Warren Pollock Warns Of Emergency Drug Shortage As EMTs Told To Go To "Alternate Protocols"

Tyler Durden's picture

Warren Pollock reports on a rather troubling development which we can only attribute to various cost cutting measures by near-bankrupt states, as anything beyond that would be far too macabre even for us. It appears that "several drugs are in severe shortfall, drugs used to treat emergency patients that might be transported by ambulance to emergency rooms, the drugs include heart attack drugs, epinephrine, lidocain, as well as drugs used to treat shock and other conditions. These emergency care drugs are now in shortfall with alternate protocols going out to emergency services in various parts of the nation. This means that if you need emergency services, the drugs you rely upon to save your life may not be there." As WEP asks, "where have these drugs gone? It is unrealistic to suggest that a whole variety of emergency treatment drugs would go missing from the inventory all at the same time, and areas around the country all at the same time." Pollock highlights the states of TN, PA and CA may have already seen the incorporation of the "alternate protocol." Once again, we hope this is merely an interim shortage and not a widespread effort to impair the traditional operation of emergency technicians across the country.


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hedgeless_horseman's picture

...which we can only attribute to various cost cutting measures by near-bankrupt states...

Propofol, the primary drug used for induction of anesthesia for surgery, is in a severe shortage at hospitals in Texas.  If it gets any worse, elective surgeries will be cancelled.

I learned of this little fact first-hand two weeks ago, and scored it high among the empirical economic data I track.  Private hospitals and ASCs are having trouble getting it at any price, and it has nothing to do with cost cutting by the states.  Atlas is shrugging.

MaximumPig's picture

"Atlas is shrugging" meaning what, exactly? The CEO of the company that makes propofol has taken off to Galt's Gulch, and those left behind can't figure out how to turn the machines that make the pills to "on"? 


hedgeless_horseman's picture

Who is shrugging?  Your guess is as good as mine.  However, that is the exact reply I received from a top level person at SCA when I asked the cause of the shortage. However, it could just be that a single 23 year old mid-level logistics clerk at the main supplier went long the maker of a competitive drug on his e-Trade account, after he jerked off in the mushroom soup, I mean FDA sample vials of his employer. 

My tinfoil hat assessment is that the chi.coms, or someone, is stocking up on all things needed for war.  China is long steel, fuel, medicine, and young men.

State budget shortages drive down demand for healthcare consumables, which does not create shortages, but rather surpluses.

seek's picture

FWIW, the web sites I listed below both have manufacturers citing increased demand as an explanation for the shortages (of epi, at least.)


Not a good sign that there's unexpected demand for trauma meds. Time to upgrade to thicker foil.

SNAFU's picture

Not thicker, just 24K gold foil baby!!!!!!!!!!!!!!!

Oh regional Indian's picture

Very astute HH.

Clearly a sign (one amongst many other multi-contextual ones) that something is "up" and we're not down with it.

War came to my mind as did the possibility of what will happen when the GOM finally delivers it's blow.

If any of the worst case scenarios for the GOM disaster pan out, they will need all that and more.

People, get off the mainstream everything! There are alternatives for each and every "modern miracle" we use.



rapunzel's picture

Oh regional Indian

you know what mr indian, if i resided in India when my husband died, i should of thrown myself onto his burning embers and be done with it.

Oh regional Indian's picture

Hmmmmmm..... now where did that come from Rapunzel? What an unusually disconnected remark.



rapunzel's picture

no, not really.

wanted your attention.

Who are you?

Oh regional Indian's picture

Hey, I missed this earlier. 

Very curious. And I'm pretty much an open book (see blog link).

Who are you?



fiddler_on_the_roof's picture

Maybe you are the type who are free to spread their legs after such an incident. How ignorant of realities in the present World.

Apostate's picture

I confess that I'm ignorant about how drug prices are fixed. But I have to assume that this is related to Medicare and other programs.

Why would there be a shortage? Is it a lack of cash for the hospitals? Why aren't the drug manufacturers producing more supply if it's an actual lack of the drugs?

I know that St. Vincent's went bust in NYC for similar reasons, and that - from my spare contacts with hospital workers elsewhere - many hospitals are in similar straits. 

Argos's picture

Propofol has two main manufactors.  The one in Israel just lost a HUGE lawsuit in Las Vegas.  The drug is very difficult to manufacture and has a low profit margin, so they quit making it.  Hence the shortage.


I don't know anything about the EMT drugs, other than most of them are pretty cheap.  I don't know why they are in shortage.

Instant Karma's picture

Same drug that contributed to Michael Jackson's state of permanent unconsciousness.

unwashedmass's picture

the peasants' money is being shoveled out the back door to the banks. there's no cash to provide them with meds, nor should there be.

the idea now is to drain the economy dry, and then get out of town before the complete collapse.

if fewer folks get fewer meds, that's a few hundred thousand left to riot when the SHTF

egdeh orez's picture

I thought the economy was booming.  Why the hell are we having near-bankrupt states and why the hell do they need to cut costs on critical drugs?  Makes no sense

janchup's picture

You thought the economy was booming....I'm sure you are kidding unless you are a Progresso-Democratic propaganda swallower. (I'm not sure why I waste time on Huffington Post Propaganda Central other than to be routinely exposed to the bad tempered ignorance of true believers.)

FASB 666's picture

Wouldn't this be a case of bankrupt hospitals ??

wyosteven's picture

Create the itch to sell the scratch.

Here comes a "national security" pitch to bail out pharma.

seek's picture

The shortages are real and nationwide:




Key EMT drugs, such as epinephrine, are on the list, as is the Propofol mentioned above.

I seem to recall there being a key shortage of a plastics-derived solvent that started in 2H2008 due to lower levels of manufacturing (it is a by product of plastics production) and this solvent was widely used in pharma manufacture.


Cognitive Dissonance's picture

My bad folks.

My......um......er......drug problem has gotten a little out of hand lately. I'll cut back real soon. I promise. Really. Honest to God, hope to die. Well, not really but you know what I mean. I hope.

knukles's picture

Ah, yes, and grateful that we do understand  such, as we trudge the road of happy destiny.  Many thanks for the outstanding read.  The quality shows through, wearing your experience, strength and hope as a loose garment.  

bob_dabolina's picture

Victory for the bulls

-Bob Pisani

Jason T's picture

LOL ugh.. 

what a mindless bull he is.

economessed's picture

Seems like nothing has impacted the supply (or price) of illegal drugs....

aheady's picture

Yet one always seems to run out at the most inopportune moment.

The Disappointed's picture

You must not live in California. It's easier for kids to get MaryJane than cigarettes. And if it is decriminalized (as is on the November ballot), it will be cheaper too.

aheady's picture

East Coast. Dry as a bone in many ways.

Biff Malibu's picture

Heroin is BY FAR the EASIEST drug to get in St. Louis.  Somehow 90% of it gets grown and manufactured in Afghanistan.  Hey what's the longest war the U.S. has been involved in again???

aheady's picture

Karzai: Cops come and try to snatch my crops.

Lndmvr's picture

Hillary:  Cops come to try and crop my snatch.

ejmoosa's picture

Dying on the way to the hospital is one way to lower medical costs in this country.

knukles's picture

Letting all of the burdens on society, the frail, sick, injured, old, useless eaters has been publicized for many years by the likes of the Kissingers, Gates (injections to control population) and Rockefellers (search the founding principles of the foundation, eugenics) to cull the herd.  Keep the productive worker caste creating the wealth...  No reason for the burden of the sick, aged, the useless eaters.

No, I am not suggesting this, neither condemming nor condoning such, nor considering the pros or cons.  Simply stating that policies such as these have been openly debated whilst shrouded on polite terms for many years.  Including, for example at the WHO which recently stated publicly that such opaqueness must be halted, the problems of population spoken about in the open, to be understood by all. 

And golly gosh, in the midst of the "emergency", the hard times, they once again manifest themselves, demanding additional sacrifice upon the "middle class".

So critical drugs to treat the sick become scarce.  Also sits well with the "necessity" for health care rationing, not to mention the recurring theme of higher taxes.  

Steaming_Wookie_Doo's picture

"No, I am not suggesting this, neither condemming nor condoning such, nor considering the pros or cons."

Really? I would because that's exactly the kind of fascist accounting that the criminals in charge would engage in. Peter Orszag (former budget dir) knew that the last 6 mos of life accounts for some 20-30% of that person's lifetime medical costs. Guess what? They are going to make sure that you'll go six months earlier (at least) than you would've otherwise. Welcome to post-Soviet style living in Amerika.

hedgeless_horseman's picture

My idea has been that any medical bills paid for by MediCare in the last 24 months of life get offset by a dollar-for-dollar reduction in the estate tax exemption for the patient.  Millionaires getting MRIs on Medicare when they are on death's doorstep should have some cost.  No?

Papasmurf's picture

Yes or course.  It's not like they paid any medicare taxes.

SNAFU's picture

That would make sense- so it wont happen!  On farm subsidies: no subsidies for any "farmer"[LLC] netting 1mil/yr.

EscapeKey's picture

Just speculating... could it be related to the alleged GoM induced respiratory illnesses?

truont's picture

How are we just going to "take a pill" like Obama tells us to, if there are no pills!  Genius!




Robert Pulson's picture
Reason for the Shortage


  • Hospira recalled several lots of their propofol injection in mid-October, 2009 due to the presence of particulate matter in the vials.1
  • Teva recalled several lots of their propofol injection at the end of October, 2009 due to possible microbial contamination. On March 1, 2010, Teva placed all of their propofol manufacturing on hold. Teva discontinued all propofol presentations in May, 2010.2
  • APP cannot keep up with increased demand for product.3 In cooperation with FDA, APP is providing Propoven 10 mg/mL injection to the US market again to help alleviate the shortage. Propoven is manufactured in FDA-approved facilities by Fresenius Kabi AG, the parent company of APP.4,5 Propoven is different from Diprivan in that it is preservative-free and contains medium-chain triglycerides as well as long-chain triglycerides. (Diprivan contains only long-chain triglycerides and also contains EDTA).4,5 APP has a Dear Healthcare professional letter regarding the propofol shortage, a Propoven reintroduction letter, and another link available that include detailed information and the product labeling for Propoven.4,6 Report any offers to sell Propoven by an entity other than APP Pharmaceuticals to drugshortages@fda.hhs.gov.  


hedgeless_horseman's picture

Hospira recalled several lots of their propofol injection in mid-October, 2009 due to the presence of particulate matter in the vials.1

Nice work. PM member jerking off in the sample vials.  Bigger payoff than the hotel's mushroom soup, Tyler?

Apostate's picture

Thanks. So this could just be a short-term shortage related to recalls. 

traderjoe's picture

Obviously it's easy to read too much into what could be casual coincidences. On the other hand, our global supply chain in many commodities and products have grown more narrow and therefore fragile, especially with the widespread use of just-in-time inventory. If just one manufacturer makes a key input, it could put parts of the system in jeopardy. In the '30's something like 30% of the US lived on farms. Now it has to be around 1%. How many days of food exist at any one time in the distribution channel? 7-10?? Have you read about the depletion of the aquifer below the Great Plains (which is really a virtual desert)? How about the over-reliance on one or two strains of Round-Up ready soybeans? And then the booming prevalence of R/U-resistent super-weeds?

Clearly, that would be reading too much into one OT issue. But, the shortage of critical life-saving drugs is potentially just one example of how our system is having a hard time perpetuating itself. People soon forget how quickly society can run out of key inputs and how the social mores can break down. Remember Katrina and people living without food and water in that dome? Just my dooms-dayer thoughts... 

Biff Malibu's picture

I'm a paramedic in St. Louis.  This is real.  Holy crap!  I was wondering what the hell was going on.  We switched to a new "resource hospital" a year ago, and I thought this was temporary growing pains. 

The drugs we are in need of are Epinephrine (given for codes (cardiac arrests)) mostly, and D-50 that is given in an almost daily basis for diabetics with hypoglycemia...  We are told to use Vasopressin instead for codes which the Europeans have been doing for years anyway but as far as the D-50 we're pretty much screwed.



Biff Malibu's picture

I love replying to my own messages almost as much as I enjoy talking to myself in the mirror.  Anyway.  Another thing I find rather amusing is several hospitals in our area no longer give us clean sheets for our stretchers.  We take a patient in and routinely use the sheets to lift the patient over to the ER bed.  So we are now short a sheet.  When we go to supply, they give us this Bounty paper towel-like thing that we are supposed to use.  It rips easily, and looks like shit on the cot.  They do this as a cost-cutting measure.  I can only imagine the astronomical cost-savings of taking away actual bed sheets from paramedics and giving them back paper towels in return.  Probably in the trillions of dollars...thanks for listening to me bitch.

Long Live ZeroHedge!

truont's picture

Hmmm...I wonder why England is working toward unregulating health-care???

Maybe rationing healthcare and underpaying healthworkers is not the best plan:



If healthcare costs are too high, then tell the USGovt to stop printing so much money and devaluing our savings and earnings.  Notice how essentials like food and healthcare are going up in price in the face of deflation, not down.  Wonder why?  M1 increases from FED money printing.  The FED can only create currency.  It cannot control where it goes....  The Fed would be tickled if their newly created currency went to prop up the housing market, but they cannot control that.