Marchese president says
Marchese Hospital Solutions thought each bag of chemotherapy drugs it prepared was for a single patient, making it unnecessary to measure and label the concentration precisely, the company’s president said Monday.
Marita Zaffiro, president of the company that owns and operates the Mississauga facility, testified before a legislative committee at Queen’s Park, speaking publicly for the first time since the scandal broke.
Marchese Hospital Solutions prepared pre mixed intravenous bags of two chemotherapy drugs that caregivers administered in weaker than standard doses to more than 1,200 patients at five hospitals, including 290 at Windsor Regional, over the course of about a year.
Zaffiro told the committee her company’s contract with the group purchasing organization Medbuy specifically said the bags did not need to be mixed to a precise concentration. If health care workers had been administering the enti pandora uk re bag of drugs to a single patient as the company believed, the precise amount of saline wouldn’t matter because the patient would still receive the correct dose of the active ingredient, Zaffiro said.
“I believe it was a communications issue,” Zaffiro told the committee. “Hospitals were using our product in a way we had no idea. We had no idea they were using them for multi patient use.”
Asked whether the amount of chemotherapy drugs present in one bag four gr pandora uk ams dissolved in 200 millilitres or more of saline is a reasonable dose for a single cancer patient, Zaffiro said her company’s job was to fill the supply order, not question it. “We are not physicians. We are not working directly with patients,” she told the committee.
In a telephone interview after the hearing, Christine Donaldson, Windsor Regional’s chief pharmacist, took issue with Zaffiro’s interpretation of Marchese’s role. The pharmacists who oversaw the preparation of the in pandora uk travenous bags should have known that four grams of the drug is about twice as much as a doctor would ever prescribe for a single patient, she said.
“I find it hard to believe that concentration strength amount in one bag did not raise some red flags for them,” Donaldson said. “It goes back to that due diligence.”
Marchese Hospital Solutions did not have a licence to operate as either a Health Canada regulated drug establishment or a pharmacy overseen by the Ontario College of Pharmacists. Zaffiro said she reached out to both organizations when she was incorporating the company and both declined to provide oversight.
“It was not created to avoid any type of regulation,” Zaffiro told the committee. “They were of the opinion we could keep doing what we were doing.”
Even though there was more saline in the bags than 200 millilitres listed on the label, the company didn’t make a labelling error because it wasn’t required to mix a precise amount of saline under the contract, Zaffiro said at the hearing. Medbuy representatives saw the labels and approved them, she said.
The committee also heard testimony from representatives of Cancer Care Ontario and the London Health Sciences Centre. The committee asked Carol Sawka, vice president of clinical programs and quality initiatives with Cancer Care Ontario, whether Marchese labelled the intravenous bags according to her organization’s standards.
Sawka said Cancer Care Ontario only has guidelines for labelling drugs for individual patients, not stock supply intended for use on multiple patients like the bags Marchese supplied. She said Cancer Care Ontario has looked into the issue of outsourcing the preparation of chemotherapy drugs versus preparing them in house and concluded there are pros and cons to both, with no clear evidence giving a definitive answer as to which is better.
“I can confidently say Ontario has a safe chemotherapy system pandora uk in place. However, as this unfortunate incident has highlighted, there’s always more to be done,” Sawka told the committee.
In an interview, Windsor Regional CEO David Musyj said he was disappointed that Zaffiro didn’t offer any insight into what Marchese could have done to help prevent the problem, since every organization in the supply chain has a role to play. He said Windsor Regional has learned from the situation and now has a system involving eight different checks for preparing the drugs in house.
“What’s still really unfortunate, at the conclusion of their testimony, is that at no point have they said that they would do something differently or that they’ve learned from this,” Musyj said. “That’s disappointing for any institution involved in this.”As hospitals deal with growing numbers of obese mothers to be, Canada fertility specialists are considering guidelines over whether they should be helping severely obese women get pregnant. Usually relegated to the bottom row on genetic plots; scientists believed its main function was to make us male instead of female. Now, they discovering it does a whole lot more. The human Y chromosome has definitely decreased in size over the past 300 million years. It once had more than 600 genes and now sports only 19. Dr. David Page, director of MIT Whitehead Institute, says this led to a popular belief that the Y chromosome is headed for extinction. can give a talk without being asked about the disappearing Y, he writes.