Opioid pain medications such as Hydromorphone have life-threatening consequences if overdosed. Those consequences can include respiratory depression (slowed breathing or suspension of breathing), low blood pressure and reduced heart rate including circulatory collapse.

The affected product is a prefilled glass cartridge for use with the Carpuject Syringe system.

The affected lot was distributed in September - October 2011. It was initially distributed to wholesalers and a limited number of hospitals in Alaska, Alabama, Arizona, California, Colorado, Connecticut, District of Columbia, Delaware, Florida, Indiana, Louisiana, Maryland, Massachusetts, Minnesota, Missouri, Mississippi, North Carolina, New Hampshire, New Jersey, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Utah, Washington, and Wisconsin.

Hospira is undertaking this recall in consideration of the potential for safety issues if the product is administered to patients

For More information, please see the FDA's Press Release concerning the recall.

(Left:  Vickie Hildreth and Dr. Drema Mace, Director of the WV Office of EMS with the EMS-C Recognition Award)

West Virginia OEMS is very proud to announce that Vicki Hildreth was chosen as one of the ten recipients of the Emergency Medical Services for Children (EMS-C) Recognition Awards at Emergency Medical Services for Children (EMSC) Program Meeting in Bethesda, MD!

The purpose of the EMSC Recognition Awards program is to call some well-deserved attention to individuals
within EMSC who, in the last year, went above and beyond to provide advice, inspiration, and leadership in grant-related
matters.

The West Virginia EMS for Children Advisory Committee states that ""Vicki is the most caring and energetic person when it comes to the children of West Virginia."

Among her list of accomplishments are

• Helped to provide equipment such as Pedimates pediatric immobilization systems and EZIOs interosseous IV systems to local squads
• Worked with the WV's Annual EMS Conference Committee to provide a pediatric track
• Revitalized the WV "Always Read for Kids" (Ark) Program
• Formed networks throughout the state

Penny Byrnside Director of West Virginia's Trauma categorization and designation program said "Vicki's passion is contagious and wonderful to watch."

Note:  The publication below incorrectly labels Dr. Mace as Penny Byrnside.

2012 National EMSC Recognition Awards Publication

This recall is from the FDA.  Full details can be found at http://www.fda.gov/Safety/Recalls/ucm301783.htm.

FOR IMMEDIATE RELEASE - April 24, 2011 - American Regent is conducting a nationwide voluntary recall to the Retail/Hospital level of the following product:

Epinephrine Injection, USP, 1:1000, 1 mL Ampules
NDC #0517-1071-25

Lot #1395, Exp Date: July 2012

PLEASE NOTE: This recall, initiated on April 24, 2012 to the Retail/Hospital Level, is for lot #1395 only. No other lot or sizes of Epinephrine Injection, USP are subject to this voluntary recall.

American Regent is undertaking this voluntary recall of Epinephrine Injection, USP, lot #1395 because of discoloration and small visible particles found in some ampules of this lot.

Potential adverse events after intravenous administration of solutions containing particulates may include disruption of blood flow within small blood vessels in the lung, localized inflammation (swelling and redness), and granuloma formation. Muscle and adipose tissue damage may occur by the intramuscular or subcutaneous injection of solutions containing particulates. Adverse events with intra-spinal injection for this product containing particles are unknown, but may cause inflammation. Adverse events after topical ocular administration with Epinephrine solutions containing particles are also unknown, but may result in ocular pain or irritation.

The Precautions section of the Product Package Insert states that "Epinephrine Injection should be protected from exposure to light. Do not remove ampoules from carton until ready to use. The solution should not be used if its color is pinkish or darker than slightly yellow or if it contains a precipitate."

Epinephrine Injection, USP is indicated to relieve respiratory distress due to bronchospasm, to provide rapid relief of hypersensitivity reactions to drugs and other allergens, and to prolong the action of infiltration anesthetics. Its cardiac effects may be of use in restoring cardiac rhythm in cardiac arrest due to various causes, but it is not used in cardiac failure or in hemorrhagic, traumatic, or cardiogenic shock.

Epinephrine Injection, USP is used as a hemostatic agent. It is also used in treating mucosal congestion of hay fever, rhinitis, and acute sinusitis; to relieve bronchial asthmatic paroxysms; in syncope due to complete heart block or carotid sinus hypersensitivity; for symptomatic relief of serum sickness, urticaria, angioneurotic edema; for resuscitation in cardiac arrest following anesthetic accidents; in simple (open angle) glaucoma; for relaxation of uterine musculature and to inhibit uterine contractions. Epinephrine Injection can be utilized to prolong the action of intraspinal and local anesthetics.

Please see Full Prescribing Information for additional details on precautions, indications and uses.

The product was distributed to wholesalers and distributors nationwide. Hospitals, Retail Pharmacies, Clinics, Physician Offices, and other healthcare facilities and providers should not use American Regent Epinephrine Injection, USP, 1:1000, 1 mL ampules with lot #1395 for patient care and should immediately quarantine any product for return.

American Regent is notifying its distributors and consumers by e-mail, facsimile, and/or overnight courier and is arranging for return of all recalled product. Consumers/distributors/retailers that have product which is being recalled should stop use.

American Regent will credit accounts for all returned Epinephrine Injection, USP, 1:1000, 1 mL ampules with lot #1395. Those with questions about the return or recall process, please call our Customer Service Department at 1-877-788-3232, Monday thru Friday from 8:30 AM to 7:00 PM ET.

Hospitals, emergency rooms, clinics, and other healthcare facilities and providers, or patients with product quality complaints, medical or other questions concerning the use of the product or reasons for this recall should contact the Professional Services Department at 1-877-788-3232, Monday thru Friday from 9:00 AM to 5:00 PM ET.

Any adverse reactions experienced with the use of this product should be reported to American Regent via e-mail at pv@luitpold.com, by fax to 610-650-0170, or by phone at 1-800-734-9236, Monday thru Friday from 9:00 AM to 5:00 PM ET. TO EXPEDITE HANDLING PLEASE DO NOT REPORT ANYTHING OTHER THAN SPECIFIC ADVERSE EVENTS TO THIS E-MAIL ADDRESS OR FAX OR PHONE.

Adverse reactions or quality problems experienced with the use of this product/lot may be reported to the FDA's MedWatch Adverse Event Reporting program online, by regular mail, or by fax.

• Online:  www.fda.gov/medwatch/report.htm1
• Regular Mail: use postage-paid, pre-addressed Form FDA 3500 available at:  www.fda.gov/MedWatch/getforms.htm2. Mail to address on the pre-addressed form.
• Fax: 1-800-FDA-0178

While American Regent continues to investigate this issue, the company is taking precautionary action and initiated this voluntary recall. American Regent has informed the FDA of its actions and is maintaining ongoing discussions with the Agency.

Epinephrine Injection, USP is manufactured by Luitpold Pharmaceuticals, Inc. and is distributed by American Regent, Inc. (Shirley, NY).

Source: Luitpold Pharmaceuticals, Inc.

This voluntary recall is being conducted with the knowledge of the U.S. Food and Drug Administration.

The Vendor Package is intended for exhibitors, vendors, and sponsors of the 2012 Emergency Medical Services State Conference, being held November 1st through November 3rd at the Resort at Glad Springs, in Daniels WV.

The package can be seen here.

These shortages have involved cancer drugs, anesthetics used for patients undergoing surgery, as well as drugs needed for emergency medicine, and electrolytes needed for patients on IV feeding.

WVOEMS has been requested to post this document for the American Society of Health-System Pharmacists that directly relates to the current known shortages.

You can also view the American Society of Health-System Pharmacists' Current Drug Shortage List at http://www.ashp.org/DrugShortages/Current/.

Beginning April 10, 2012, the Yellow Dot Program (YDP) will be kicked- off and will be available to West Virginia citizens throughout the State.

While the YDP is mainly geared toward the senior population who has a medical condition or suffers from allergic reactions to certain medications, anyone of any age can participate.

Interested participants may sign up to participate in the program at any DMV Regional Office throughout the State beginning April 10, 2012.

The participant will be asked to sign a consent form, they will then be provided with a current picture, an emergency contact/medical information sheet and a Yellow Dot folder to house these items in the glove compartment.

A Yellow Dot Sticker will also be provided to be placed on the outside of the lower left rear window of the vehicle.
In the event of a crash, the first responder will know to look for a yellow dot sticker on the rear window and look in the glove compartment for a yellow dot folder containing information about the driver, a list of medications taken, allergies, etc., along with a photograph of the individual.

For more information, see West Virginia's DMV's Yellow Dot page at http://www.transportation.wv.gov/dmv/HighwaySafety/Pages/YD.aspx and the promotional material can be viewed here.

These new protocols become effective at 12:01 AM on May 1, 2012. We hope this allows sufficient time to permit agencies to train personnel and purchase needed equipment or supplies.

If you have any questions, please feel free to contact Deron Wilkes (deron.e.wilkes@wv.gov) or Dr. Lee Smith(lee.b.smith@wv.gov).