The laparoscopic power morcellators provided by Johnson & Johnson enabled surgeons to perform procedures such as hysterectomies with minimal invasiveness. Unfortunately, an estimated 1 in 350 women undergoing hysterectomies have an undiagnosed case of uterine cancer, and when the uterus is broken into pieces by this device, it can cause the cancer to spread. This is what happened to a Harvard anesthesiologist and medical professor who underwent a laparoscopic hysterectomy and subsequently petitioned the FDA to put an end to the use of this method.
Accordingly, the FDA began conducting a study, the findings of which were published in July. As a result of this study, the FDA recommended that use of morcellators be suspended or restricted. Following this report, Johnson & Johnson announced that it will no longer produce the devices and has recommended that customers return them.
However, the wisdom of this decision is being challenged by many in the medical field who feel that the potential dangers are not as significant as the FDA is reporting. Outpatient Magazine reports on this argument in an article entitled “Johnson & Johnson Asks Customers to Return Morcellators.”
As we all know, tissue damage from hypoxic ischemic injury during a heart attack leads to ongoing problems, like congestive heart failure. Once heart muscle is damaged, neighboring healthy tissue will become damaged too, due to the “bystander effect.” This can turn what might be relatively minor heart damage into major, life-threatening damage. So the question becomes: is it possible to stop this “bystander effect” in its tracks?
With more than 35 new ASCs opening in the first quarter of 2018, business continues to boom for many ambulatory surgery centers across the nation. But, some states are more favorable than others when it comes to where ASC doctors choose to practice medicine.
Those in the surgical arena are likely aware of the recent propofol shortage. This resulted when Teva Pharmaceuticals, which supplied approximately 40% of the propofol used in the U.S. announced that they would no longer produce the drug. This decision came after they were ordered to pay $356 million to a patient who developed Hepatitis C after his doctor reused the same single-use vial on several different patients. You can read about that controversial decision as well as the resultant drug shortage at the in this article at the National Center for Biotechnology Information (NCBI). Because the propofol vials are designed for single use only, disposing of unused medication led to a great deal of waste, particularly in ambulatory surgical centers where surgeries tend to be of a shorter duration and less of the drug is therefore needed. David Bernard, of Outpatient Surgery Magazine, reports that in response to this problem, German drug manufacturer Fresenius Kabi is now offering Diprivan, its injectable emulsion of propofol, in 10mL vials, the smallest dosage of single-use vial ever created. In addition to eliminating waste, this smaller dosage vial is likely to reduce the chances of patients being infected due to reuse.
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