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Medical Forum / General / General / March 2008

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Heparin, The Blood-Thinning Drug:  IS CHINA SELLING A CONTAMINATED     DOSE?

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perrie - 06 Mar 2008 19:24 GMT
If it ain't toys, it's tires, and if it isn't baby furniture, its
seafood, and then it's sweatshop goods, or it's pet food, or maybe
it's ... HEPARIN !

Christ-all-fuckin'-mighty!

When's it all gonna END?

Right.

It won't.

O.K.

--------------------------------
"Contaminant Found in Heparin"

"FDA Probes How Compound Got Into Blood-Thinning Drug"

By Marc Kaufman
Washington Post Staff Writer
Thursday, March 6, 2008; A03

The U.S. Food and Drug Administration has detected a "contaminant" in
many samples of Chinese-supplied heparin that may be the cause of
hundreds of severe and sometimes deadly allergic reactions to the
blood-thinning drug, agency officials said yesterday.

Chief Medical Officer Janet Woodcock said the agency is investigating
whether the presence of the contaminant, a large molecule similar to
heparin, was the result of faulty manufacturing or was intentionally
added to reduce costs.

"We don't know how this heparin-like compound got into the heparin,
but we are aggressively investigating it," Woodcock said.

Millions of Americans are treated every year with the drug, which is
widely used in surgery and kidney dialysis. The FDA yesterday
increased from four to 19 its estimate of the number of patients who
may have died as a result of reactions to the drug.

Since the initial deaths associated with heparin were reported more
than three weeks ago, the episode has intensified concern over the
safety of foods, drugs and other products imported from China and
other developing countries with limited regulatory agencies. Some in
Congress have questioned whether the FDA has the resources or the will
to exercise the same kind of oversight over foreign drugmakers --
which supply a large and growing share of the drugs and drug
ingredients sold in the United States -- that it gives to domestic
drugmakers.

The active ingredient for much of the heparin used in the United
States comes from China, but the problematic batches were sold only by
Baxter International, which gets the raw product through
intermediaries from a plant outside Shanghai. FDA officials have
acknowledged that the agency never inspected the Changzhou SPL plant,
apparently because it was mistaken for another plant with a similar
name.

Woodcock said the contamination came to light only through a
sophisticated test never before used on heparin. She said 5 percent to
20 percent of samples were found to contain the contaminant, but all
would have been deemed safe under the standard testing procedures. The
substance had never before been detected, she said.

The agency detected a spike in reported severe reactions to Baxter's
heparin -- including anaphylactic shock, fainting and a racing
heartbeat -- in early February.

While it remains uncertain whether the contaminant caused the adverse
reactions and deaths, Woodcock said the FDA and company think there
may be a connection. They also suspect that the problem came from the
Chinese active ingredients and not from a problem with Baxter's
finishing plant in New Jersey.

Heparin, which has been used in medicine for more than 60 years, is
made from a compound found in pig intestines. Heparin injections are
used to prevent blood clots in people undergoing dialysis and surgery.

Baxter, which supplies about half of the U.S. market, sold 35 million
vials last year. Virtually all of the nation's 450,000 dialysis
patients use heparin regularly.

In a teleconference, Woodcock and FDA Commissioner Andrew von
Eschenbach defended the agency's oversight of the fast-growing number
of foreign manufacturers of drugs and drug ingredients. They said the
plants are monitored by a complex system of international and local
oversight, and supported by quality controls built into their system
designs.

Von Eschenbach said his agency plans to do more, but also said many
products made in places such as China are tongue depressors or other
items that do not need intense oversight.

The issue of foreign inspections of food and drugmakers in lightly
regulated nations such as China and India has become a political as
well as a safety issue, with several congressional committees
conducting investigations and proposing legislation.

Last year, thousands of pets were reported to have fallen ill and died
after eating pet food from China that was found to have been spiked
with the chemical melamine, which was apparently added to make the
food appear to be of higher quality. Authorities also recalled
thousands of Chinese-made toys last year that were found to contain
lead-based paint.

Regarding the contaminated heparin, Woodcock said: "We still don't
know whether this inadvertently got into the supply or whether it was
actually added. We can't tell you where the contamination originated."

Woodcock said that since December, the FDA has received 785 reports of
serious allergic reactions linked to heparin, either in products
supplied by Baxter or of unknown origin. She said the number of deaths
associated with heparin had risen from four to 19, some occurring as
far back as January 2007. In a statement, the company that supplies
raw heparin to Baxter, Scientific Protein Laboratories LLC, said it
had recalled all active ingredients from China that showed signs of
possible contamination. The company also said it remained unclear
whether the contaminant was the cause of the reactions.

"During the call with the media, FDA speculated that the source of the
adverse events may be a contaminant. It is important to note that this
theory is speculation at this point, and SPL is participating actively
in working with the FDA to pursue this theory as well as others," the
company said in a statement.

Baxter stopped distributing heparin early last month and last week
recalled all remaining heparin products. The FDA stressed that the
remaining supplies of heparin, made by APP Pharmaceuticals also from
Chinese sources, did not show contamination.

Baxter's statement said it found the contaminant in samples from the
Chinese plant and in samples processed at its Wisconsin factory from
Chinese ingredients.

"These results suggest that the root cause may be associated with the
crude heparin, sourced from China, or from the subsequent processing
of that product before it reaches Baxter," the firm said.

The FDA said last week that a team of inspectors had found quality-
control, waste-removal and machine-cleanliness issues at the Changzhou
plant. But officials said they had not made any determination about
whether those factors contributed to the contamination.

http://www.washingtonpost.com/wp-dyn/content/article/2008/03/05/AR2008030502476.html
ltlee1@hotmail.com - 06 Mar 2008 20:17 GMT
> If it ain't toys, it's tires, and if it isn't baby furniture, its
> seafood, and then it's sweatshop goods, or it's pet food, or maybe
> it's ... HEPARIN !

You miss the Chinese restaurant as in "The Chinese Restaurant
Syndrome."

http://www.nytimes.com/2008/03/05/dining/05glute.html?

"It was a nightmare for my family," said Jennifer Hsu, a graphic
designer whose parents owned several Chinese restaurants in New
York City in the 1970s. "Not because we used that much MSG --
although of course we used some -- but because it meant that
Americans came into the restaurant with these suspicious, hostile
feelings."

Even now, after "Chinese restaurant syndrome" has been thoroughly
debunked (virtually all studies since then confirm that monosodium
glutamate in normal concentrations has no effect on the overwhelming
majority of people), the ingredient has a stigma that will not go
away."

> Christ-all-fuckin'-mighty!
>
[quoted text clipped - 137 lines]
>
> http://www.washingtonpost.com/wp-dyn/content/article/2008/03/05/AR200...
bmoore@nyx.net - 06 Mar 2008 21:36 GMT
> If it ain't toys, it's tires, and if it isn't baby furniture, its
> seafood, and then it's sweatshop goods, or it's pet food, or maybe
[quoted text clipped - 141 lines]
>
> http://www.washingtonpost.com/wp-dyn/content/article/2008/03/05/AR200...

cue Charles to start ranting about anti-China bias in 3... 2... 1...
James Fenimore - 07 Mar 2008 15:22 GMT
"U.S. Under Bush Stymies Consumer Product Safety Commission"

"Administration, Ever-Pro-Business, Wants To Tightly Control Consumer
Safety Costs, Boost Industry Profits"

But ... some hope ...

------------------------------

"Senate Votes For Safer Products"

"Enforcement Would Get Major Boost"

By Annys Shin
Washington Post Staff Writer
Friday, March 7, 2008; A01

The Senate yesterday approved the most far-reaching changes to the
nation's product safety system in a generation, responding to recalls
of millions of lead-laced toys that rattled consumers last year.

Lawmakers still have to resolve key differences between the Senate
bill and a similar measure that passed the House in December. While
the Senate version is considered by consumer advocates to be tougher,
both contain provisions that would require retailers and manufacturers
to be more vigilant about product safety.

The biggest change is likely to be a better-staffed Consumer Product
Safety Commission, with more enforcement power. Both bills would boost
funding for the agency, which had a budget of $63 million in fiscal
2007 and just less than 400 employees, fewer than half the number it
had in 1980. The Senate bill, which passed by a vote of 79 to 13,
would increase the budget to $106 million by 2011. The House's version
would increase it to $100 million.

Both bills would provide funds to upgrade the CPSC's antiquated
testing facilities. Both bills also would raise the maximum amount of
money the CPSC can fine companies that fail to report product hazards
immediately. Fines are now capped at $1.8 million. The House bill
would raise the cap to $10 million; the Senate to $20 million.

The Senate and House measures would also effectively ban lead in all
children's products, not just toys, and require toys to be tested by
independent labs.

"I'm glad something is going to change. I just hope future families
don't have to go through what we had to go through," said Andrew
Hartung of Manalapan, N.J., whose 14-month-old daughter, Abigail, was
injured last fall in a Bassettbaby crib that was later recalled.

The bill's sponsor, Sen. Mark Pryor (D-Ark.), said, "The vote is a
victory for the health and safety of children."

The differences that remain involve which federal safety laws state
attorneys general would be able to enforce, whether to grant whistle-
blower protection to corporate employees, and which information would
be included in a public database of product-safety incidents. The
White House and the nation's largest manufacturers oppose giving state
attorneys general too much leeway to interpret federal safety
regulations, and they oppose whistle-blower protection, which they
contend would encourage needless litigation.

The president has not threatened a veto.

An overhaul of the nation's product-safety system seemed a remote
possibility just a year ago.

For the past decade, consumer and environmental groups had been
finding lead in children's products. After a boy died in 2006 from
swallowing a metal charm made of lead, the CPSC began to examine lead
in children's jewelry. But until last year, the CPSC attracted little
attention from lawmakers, despite regular testimony by consumer
advocates about problems at the agency. Occasional pleas from industry
were also futile.

Then, starting last March, a string of recalls involving toothpaste,
tires and pet food containing contaminated ingredients from China
caused U.S. consumers to question product safety. Public confidence in
federal oversight of imports sank further in June when toymaker RC2
recalled Thomas and Friends toys for having lead paint, a toxic
substance that most people thought had been banished from toys in the
1970s.

Lawmakers and the toy industry began talking about overhauling the
CPSC in September after Mattel recalled more than 20 million products,
including Barbie, Elmo and Dora toys, because they were coated in lead
or contained small, dangerous magnets.

"It wasn't until some of these recalls began to happen relating to
standards that had been in place for many years that we realized the
system needed to be strengthened," said Toy Industry Association
President Carter Keithley.

After years of sparsely attended congressional hearings, Nancy A.
Nord, acting chairman of the CPSC, was greeted by a standing-room-only
crowd at her September appearance before a Senate subcommittee. By
then, retailers had begun retesting their inventory and recalls of
lead-laced toys became almost daily events.

Despite a desire by both consumer groups and manufacturers to get a
bill passed by year's end, negotiations over the House and Senate
bills dragged on.

In early November, several Australian children fell into comas after
ingesting parts of a craft toy. Doctors discovered that a chemical
component in the toy metabolized into a substance used as a date-rape
drug. The same toy was marketed in the United States and sickened two
children.

http://www.washingtonpost.com/wp-dyn/ontent/article/2003/03/06/AR2008030604081.html
rst0wxyz - 07 Mar 2008 15:33 GMT
> If it ain't toys, it's tires, and if it isn't baby furniture, its
> seafood, and then it's sweatshop goods, or it's pet food, or maybe
[quoted text clipped - 9 lines]
>
> O.K.

What do you expect?  China is a dirty country.

> --------------------------------
> "Contaminant Found in Heparin"
[quoted text clipped - 127 lines]
>
> http://www.washingtonpost.com/wp-dyn/content/article/2008/03/05/AR200...

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