Single-Use Vials -- The Debate Continues

Laura A. Stokowski, RN, MS


December 11, 2012

In This Article

Not Me or My Family!

A nurse expressed this view. "I have always complained about wasting meds, but having read about the actual case reports of serious infections from accessing single-dose vials more than once, I have changed my thinking on this. Meds may be expensive, but the human and financial cost of infections is certainly more expensive."

Several other commenters added that they wouldn't want such practices to be used in their own care or in that of their families. "As a healthcare professional, I can understand the cost and medication shortage issue, but as a consumer I am fearful for myself. If I wouldn't risk any type of infection on my own family, why would I do it to another person's family? A small risk it may be if medications are prepared properly, yet it is a risk that we should not be willing to take. I am not willing to risk any patient's life over costs or shortages."

Nevada resident and school administrator Harry Chanin would agree with this sentiment. Here is his story:

I underwent a routine colonoscopy for screening purposes in June 2006 and presented with acute hepatitis C infection 8 weeks later. I went through an ordeal of chemotherapy that luckily for me (the success rate is only 50%) suppressed the virus. I suffer lingering fatigue and chronic joint pain as a result of the treatment side effects.

The outpatient clinic where I had my colonoscopy was administered by doctors who decided to consciously cut whatever corners they could to speed things up and increase their billings. They were supplied the anesthetic propofol in 50-mL vials by drug manufacturers who knew these vials were being used for multidosing patients, but who continued selling them because their profits were higher given the lower packaging costs of bigger vials.

The Nevada outbreak was the result of systematic failure of the entire healthcare delivery system. The insurance company that directed me to the clinic never checked on the quality of the care being provided; the doctors ignored their oath; and the drug manufactures put profits over safety, consciously. The system has repeatedly failed. [Personal communication; December 4, 2012]

Web Resources

CDC has introduced a new suite of practical resources to help clinicians follow and evaluate safe injection practices. These include: