Saturday 16 December 2017

Q & A: Why is there such a scare about chemotherapy treatments?

Chemotherapy units mixed at Fannin Compounding were made in an isolator which was contaminated with bacillius cereus
Chemotherapy units mixed at Fannin Compounding were made in an isolator which was contaminated with bacillius cereus

Eilish O’Regan

Why is there such a scare about chemotherapy treatments?

The apparatus known as an isolator used to mix chemotherapy at Fannin Compounding Ltd in Dublin was found to be contaminated during a check. Obviously, this should be completely sterile.

Fannin supplies public and private hospitals with some of these treatments and once the contamination was found, the products needed to be recalled.

The bug could have passed from the machine on to the mixed chemotherapy given to the patient.

What kind of contamination was found?

It took time to identify, but it was found to be a form of bacteria known as bacillus cereus.

It normally causes food poisoning, but increasingly it is linked to serious and potentially fatal non-gastrointestinal infections.

It can be potentially severe for newborns and people whose immune systems are weakened.

How is chemotherapy given to the patient?

It is administered into the bloodstream through a drip.

Were the chemotherapy treatments contaminated?

That is not yet clear but the potential was obviously there. Thankfully, no patient so far appears to be affected.

How many patients would have received the treatment?

Around 200.

Is there particular concern about cancer patients?

Yes, their immune systems would be low so they would find it more difficult to fight infection.

What is the HSE saying about all this?

It has confirmed the recall, using the term it normally employs in these situations: saying it was "precautionary".

So is it an over-reaction?

Absolutely not.

The risk might be low but it could have had very serious consequences for a patient.

When did all of this come to light?

The company says it identified the contamination during tests last Monday morning. It conducts its own internal tests on products that are not sold on.

What action did it take?

It contacted the medicines watchdog, the Health Products Regulatory Authority (HPRA), "immediately".

The HPRA then oversaw the recall.

How were doctors notified?

The company said it rang all hospitals involved and then also issued letters to pharmacists and doctors in each of the hospitals impacted.

How come one patient believes she received the treatment on Wednesday?

She was contacted by the hospital staff on Thursday and asked if she had any symptoms.

It was explained to her that the treatment could have been potentially contaminated.

How far back did they go in recalling the products?

To products manufactured from Sept 29. Some 132 of the 297 units filled over two weeks are declared safe.

Another 48 unused units were recovered. That leaves about 120 which are still suspect, which would have been given to 100 patients.

How was it all handled?

There appears to be a lot of confusion and understandable fear.

One man whose wife received chemotherapy last week was informed on Tuesday that it was part of the suspect batches.

Others were still being contacted yesterday.

Is this the first time Fannin has had a recall?

No, according to the HPRA it has overseen two other precautionary recalls in the last six months related to this company. In both cases, no product was found to be contaminated, the watchdog added.

Irish Independent

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