Baking Soda Shortage Has Hospitals Frantic, Delaying Treatments and Surgeries (arstechnica.com) 250
An anonymous reader quotes a report from Ars Technica: Amid a national shortage of a critical medicine, US hospitals are hoarding vials, delaying surgeries, and turning away patients, The New York Times reports. The medicine in short supply: solutions of sodium bicarbonate -- aka, baking soda. The simple drug is used in all sorts of treatments, from chemotherapies to those for organ failure. It can help correct the pH of blood and ease the pain of stitches. It is used in open-heart surgery, can help reverse poisonings, and is kept on emergency crash carts. But, however basic and life-saving, the drug has been in short supply since around February. The country's two suppliers, Pfizer and Amphastar, ran low following an issue with one of Pfizer's suppliers -- the issue was undisclosed due to confidentiality agreements. Amphastar's supplies took a hit with a spike in demand from desperate Pfizer customers. Both companies told the NYT that they don't know when exactly supplies will be restored. They speculate that it will be no earlier than June or August. With the shortage of sodium bicarbonate, hospitals are postponing surgeries and chemotherapy treatments. A hospital in Mobile, Alabama, for example, postponed seven open-heart surgeries and sent one critically ill patient to another hospital due to the shortage.
The Free Market at Work (Score:2, Interesting)
Re:The Free Market at Work (Score:5, Informative)
There are always shortages - it's just not apparent to the average Slashdotter. This page lists current and past drug shortages going back to 2010. [ashp.org]
Here's the Canadian version. [drugshortagescanada.ca]
There seems to be a similar site for the EU [europa.eu], though the page says most shortages are handled by the individual national governments. I'd check the French or German health websites, but I'm not good in those languages. The UK seems to have ceased tracking shortages.
Re: (Score:3)
Right but that's dodging the question isn't it?
Not at all - I provided some resources to help people get started answering that question. I'm not gunning for a PhD, so I'm not going to do the study myself :)
confirms that the shortage is due to a contractual dispute
My public school had a strike when the teachers walked out for a contractual dispute. Government is not immune from this.
The UK's NHS typically does quite well at ensuring supply,
We'll never know if that is true or not, since they deliberately stopped tracking shortages.
Re: (Score:2, Informative)
The "free market" never existed, it's a construct of man's imagination, but let's set that aside for a moment while we talk about something more serious - Life or death serious. Health care. Physicians follow a code to do no harm. Drug companies have no such compunctions. There is no business imperative, regulation, general guideline or established best practice to maintain production of CRITICAL, EVERYDAY PRODUCTS that the world needs lots of. There is NO safety net. There is no planned economy gover
Re: (Score:2)
Free market is not anarchy. Menger, von Mises, Milton Friedman were not anarchists. You're playing the true Scotsman card and it's really tiring to hear this BS.
Drug companies have the compulsion of reputation, the same as other businesses Go to the
Re: (Score:2)
Thanks to regulation, I can safely buy no-name generic OTC drugs at the store without any fear and at an extremely low price.
I'd rather not be the person who died to mediate a brand's reputation on the market.
Re: (Score:2)
Re: (Score:2)
I guess you never heard of sulfanilamide [fda.gov]
Nor Thalidomide. From 1962:
http://www.washingtonpost.com/... [washingtonpost.com]
https://en.wikipedia.org/wiki/... [wikipedia.org]
Re: (Score:2)
Did you mean "The Jungle," by Upton Sinclair, Jr? Or some other book by Nobel laureate, Sinclair Lewis?
The first does make a strong argument for regulation and monitoring, in the case of meat packing on industrial scales as practiced in turn of the 20th century United States.
Applicable to current topic... how?
It's a counter-argument to the libertarian "any government regulation is always bad" position being espoused by several posts here.
Re: (Score:2)
https://en.wikipedia.org/wiki/National_Helium_Reserve
Re: (Score:2)
If you think you know how the free market would work in drug manufacturing, then you need to read this:
http://fortune.com/2013/05/15/... [fortune.com]
Re:The Free Market at Work (Score:5, Insightful)
Is this shortage happening in countries with "socialized medicine", or just in free market America?
We don't have a free market medical system. We have a cronyist monopoly enforced by laws written by hospitals and pharma company. If the medical system produced computers, a PC would cost about the same as a Lamborghini.
Re: (Score:3, Insightful)
That is literally the Free Market at work.
It purchased legislators to bypass the concept of being regulated.
Re: (Score:2)
Explains Microsoft Windows: the complexity of a Lamborghini but the performance of a Yugo.
Monopolies and oligopolies almost always end up sucking. Newly arrived x-opolies may be okay, but over time they grow sloppy, evil, slow, and/or anti-competitive due their size (influence power) and lac
Re:The Free Market at Work (Score:5, Insightful)
The problem is that medical services may require economies-of-scale such that having say 7 competitors in a given market, especially rural areas, is just not realistic. Medical services are just not the same market profile as manufacturing light-bulbs.
Personnel are not even so much the problem. Medical salaries are only a small percentage of total costs, and if a real shortage develops we could always turn on the H-1B spigot.
It's more about the total opaqueness of all pricing: nobody knows what anything costs. Pharma keeps insisting that "nobody actually pays $120,000 for Harvoni." My brother didn't, for example - but what did his insurance plan actually pay for it, and why aren't we allowed to find out? And if nobody actually pays it, why is that the advertised price?
We expect higher prices for newly branded compounds, but how can the supply of generic drugs, which anyone can make, be monopolized? What can't we have our prescriptions filled on the world market, through Amazon?
Re: (Score:2)
A lot of the problem is that even doctors don't always know what the medicines cost. Thus they prescribe something that is more expensive than an alternative because of marketing. Drug A does the job, but drug B does the job with an easier to swallow pill because it's coated, but drug B is double the cost. The doctor not knowing the cost prescribes drug B in all cases.
Patients also need to learn to question the doctor and ask if there are alternative drugs available, such as generic brands. Even if insura
Re:The Free Market at Work (Score:5, Informative)
That system exists, and it's why medical billing is a speciality in and of itself. It's called the ICD-10, and has been around for decades. The pushback is because the latest revision, which went into effect two years ago, is hyper-specific to the point of absurdity.
Pecked by a chicken? There's a code for that: W61.33. But don't you dare get that confused with getting pecked by a turkey or bitten by a duck, which are W61.43 and W61.61 respectively. Don't like your in-laws? That's Z63.1. Injured? It's very important for proper diagnosis to know if you were at the library at the time (Y92.241) or at the opera (Y92.253). Shredding it on water so awesomely that your skis catch on fire? Not only is there a code for that, there are three sub-codes to describe the diagnosis in greater detail. I am not making this up. [icd10data.com]. You know all those Imperials who died when those two Star Destroyers collided in Rogue one? That's V95.43. And it only gets more wacky from there.
Now do you see why there's been some pushback?
Re: (Score:2)
Re:The Free Market at Work (Score:5, Informative)
Well expressed. I recently looked into the price of rattlesnake antivenin in the US and was astounded to see it costing up to $10000 per vial. A little searching revealed the cost of production was estimated to be about $14.
Link to an article discussing the costs:
http://www.smithsonianmag.com/... [smithsonianmag.com]
Link to a research paper by the person responsible for creating the antivenin:
https://www.researchgate.net/p... [researchgate.net]
Re:The Free Market at Work (Score:5, Insightful)
Yeah, but a lot of people would have those Lamborghinis. You wouldn't just buy a computer though. You'd make computer payments. You wouldn't just buy stuff online. You'd make a $0.50 copay for each $100.00 iTunes or Netflix purchase because nobody actually buys directly from online retailers. I'm just guessing at what things cost, because the price list is secret. You could apply for a new computer right around the same time every year, along with a bunch of other people, unless your computer broke down our you got married, or needed a computer for your child, or Congress had gas. Then it's hard to say. You wouldn't be on the internet unless it was in your network. Maybe your state would only support the Bing network, unless you wanted to pay a lot extra. You could Google if you really wanted to; but then your next computer payment would be higher. You get free antivirus though, so you use that to feed some kind of delusion that this is all working out for the best. Sometimes reality intrudes and you get depressed. Then you fork over a copay for a program from Big Gaming that may or may not cause your computer to self-destruct. If that happens, it's GAME OVER.
Re: (Score:2)
Re: (Score:2)
The medical industry
Try every industry. All markets are protected to a greater or lesser extent here. We live behind an economic Iron Curtain.
Re: (Score:2)
try importing text books from overseas and see what happens.
Re:The Free Market at Work (Score:4, Insightful)
>"Is this shortage happening in countries with "socialized medicine", or just in free market America?"
If we had a really free market (with safeguards to prevent monopolies or near-monopolies), then plenty of other companies would make such "drugs" available, too (in this example, it is not really a drug, it is just a commodity). Besides, even if a shortage occurred in such a market, it would send the price up and other companies would rush to market with completing product and pricing would go down and supply would then increase then eventually stabilize.
In a perfectly free and elastic economy (and part of that freedom *is* preventing monopolies with take away from free trade), supply and demand and pricing is completely self correcting. If anything, the more "socialized" a place is (with more government controls on supply and demand, limiting competition, restricting price changes, tampering with demand) the more likely shortages will occur.
No system is perfect. But free markets have generally been proven to work better than anything out there.
Disputing the Free Market (Score:3)
The whole problem that neither the free market or the socialized system completely solves is the basic reality is that people don't want to work and shucks, no one really wants to compete, either.
Competition is a lot of work and the simplest way to make money is to try and be in a business that can avoid it. The easiest way to do that is to churn out intellectual property and rely on the regulated monopoly to attract investment in that property. In systems where there is no intellectual property, then, th
Re: (Score:3)
Scale is very important here. Pfizer has a big leg up because it has already purchased the necessary equipment to make acceptable drugs that pass inspections and testing, even in the case of something simple like sodium bicarbonate. If you want to compete with sodium bicarbonate here as a small provider then the cost outlay to even get started in the market is very high. The profit and margins for such a product is very low at the same time. You basically already have to be a large drug maker just to get
Re:The Free Market at Work (Score:4, Interesting)
Happens in Australia, too. We have a large, well developed public hospital system in each state.
http://www.smh.com.au/national... [smh.com.au]
Re: (Score:3, Interesting)
Tired meme. Venezuela failed because they married their economy to oil. Narrow product focus can also mess up capitalism. In fact, Adam Smith's "Comparative Advantage" encourages putting too many eggs in too few baskets. It can be quite profitable in the shorter term, but bite hard later. Focusing on "big ticket" manufacturing slammed the USA "rust belt", for example, because it stopped being their comparative advantage.
In which poor 3rd-world country did this happen? (Score:2)
Is Martin Shkreli exploring a new market? (Score:2)
Good thing the FDA is looking out for US (Score:5, Insightful)
See, without the great and wise FDA's policies of looking out for the people by allowing the concentration of critical supplies and medicines into the hands of 2 such wise and benevolent entities we'd not be in a position where decisions made entirely for profit could affect the lives of the general public. As much as I hate to see people suffer, I almost wish there would be deaths as a result of this and that forced some legal light onto the situation. Critical basics that are free from patent should required to be multiply sourced to ensure a steady interruption free supply chain, not concentrated into one or two 'most' profitable and controllable streams.
Re: (Score:2)
As commerce and trade are not in the FDA's jurisdiction, it should be unsurprising that FDA is not taking any particular action to enforce commerce and trade laws.
Call Arm & Hammer!!!! (Score:2)
Why not? /s
Ridiculous (Score:5, Interesting)
I once worked in the analytical laboratory at J.T. Baker as an analytical chemist. I personally tested NaHCO3 among many other chemicals to USP, FCC, and ACS standards. We had a warehouse with plenty of barrels of these kinds of commodities. Also, I seem to recall that the ordinary box of Arm&Hammer on the supermarket shelf is actually very high quality material, almost pure enough to use for creating primary standard grade sodium carbonate by baking out some water and CO2 at a specific temp.
Note that the costs to certify to USP grade are little different than for the other grades. It is important to understand that many chemicals which come into a chemical plant never require any further purification. In such cases, a portion is split off to be packaged as ACS, another portion goes in the USP bottles, etc. The remainder can be sold off as "Technical" grade if there isn't enough room to store it. If there is room, it might be preferable to store the raw material that meets the higher specs. rather than sell it all off as tech. grade, because the next load that comes in might not meet the requirements for certs. and thus would need to go through a purification process.
What's sad about this story is that because of the regulatory/liability state, it is impossible to engage in simple acts of innovation ("winging it") that could solve problems such as this "shortage." E.g.:
Find a chemical company with some barrels of bicarb. that has been tested to one of the specs., or USP if possible. If they don't have the USP, then have them test the ACS or FCC to the USP std., which would probably pass if it already met one of the other stds.
Then just procure the damn stuff!
If additional sterilization is needed, have the truck routed to an accessible sterilization service. Ie., a facility with a gamma ray sterilization unit, where the material could simply be put on a belt and sent through the rays.
Hospitals should have the capability to filter small lots of solution to further remove any particulates if necessary.
But no, we'd rather incur large risks of an actual death to a patient to stave off some tiny risk.
What a pathetic thing we have become.
Seems like (Score:3)
This is the one thing that scares me about Utopia (Score:4, Interesting)
Highly optimised systems get increasingly fragile. A highly optimised market for drugs will falter on the slightest off-the-regular imbalance. Same goes for IT services. Imagine everything running on and with Google in 3 decades. And Google then having some kind of hickup that puts the entire society of humanity to a grinding halt for a few days. Or weeks.
A Utopia would have to be built taking this systemic problem into account. But then again, this might not be the best example. As we all know, the US medical system is about as far away from Utopia as it gets.
Confidentially Agreements (Score:5, Informative)
This is the smoking gun, people. The fact that the situation is constrained by secret agreements between players shows that no free market existed.
The "free market" is a myth, and it has always been a myth. Without some independent mechanism to enforce honest behavior any market will become a criminal extortion enterprise. That is why there are laws against raising prices in emergencies. Otherwise bottled water and cans of food would go up by double digit amounts in case of a hurricane, tornado or earthquake, and people might even die as a result.
Of course these days it doesn't take a catastrophe for greedy corporations to charge obscene prices. Epi-Pen [wikipedia.org], Valeant Pharmaceuticals [wikipedia.org], and Turing Pharmaceuticals [wikipedia.org] have all engaged in extortion pricing after acquiring existing drugs. This is life threatening and gouges the taxpayer as well.
The history of food and drug regulation in the US is the history of mass poisoning [wikipedia.org] as a result of ignorance, greed and lack of regulation. All the comments about the "ebil gobment" blocking noble free enterprise are right wing masturbatory fantasies.
The biggest issue we face is regulatory capture [wikipedia.org] where special interests take over the government agencies that are supposed to keep them in check. Examples are the revolving door between the FDA and the pharmaceutical industry or the end of Net Neutrality at the hands of the telecommunication cartel.
It's not about the government squashing the free market, it's about corrupt powerful monopolies using the government to enforce their dictatorial control over the economy.
Re: (Score:3)
"Without some independent mechanism to enforce honest behavior any market will become a criminal extortion enterprise."
Government is just a criminal extortion enterprise cloaked in a veil of legitimacy. Once you look past the bullshit, government operates on the basis of violence. All of their revenue is extorted based on the threat of violence and all their decrees are enforced at gunpoint. If you don't pay your taxes, government will steal your property and/or try to throw you in a cage. If you resist
Re: (Score:3)
The problem is that things would be a lot worse without governments. Government is far from perfect, but it's an improvement over what we'd have without it.
It's all Trump's fault (Score:2)
Re: (Score:3)
My local Office Depot has some "Commercial Grade" Baking Soda available, made by some other supplier named "Arm & Hammer". It's in stock, and $1.39 for a pound of it.
I think the summary neglected to mention this is "Pharmaceutical Grade" baking soda. Which would need approval from the FDA to be used as medicine.
Re: (Score:2)
I think the summary neglected to mention this is "Pharmaceutical Grade" baking soda. Which would need approval from the FDA to be used as medicine.
Other than handling and packaging requirements any idea what exactly makes sodium bicarbonate "pharmaceutical" vs "commercial" besides millions of dollars and years of approval processes?
Re:Pfizer and Amphastar the only option? (Score:5, Informative)
Purity.
Re:Pfizer and Amphastar the only option? (Score:5, Informative)
Purity.
Not exactly. Both food grade and pharma grade sodium bicarbonate are greater than 99% "pure". Many industrial producers make both food and pharma grade sodium bicarbonate, some of them on the same line and processed to the same purity level...
The difference is that Pharma grade sodium bicarbonate is specifically tested to assure very small levels of certain specific impurities** mostly to minimize potential issues with inconvenient formation of various precipitates and other complications in equipment (e.g., hemodialysis), or your body.
All that product testing/certification isn't cheap and is completely unnecessary if you are simply eating it. For example, if 0.05% of the impurity was NaCl or MgCl, that would *bad* in your blood, but if you ate the typical amount of bicarbonate, you wouldn't even notice that impurity.
**USP has specific tests for impurities such as Chloride (0.015%), Sulfur (0.015%), Aluminium (2ug/g), Arsenic (2ppm), Calcium (0.01%), Magnesium (0.004%), Copper (1ppm). Iron (5ppm), Ammonia (20ppm), Organics (0.01%), etc...
Re: (Score:2)
Re: (Score:2)
I would suggest going to another country, but apparently it's illegal to import medicine (for Americans).
The top producers and consumers of sodium bicarbonate are China and the USA. Europe is the next largest and they consume nearly all of their own production.
I'm not so sure that many would want to follow your suggestion of importing pharma grade sodium bicarbonate from China...
Re: (Score:2)
Re:Pfizer and Amphastar the only option? (Score:4, Informative)
Let's restate "purity" in terms that someone at your level will understand. It has less shit in it that shouldn't be there. Kind of important when you're using it in medical procedures, not so important in industrial procedures.
It's a perfectly simple concept to understand so I'm not sure why you're having so much trouble. If the stuff available from Wacko's Online Emporium was as pure as what's required for medical procedures, there wouldn't be A FUCKING SHORTAGE.
Re:Pfizer and Amphastar the only option? (Score:5, Insightful)
The ordinary Walmart product is pure enough for human consumption, as a tooth powder and stomach remedy. My example is chemical reagent purity.
Re: (Score:3)
The ordinary walmart product isn't being directly mixed with the content of your bloodstream.
There are a number of barriers between the digestive tract and your internal liquid systems.
Re: (Score:3)
I call bullshit on the whole "pharmaceutical grade bicarb is so spesh-ul" argument. If you're in medicine in the UK, guess where you can order this grade, and at what price?
https://www.amazon.co.uk/Sodiu... [amazon.co.uk]
Note the big red caution that no supplier will ship this product to the US. Since the bloodstreams of British [patients are going to be the same as US patients, the reason for this is that US pharma is setting us up for another Daraprim.
If they get away with this one, we might as well fill our bathtubs fo
Re: (Score:2)
Re: (Score:2)
It's not FDA approval of the initial product so much as FDA approval of the ongoing use of the product. A drug maker's FDA interaction does not end when the drug gets approved for use. Pfizer cannot just take industrial grade sodium bicarbonate and sell that instead because it will fail to pass the inspections and audits. Even if the owners are evil there are going to be some employees saying "boss, there's something wrong with this batch, it's clumping up and has impurities, we should toss it out before s
Re: (Score:2)
Because the FDA doesn't care about the purity of the manufacturer's product all that much.
Oversimplified, but here's kind of how it works.
In general, as far as the FDA is concerned, it is all about the manufacturing process.
The FDA does not look at whether one manufacturers version is as pure as the other; the testing of new manufacturers of a drug isn't about purity, it is about determining equivalent biological activity.
The reason is that two pills containing the exact same chemical and purity can have di
Re:Pfizer and Amphastar the only option? (Score:5, Informative)
1. Purity. Guaranteed absolutely free of anything that could be dangerous if injected.
2. Sterility. No microbes. Hermetic seal container made free of life at the factory.
3. A paper trail saying where it was made, when, and who shipped it where, for use in identifying any contamination that does occur.
4. Someone who can be sued if all the above fails.
Re: (Score:2)
Re:Pfizer and Amphastar the only option? (Score:5, Insightful)
- ensuring everything is done in a sterile environment
- ensuring its purity
- testing of batches
- tracing and tracking the whole process
- precise weighing and packaging
- ensuring everything is in tamper proof packaging
- auditing of the whole process
All the equipment used in the manufacture, testing, packaging and the people involved are also traced and certified, with everything going back to calibrated National Standards and tested annually (or more). The temperature, humidity, raw materials, etc etc etc etc etc are all tracked right through the whole system in triplicate.
This is not a "throw a teaspoon full in" and it will be all OK.
Ingesting something (and we all swallow a low of bugs, insects, dirt, etc every year) is totally different to having it injected into the blood stream,
Balance Risks Against Benefits (Score:3)
For example, if it is used to treat poisoning and the patient will probably die without baking soda it might be worth the risk of commercial grade baking soda. Similarly, open heart surgery sounds pretty serious and might be something which is potentially ve
Re: (Score:2)
If you administer a non-clinically approved dose and the person dies then you are automatically at fault.
This would result in both criminal and civil action.
Put it this way. People win big in lotteries all the time. Would you risk your house and everything you own as well as your job and your family and spend the next 20 years or more in prison to maybe win the lottery ?
Re: (Score:2)
Re: (Score:2)
Maybe Arm & Hammer is fine, and maybe it will kill 90% of patients when administered internally. The FDA approval process is what ensures either testing, or more likely, strict adherence to a procedure that produces a product in spec for internal use. Shouldn't we at least have a ballpark estimate of what the risk is before we start using unapproved drugs? (Emergencies may be different, but they may not. Are there any surgeries where baking soda is guaranteed to be the difference between life and death?
Re: (Score:2)
Other than handling and packaging requirements any idea what exactly makes sodium bicarbonate "pharmaceutical" vs "commercial" besides millions of dollars and years of approval processes?
Purity as well as the certification process. Same difference between Certified Unix(TM) and Unix. If it doesn't matter to you that the certification was met, you can use commercial grade (like as a cleaner). If it matters to you that all necessary protocols were followed including ones on contamination, then you need to get the pharmaceutical grade.
Re: (Score:2)
Re: (Score:2)
Re:Pfizer and Amphastar the only option? (Score:5, Informative)
You say "purity and packaging" as if it's no big deal. It's a very big deal for something you're going to inject into someone's bloodstream. Take some common fungal spores which might not even count as contamination in food, inject them into patients and you could be facing horrific medical consequences [wikipedia.org] on a massive scale.
Re: (Score:2, Funny)
The commercial stuff is cut with baby laxative.
Re: (Score:2)
Re: (Score:2)
My local Office Depot has some "Commercial Grade" Baking Soda available
Personally, I only smoke crack that’s been rocked-up with pharmaceutical grade baking soda, but I get that not everyone is a connoisseur.
Re: (Score:2)
And will Office Depot certify that it is safe for medical use and is free of contaminates? I mean who do we sue when people start dying, Office Depot, the hospital or you for suggesting it?
Re: (Score:2)
It does seem a little silly though, that it's fine we eat it. Hell, some people brush their teeth with it. But "Oh no, don't use the substitute in an emergency!".
Re: (Score:2)
Brushing your teeth and injecting it (or equivalent like adding it to dialysis to augment a kidney's natural excretion) is wildly different usage. Think about it a bit more.
Re: (Score:2)
Sepsis ain't no fun.
Re: (Score:2)
There are remarkably few bacteria that can survive in such a basic environment (8.3 pH), and I don't think they would survive in the much less basic environment inside the human body. Contamination with heavy metals (e.g. aluminum oxide) would be a more plausible concern.
Re: (Score:2)
Sure, but the ones that can survive, most likely you really absolutely do not want in your more neutral ph bloodstream
Re: (Score:2)
Sure, but the ones that can survive, most likely you really absolutely do not want in your more neutral ph bloodstream
Is it most likely, or really and absolutely? Or just bullshit? Because if it can even survive 8.3, it's not likely to be comfortable at 6.5.
Re: (Score:2)
Would contamination be restricted to microbes that can survive in a basic environment even if the baking soda is dry? I thought antimicrobials generally had to be solution/liquid/gas to be effective.
And that's not even getting into spores which can't thrive in a basic environment, but wouldn't be killed either.
Re: (Score:2)
It's used as a solution to clean wounds and mixed with injectable anesthetics to make them less painful. Considering how much sh*t people inject on a regular basis, including bathtub caulking* [wordpress.com] and >a href=http://content.usatoday.com/communities/ondeadline/post/2010/03/6-women-hospitalized-for-butt-enhancement-injections-with-bathtub-caulking/1#.WSNi3uvyvDA>industrial silicon oil, I doubt that there'd be enough of an impurity to make a difference considering the very small quantities used.
* Warning:
Re: (Score:2)
well, go shoot up some toothpaste and tell me how well that works out.
Re: (Score:2)
That's fine right up until you realize the arm and hammer baking soda was stored in the same warehouse as raw uncured pork bellies and now has trace amounts of botchulism in the baking soda, and now you're injecting it in to people's blood streams.
Re: (Score:2)
That's fine right up until you realize the arm and hammer baking soda was stored in the same warehouse as raw uncured pork bellies
If you get outta town to where you're breathing dirt kicked up by off-road vehicles, you're probably breathing botulism spores. But they don't produce a viable culture unless they are in the right conditions. Now, ask yourself, can botulism grow in baking soda? And even if it can, can it get through a plastic bag?
Re: (Score:2)
Re: (Score:2)
The option is delaying surgeries and running less effective dialysis. It's not a great long term option, but it is a viable short term option. (obviously with risk and consequences)
Re: (Score:2)
They're not out of sodium bicarbonate, they just have shortgages. So they will use the supplies on the most important cases, if your surgery can be delayed then they'll delay it as needed.
Re: (Score:2)
"delaying surgeries" .. plural forms of a word does not mean all possible instances. I clearly did not say "every surgery must be delayed" and I don't see how I could have even implied that.
Re: (Score:2)
There were many posters implying that because surgeries were delayed that we should use off the shelf cooking or industrial sodium bicarbonate. After seeing several of those I assumed yours was falling into that category.
Re: (Score:2)
if the option is nothing or commercial grade, wouldnt commercial grade be the better option???
| know slashdotters love binary choices, but it's just possible that there is a slightly more nuanced risk assessment going on, and that delaying an operation rather than risking infection is the better clinical decision.
Re: (Score:2)
"The solution must be pure and sterile because it is injected into the bloodstream."
From deep inside the New York Times article.
Re: (Score:2, Interesting)
I wouldn't trust commercial grade, but the FDA could save a ton of lives by allowing hospitals to buy food-grade and sanitize it and create their own solutions. The FDA and malpractice insurers would rather go after hospitals for trying to save lives than to recognize what's best for everyone.
Re: (Score:2)
Looking at some of the things it's used for, the risk seems to be worth it in some cases.
Re: (Score:2)
If you've no other option, sure. It wouldn't be the first time doctors have improvised treatment in a disaster situation using whatever comes to hand. But such practices should be avoided where at all possible, and it's not that desperate yet.
Re: (Score:3)
Re: (Score:3)
Re: (Score:2)
Amusing or terrible parenting? Obviously intentional.
Re: (Score:2)
Re: (Score:2)
Apparently he bought that share to make people shut up about his name. Though he was named after a different Arm & Hammer [wikipedia.org] according to this source. [slate.com]
Re: (Score:3)
FDA approval and the guarantee that it is pure. Hospitals pay for that stuff even though there is no reason that an average lab couldn't produce similar qualities, the brand name of the product would probably have to go through FDA approval which can take years.
Re: (Score:2)
Japan does something better. "Wow, look how smart they are and how dumb short-sighted Americans are."
We copy the idea (because it's a good idea) and you say
"This is what happens when you manage your supply chain to maximize profit."
Re: (Score:2, Insightful)
Critical systems should have redundancy built in.
That isn't the same thing as inefficiency.
Re: (Score:2)
there are a lot of things where the supplier bears the cost of a fat supply chain, but society bears the cost of a too thin supply chain.
For example, transformers. We should have TONS of spares in case of EMP, but who would pay for them. the answer is no one, so expect it to take YEARS to build enough new transformers
Re: (Score:2)
Unless of course they already are, and they're the undisclosed supplier having unspecified problems.