Sodium Chloride Injection.

The labeling changes in part were spurred by the much-publicized overdosing of actor Dennis Quaid’s newborn twins, who nearly died in 2007 when they were accidentally given 1,000 times the intended dose of the blood thinner. The Quaid’s case is just one of many cases where health care workers claimed to have confused high-dose and low-dose heparin. Some argue that the two bottles can be easily confused.

Heparin is generally used when a patient – adult or infant – receives fluids through a central line to prevent a blood clot from forming, which could eventually grow and break off and kill a patient. But if the blood is too thin, it puts the patient at risk for life-threatening bleeding or hemorrhages, including in the brain.

Heparin has seen its fair share of the spotlight lately. Last year more than 80 Americans died and hundreds more were sickened after receiving doses of heparin made at Baxter International’s China plant. An investigation found that lots made in that plant were contaminated with oversulfated chondroitin sulfate (OSCS). The contaminant can cause serious allergic reactions and even death.

SOURCE: Heparin Recall › FDA announces labeling changes for heparin

Rivaroxaban, a pill marketed in Europe as Xarelto, showed to be more effective than the anticoagulant heparin, while presenting no more side effects than heparin. Side effects of heparin and rivaroxaban include the risk of internal bleeding. Another benefit of rivaroxaban is that it does not need constant monitoring like another popular blood thinner, warfarin. Heparin is administered intravenously while warfarin is a pill taken orally.

Pharmaceutical companies have long been working on safer and easier alternatives to heparin and warfarin, especially since the tainted heparin scandal last year where more than 80 Americans died and hundreds more were made sick after receiving injections of batches of heparin that had been laced with oversulfated chondroitin sulfate (OSCS), a contaminant that mimics heparin but can cause serious allergic reactions in humans.

The FDA is expected to make a decision whether to approve rivaroxaban by May 28. If approved, rivaroxaban would be the first oral blood thinner approved since the FDA approved warfarin in 1954, according to Forbes.

“We appreciate the thoroughness of the advisory committee’s review, and we will continue to work with the FDA as they finalize their review,” Dr. Peter DiBattiste, vice president of Johnson & Johnson Pharmaceutical Research and Development, said in a prepared statement.

SOURCE: Heparin Recall › FDA panel recommends agency approval of heparin alternative

Sharfstein made headlines in 2007 when he convinced the FDA to restrict the use of over-the-counter children’s cough and cold medicines based on evidence they can cause serious health complications and even death in children.

If there is one government agency that needs overhauling, it is clearly the FDA. The agency has been under scrutiny for the past few years over contaminated food and drug products that have harmed and even killed Americans.

The agency is still feeling the repercussions from the tainted heparin scandal. Last year more than 80 Americans died and several more were made seriously ill after receiving injections of specific batches of the blood thinner that had been manufactured in a China plant. Those batches were found to have been contaminated with oversulfated chondroitin sulfate (OSCS), a contaminant that mimics heparin but can cause serious allergic reactions.

Following the revelation, the FDA admitted that it simply did not have manpower to properly inspect foreign food and drug manufacturing plants. Since then the FDA has taken measures to step up its inspections by opening field offices overseas. The first three offices opened late last year in China.

The FDA employs more than 11,000 employees and an annual operating budget of $2 billion.

SOURCE: Heparin Recall › Hamburg, Sharfstein to head troubled FDA

Heparin is routinely given to patients before certain types of surgery and prior to treatments such as kidney dialysis to prevent blood clots from forming. Clots that do not naturally dissolve can travel through the blood stream and end up in the brain, causing stroke or in the lungs resulting in a pulmonary embolism.

Heparin is produced naturally by most animals, including humans, but most heparin used today is derived from pig intestines. China has become a popular location for manufacturing heparin because it has a much larger pig population. It is somewhat inexpensive to produce, however, ensuring the safety of drugs manufactured overseas has been a challenge for the Food and Drug Administration (FDA). Just last year, more than 80 Americans died and hundreds more were sickened after they received injections of specific batches of heparin that were manufactured in China. That heparin was later found to have been contained with oversulfated chrondroitin sulfate (OSCS). As a result, researchers have been working to find safer alternatives to heparin.

Liu, whose Recomparin research was published online in the Proceedings of the National Academy of Sciences journal last November, says he is also looking into customizing heparin for other uses, such as a treatment for small-cell lung cancer.

SOURCE: Heparin Recall › Researcher awarded NIH grant for development of synthetic heparin

However, an FDA spokesperson says no details were available on those “new efforts” the agency will undertake to ensure quality control, though a spokesperson with the Department of Health and Human Services, which oversees the FDA, says more information will be available when Obama releases the more detailed budget in April.

The Bush administration largely opposed the idea because of safety concerns. One cannot soon forget the toll tainted heparin took on the U.S. just last year. More than 80 people died and hundreds more were sickened when vials heparin imported from a China manufacturing plant were found to have been contaminated. FDA admitted then that it didn’t have sufficient staff to properly inspect all food and drug manufacturing plants on foreign soil.

Countries such as Canada sell medicines for much less than in the United States because the government helps control prices. Critics of importation say that buying drugs from foreign countries would leach vital funds from the U.S. drug industry that otherwise would be used to research new therapies and innovations.

In the past several months, the FDA has stepped up quality control measures by setting up offices overseas to inspect food and drugs being imported into the U.S. The first offices were placed in China.

SOURCE: Heparin Recall › New budget supports plan for importation of drugs

Von Eschenbach was appointed by President Bush in 2005 after the agency’s previous commissioner resigned due to ethical issues, the AP reports. While under von Eschenbach’s helm, the FDA has undergone scrutiny by Congress and consumer groups over issues such as the tainted heparin scandal earlier this year.

The FDA ordered a recall on batches of the blood thinner heparin made at Baxter International’s Chinese facility after some lots were found to have been contaminated with over-sulfated chondroitin sulfate. The tainted heparin killed more than 80 Americans and sickened hundreds more before the contaminant was identified and linked to the China plant.

Over the past several months the FDA continued to come under fire for its handling of the heparin recall. Last week, Rep. Joe Barton, a ranking member of the House Energy and Commerce Committee, questioned why the FDA waited six months to seize lots of contaminated heparin from Celsus Laboratories in Ohio. Last month Rep. Barton also asked the Government Accountability Office to look into the agency’s overall handling of the recall.

Despite the criticism, von Eschenbach has been favorably regarded for strengthening the agency’s international food and drug regulations, opening three offices in China last month and vowing to place more than 60 food and drug regulators worldwide to oversee quality standards of food and drugs imported to the United States.

President-elect Obama is considering a list of candidates to succeed von Eschenbach that includes Baltimore’s health commissioner, several prominent physicians, and former and current FDA officials, according to AP.

SOURCE: Heparin Recall › FDA commissioner announces plans to resign next month

The FDA ordered U.S. Marshals to seize the products today. Mike Chappell, acting associate commissioner for regulatory affairs for the FDA is quoted as saying, “This action will help prevent this contaminated heparin from finding its way into the marketplace.”

Earlier this year, heparin manufactured by Baxter International, Inc., was found to be contaminated with OSCS. That heparin also contained components manufactured in China, which is believed to be the source of the contamination. The Baxter contamination led to hundreds of injuries and 81 deaths.

The FDA news release states that the agency has initiated 13 recalls of multiple contaminated medical products containing heparin from several companies, to date this year.

Information in the news release indicates the Celsus heparin entered the United States before the establishment of FDA import controls for the drug, and was reviewed by the FDA after it was processed at Celsus as a part of the agency’s process to implement the controls.

The release also indicates that the FDA knew about the contamination in April 2008, when it warned Celsus Laboratories during an inspection that the company’s actions to notify customers about the contaminant were insufficient. The FDA says it warned Celsus again that it needed to step up its efforts to notify customers about the potential hazard in a May 8, 2008 letter. Finally, today the FDA seized the contaminated product from the lab.

Manufacturers who may have purchased heparin from Celsus are urged to contact the company immediately to make sure they are not using any heparin from the since-seized lots. The product does not meet acceptable quality standards, the release says.

SOURCE: Heparin Recall › Contaminated heparin removed from Cinnicinnati plant

The report revealed that inspecting the more than 3,000 overseas drug plants would take the FDA more than 13 years to complete The agency fired back, saying “The conclusion that FDA should endeavor to conduct foreign inspections based on the same criteria as domestic inspections is…problematic because of the differences in regulatory methodology and resources,” according to the Associated Press.

The need for careful inspections of foreign drug manufacturing plants has come to the forefront since the tainted heparin scare earlier this year that killed more than 80 people and sickened hundreds more. Those batches of heparin were found to have been contaminated in Baxter International’s Chinese manufacturing plant.

Now the Natural News is reporting that the FDA is refusing to release information on which Chinese companies supplied the tainted heparin. According to Natural News, the FDA claims that a confidentially agreements with producers of heparin are preventing the government agency from revealing which Chinese companies supplied heparin ingredients to the United States. It also claims that because of the Memorandum of Agreement that regulates relationships between the FDA and China, the FDA does not have the legal authority to prevent Chinese-manufactured medicines from being imported into the U.S. The FDA says it relies on companies to voluntarily rest their own heparin ingredients, a process that obviously failed last year when contaminated heparin entered the United States.

Meanwhile, Chinese health officials say that it has not been proven that the heparin was contaminated in Chinese plants, and that contamination could just have easily happened in Baxter’s New Jersey plant.

SOURCE: Heparin Recall › FDA will not name Chinese plants that supplied tainted heparin

The U.S. Food and Drug Administration (FDA) recently announced that it will place more than 60 food and drug regulators worldwide over the next year to inspect foreign drug manufacturing plants.

However, congressional investigators say inspecting the more than 3,000 drug plants in other countries could take as long as 13 years, according to the Associated Press. In comparison, U.S. pharmaceutical factories are inspected by the federal government every 2.7 years on average.

Of the 3,249 foreign facilities for which the FDA has set enforcement priorities, the government agency has only been able to inspect an average of 247 per year, compared to 50 percent of the 3,000 U.S. facilities, according to the Government Accountability Office (GAO).

Inspections of most domestic plants involve ongoing surveillance of facilities’ manufacturing practices. By contrast, foreign facilities are inspected before they are allowed to ship drugs to the U.S. When problems are found at a foreign plant, steps are taken to fix them. However, follow up inspections on those measures by the FDA can take up to five years, the report said.

The GAO report stated significant growth in the foreign drug manufacturing market has presented the FDA with “significant challenges” in ensuring the safety of imported drugs, and urged more surveillance of all foreign drug facilities.

SOURCE: Heparin Recall › FDA inspections of foreign drug facilities could take years

“We are sending a very clear message to producers: if you want to have access to our market you need to make products that meet our standards of quality,” Health and Human Services Secretary Michael Leavitt was quoted in the story. Leavitt oversees the FDA and other federal health agencies.

While particular attention will be paid to India, Latin America and the Middle East, the FDA will make China a priority, establishing its first office in Beijing by the end of the year. The Beijing office will employ eight U.S. staffers. Additional outposts are planned for Shanghai and Guangzhou.

Products made in China have caused much heartache lately. Last spring, the FDA
recalled batches of heparin after some lots were found to have been contaminated while produced in Baxter International’s Chinese factory. The tainted heparin killed more than 80 people and sickened hundreds more.

Similarly, dozens more products made in China have been recalled over the past several months for harming people, including tainted baby formula, toys made with lead-based paint, and contaminated pet food.

Details on how the FDA will carry out the plan are unclear, as FDA officials admit that the hiring of several dozen more staffers, as the plan lays out, would not provide enough personnel to visit the thousands of plants around the world.

SOURCE: Heparin Recall › FDA to set up offices worldwide

FDA approval isn’t a guarantee of safety. For example, last spring, FDA-approved batches of heparin were recalled after they were found to have been contaminated. The tainted drug killed more than 80 people and sickened hundreds more before the FDA recalled the medication.

At issue in the new Supreme Court term is the “final rule” established on June 30, 2006, by the FDA. That rule protects drug companies whose drugs have harmed others from lawsuits by individuals who have been harmed. This extends to companies that deliberately withheld information that would have proven their drug to be harmful.

According to the Natural News story, the FDA runs without oversight and has declared that it gets the final word on a drug’s safety regardless of its harmful effects. Therefore, both the FDA and the pharmaceutical companies it represents are protected from suits under this arbitrary rule.

The Supreme Court currently is considering a lawsuit against drug-maker Wyeth and its drug Phenergan after a woman who received an injection of the nausea drug led to a gangrene infection that resulted in the amputation of her arm. Wyeth is accused of inadequately warning about the risks involved with this type of injection.

SOURCE: Heparin Recall › High court rule may affect right to sue drug makers

“With more drug companies buying ingredients and producing products overseas, country-of-origin labeling is more important than ever,” Sen. Brown said in a press release.

Country-of-origin labeling for active pharmaceutical ingredients was initially proposed last April as part of the Food and Drug Administration (FDA) Globalization Act. Sen. Brown’s proposal would require similar labeling for active ingredients as well as inactive ingredients on both prescription and over-the-counter medications.

The bill comes on the heels of the FDA recall of heparin last spring, which was found to have been contaminated at Baxter International’s China manufacturing plant. The contaminated heparin killed more than 80 people and sickened hundreds more.

The bill coincides with new provisions for country-of-origin labeling of food products. As of September 30, 2008, retailers must notify their customers of the country of origin of commodities outlined by the newly amended Agricultural Marketing Act of 1946.

With so many alarming recalls from China – from contaminated heparin and baby formula to toys laced with lead paint and generators plagued by fire hazard claims – knowing where our medications and food originate will help us all make more informed decisions whether to buy them.

SOURCE: Heparin Recall › Senator proposes country-of-origin labeling for medications

Nearly 100 pharmacists and the hospitals they work for were fined $2,000 to $5,000 by the Board of Pharmacy, according to the report.

The Food and Drug Administration (FDA) recalled heparin early last year after a large number of patients suffered adverse effects after taking the drug. The FDA later determined that batches of heparin made in China contained a contaminant that ultimately killed more than 80 people and made hundreds more ill.

In 2004, California took the lead in making sure recalled medicines were removed from pharmacy and hospital shelves by becoming the only state in the country to approve a stringent electronic system for drug makers, wholesalers and pharmacies to track all prescription drugs from manufacturer to patient, according to the San Francisco Chronicle.

But implementing this system has been challenging. The law originally was set to go into effect in 2007, but was delayed until January 1, 2009. Last March, the California Board of Pharmacy voted to give until Jan. 2011 to start electronic tracking. Board officials were concerned if they did not extend the deadline that the law would be poorly implemented or drug makers would refuse to sell their medications in California.

SOURCE: Heparin Recall › Recalled heparin still appearing in hospitals, pharmacies

Last month I told you that California Rep. Harry Waxman, who serves as head of the House Oversight and Government Reform Committee, raised concerns that items outlined on the FDA’s 2007 priorities list appeared to prioritize industry desires over consumer protection.

This, just months after more than 80 American deaths were linked to tainted heparin that was made in Baxter International Inc.’s facility in China. FDA officials later acknowledged they had not inspected that facility and claimed they had insufficient staff and financial resources to regularly inspect overseas manufacturers.

Today, the Washington Post reported that the FDA has hired a public relations company it improve its image. However, in yet another PR blunder, the story reports that the way it hired the company may also be raising eyebrows.

The story suggests that the FDA may have violated government contracting rules by not holding a bidding competition for a $300,000 contract hiring a firm to create “a lasting positive public image for the agency.” Instead it made a deal with Alaska Newspapers Inc., (ANI) which is exempt from having to compete for federal work because it qualifies for special set-asides. ANI agreed to funnel all the work to the FDA’s agency of choice, Qorvis Communications. Apparently the FDA’s new PR head, Mildred Cooper, had connections to the firm and wanted to use it.

The FDA cancelled its contract with ANI/Qorvis Communications after the Washington Post’s story ran. And while the FDA claims it never meant to do anything questionable during the selection process, this latest blunder certainly hasn’t helped the organization’s public image.

SOURCE: Heparin Recall › FDA makes blunder during hiring of PR firm to improve image

Lovenox, the company’s number one selling medicine, was first recalled last June after some batches of its pre-filled injectible solution were found to be contaminated with trace amounts of oversulphated chondroitin sulphate, according to Reuters.

Oversulphated chondroitin sulphate is the same contaminate found last March by the Food and Drug Administration (FDA) in batches of heparin that killed more than 80 Americans and sickened hundreds more. Those batches were traced back to Baxter International’s Chinese plant.

The level of contaminant found in Lovenox was much lower than what was found in the heparin manufactured by Baxter International, according to Forbes.

So, what exactly is oversulphated chondroitin sulphate?

According to a March 20, 2008, New York Times report, chondroitin sulphate is an inexpensive and readily available dietary supplement made from animal cartilage. In its natural state chondroitin sulphate does not have anticlotting properties, however when it is altered to what is called oversulphated chondroitin sulphate, it mimics heparin.

According to the FDA, oversulphated chondroitin sulphate is not an approved drug in the U.S., nor should it be found in heparin, as it likely caused the allergic reactions that have killed and sickened so many individuals worldwide.

SOURCE: Heparin Recall › French Lovenox brand heparin recall

The FDA also planned to change its regulations to protect device makers’ FDA-approved products from lawsuits with a so-called preemptive clause, according to Reuters.

The news agency says that in a letter from California Rep. Henry Waxman, to FDA Commissioner Andrew von Eschenbach, Waxman raised concerns that the items outlined on the FDA’s 2007 priorities list “all appear to prioritize industry desires over consumer protection.”

Then-FDA Chief Counsel Sheldon Bradshaw told Waxman in an e-mail that he planned to forward the list of priorities to Deputy Secretary of Health and Human Services Tevi Troy. Both Bradshaw and Troy have ties to the pharmaceutical industry, Reuters reports.

Waxman, who serves as the head of the U.S. House of Representatives Oversight and Government Reform Committee, suggested that political appointees at the agency may be promoting industry priorities at the expense of FDA’s core public health mission.

Highly publicized safety scares, including bacteria-laced foods and contaminated batches of heparin, have put the FDA in the hot seat in recent years. According to Reuters, an FDA spokesperson said the agency would respond directly to Waxman about the concerns he raised.

SOURCE: Heparin Recall › Lawmaker questions FDA priorities, suggests industry ties

The U.S. Food and Drug Administration announced today that Baxter Healthcare Corporation has temporarily stopped manufacturing multiple-dose vials of the injectable blood-thinning drug heparin due to reports of serious allergic reactions and hypotension (low blood pressure) in patients who receive high “bolus” doses of the drug.

Serious reactions to the drug have included difficulty breathing, nausea, vomiting, excessive sweating, and rapidly falling blood pressure that can lead to life-threatening shock. Four people have died after receiving heparin, although the relationship to the drug is unclear.

Heparin sodium is derived from pig intestines and has been marketed in the United States since the 1930s. Millions of patients benefit from the intravenous administration of this drug every year to avoid potentially life-threatening blood clots in the veins, arteries, and lungs.

“FDA concurs with Baxter’s decision to halt manufacture of heparin sodium in multiple-dose vials,” said Janet Woodcock, M.D., FDA’s deputy commissioner for scientific and medical programs, chief medical officer, and acting director of its Center for Drug Evaluation and Research. “FDA is vigorously investigating to determine the root cause of these serious reactions associated with the use of heparin made by Baxter. In the meantime, patients and health care professionals who cannot obtain alternative sources of heparin should use caution in administering any Baxter multiple-dose vials that remain.”

Heparin is commonly used before certain types of surgery, including coronary artery bypass graft surgery, and in kidney patients before they undergo dialysis. In some situations, heparin treatment is initiated using a high bolus dose given directly into the bloodstream (intravenously) over a short period of time, usually less than one hour. The reported adverse events occurred in patients who were given heparin in this form of administration. There are many other uses of heparin involving lower doses or administration over a longer period of time; adverse events have not been seen with those uses.

About 350 adverse events associated with the Baxter product have been reported since the end of last year compared to less than 100 reports in 2007. Most of the events have taken place at hemodialysis centers, almost exclusively involving patients receiving a bolus dose – which is a high dose administered over a short time. While most of the reports involve multiple-dose vials, several cases include patients who received a bolus dose after their health care professional combined heparin from single-dose vials.

The Missouri Department of Health and Senior Services first notified the Centers for Disease Control and Prevention (CDC) in January of several severe allergic-type reactions to heparin that occurred at a single pediatric hospital beginning in November. The CDC in turn alerted FDA and Baxter, prompting the company’s voluntary recall of nine lots of heparin on Jan. 17.

Since then, FDA has learned of adverse events that extend beyond the recalled lots and involve patients receiving heparin for other purposes besides hemodialysis. Recent cases have included patients undergoing cardiac surgery and a specialized blood cell treatment known as photopheresis.

Over one million multiple-dose vials of heparin are sold per month in the United States; half of the vials are manufactured by Baxter of Deerfield, Ill. FDA is currently investigating whether similar events have been seen with other heparin manufacturers.

Physicians, dialysis center staff and health care providers are advised to use an alternate source of heparin or another blood-thinning drug when possible. When only Baxter product is available:

• Administer the heparin as an infusion (not a bolus) whenever possible.
• Use the lowest dose necessary at the slowest infusion rate acceptable to obtain the desired clinical effect.
• Closely monitor the patient for adverse events, particularly hypotension and signs and symptoms of hypersensitivity and ensure that resuscitation equipment is available.
• Consider pretreatment with corticosteroids (cortisone type medicines) or antihistamines (drugs that relieve the symptoms of allergic reactions) although it is not known if such pretreatment is effective.

Any allergic-type reaction to heparin infusion should be reported to FDA’s MedWatch Program by phone at 800-FDA-1088, by fax at 800-FDA-0178, by mail at MedWatch, HF-2, FDA, 5600 Fishers Lane, Rockville, M.D. 20852-9787, or on the MedWatch Web site at www.fda.gov/medwatch.

SOURCE: http://www.fda.gov/bbs/topics/NEWS/2008/NEW01797.html

SOURCE: Heparin Recall › Heparin Linked to Severe Allergic Reactions