Shortage of contrast dyes has left many patients ‘in limbo’
The United States is currently experiencing a national shortage of imaging agents used in approximately 50 million exams per year – a shortage that has forced many hospitals to delay procedures and ration their limited supply, reports Reed Abelson for the New York Times.
Over the past few weeks, experts across the country have expressed growing concern over shortages of contrast dyes resulting from the closure of GE HealthcareThe Shanghai factory amid China’s Covid-19 lockdowns.
Earlier this month, the American Hospital Association (AHA) wrote a letter urging GE Healthcare to distribute needed supplies throughout the shortage. In response, the company said it was “working to return to full capacity as soon as local authorities allow.”
Last week, GE Healthcare announced that its supply of imaging agents continues to grow. However, he did not provide an estimate of when the shortage would end.
“After having to close our Shanghai manufacturing facility for several weeks due to local Covid policies, we have been able to reopen and are using our other global factories wherever we can,” the company said.
In the statement, GE Healthcare said the plant was operating at 60% capacity and would be at 75% within the next two weeks. Additionally, the company said it has taken further steps to ease the shortage, including increasing production at its plant in Cork, Ireland, and shipping products to the United States.
Still, lawmakers have expressed concern over the shortage. “In the wealthiest country on the planet, there should be no reason why doctors are forced to ration lifesaving medical tests to make up for a shortage of supplies,” said Rep. Rosa DeLauro (D-CT). “We are seeing supply chains collapsing due to consolidated industries experiencing manufacturing shortages and shifting American jobs to China.”
“The shortage of a vital imaging agent is the latest example of the country’s vulnerability to global supply chain disruptions and its overreliance on a small number of manufacturers for such critical products,” writes Abelson.
How Dye Shortages Affect Care
Whereas FDA said it was working closely with manufacturers “to help minimize the impact on patients,” some experts said shortages could last through the summer due to distribution delays, further delaying procedures and potentially threaten patient safety.
According to Elliott Haut, a trauma surgeon who oversees quality and safety in the surgical department of the Johns Hopkins School of Medicinethe shortage “is probably one of the biggest risks to patient safety since COVID hit.”
On Thursday, FDA Commissioner Robert Califf said the shortage was “just unbelievable,” while testifying before a Senate committee. “A person who had a stroke or a heart attack could not have angiograms,” he added.
“We continue to be concerned about the impact of delayed, deferred or ignored screening over the past few years,” said William Dahut, scientific director of the American Cancer Society.
According to Dahut, a lack of contrast dye in a screening exam can make it harder to diagnose cancer and harder to determine if a treatment is working. “Patients could be in a situation where clinical decisions are going to be negatively affected,” Dahut said.
Additionally, the shortage has left many other patients “in limbo,” writes Abelson.
“It definitely causes more stress for patients,” said Shikha Jain, an oncologist in Chicago. “Some patients are frustrated because scans are delayed or cancelled.”
Ultimately, the full impact of the shortage is difficult to predict. For healthcare workers, many of whom have struggled with supply shortages and the pandemic, “it feels like an endless marathon,” Jain said.
As concerns about shortages of contrast dyes have grown, many hospitals have been forced to ration their supply.
For instance, Memorial Hermann Health System has “reduced” its use of contrast for elective procedures to preserve its existing supply, said Jamie McCarthy, the health system’s chief medical officer. According to McCarthy, the healthcare system is currently performing about half of its typical daily volume of CT scans.
When Delaware-area hospitals ran out of dye, they began referring patients to ChristianaCare. But even at ChristianaCare, the shortage “became a serious problem very quickly”, after starting in mid-May, said Kirk Garratt, medical director of the group’s heart and vascular health center.
“It impacted our burn rate,” Garratt said. “We are really worried here,” he added while explaining why the health system decided to delay elective procedures. “We believe we need to make this change now to ensure we have a supply so we can continue to provide the urgent care we need.”
Meanwhile, Nancy Foster, vice president of quality and patient safety policy for the AHA, compared the shortage of contrast dyes to other shortages seen throughout the pandemic.
To help prevent future shortages, Foster urged GE to share more information about the shortage. “We need to figure out how to really create a much more robust, not as lean, supply system that has something to do with it,” she said. (Abelson, New York Times05/26)