Propofol, TEVA, and five hundred million dollars

I have been trying to read anything I can find about the recent verdict in favor of the plaintiff, holding TEVA and Baxter liable in a hepatitis C outbreak in Las Vegas because…

This. Makes. No. Sense.

I’ve been looking for a copy of the actual trial documents but have failed to date. My comments that follow, then, are based on what I’ve read in news accounts like this one. I keep having to remind myself that lawsuits are not about discovering the truth but assigning blame, preferably to the party with the deepest pockets.

At issue is whether it is safe to divide the contents of a large vial of a drug (in this case the 50cc and 100cc vials of Propofol) among multiple patients. In the Las Vegas case, the entity involved was a GI endoscopy center. In my practice, being assigned to outpatient endoscopy means doing roughly four endoscopies per hour, give or take. Most of these patients will require between ten and twenty cc of Propofol. With me so far? Good.

Propofol comes in vials of 20cc, 50cc, and 100 cc and my understanding is that the larger vials are less expensive on a per cc basis. I don’t know for sure because the facilities buy the drugs–I’m just the pusher (or Propofologist, as I like to say).

Now, here’s the key. If I use a brand new, sterile needle and brand new, sterile syringe each time I access the vial, the risk of passing anything from one patient to another is zero point zero zero. I also clean my hands between cases and swap the vial with alcohol before accessing it. That’s common sense, sterile technique. And, of course, we make sure that it’s within the time frame suggested by the manufacturer

Why do I care? I care because there is a national shortage of propofol and this stupid jury verdict is making it worse. Propofol is a great drug. Whoever invented it (or the team that did) should be getting a nobel prize.