Don’t Break a Leg Looking for Baby Food

Michael Quintos of Chicago, suffering from acute stomach pain, cannot get a scan that might help determine the cause of his illness. Credit…Taylor Glascock for The New York Times

by James C. Sherlock

Iodinated contrast media (ICM) are diagnostic imaging support drugs containing iodine that are given to patients to enhance the ability to see blood vessels and organs on medical images such as X-rays or computed tomography (CT) scans.

These images provide greater detail when necessary to help health care professionals diagnose potential problems. ICM products can be given as injections into the veins, by mouth as a drink, or rectally. They are given to patients, including babies.

Intravenous contrast solution is used in many medical procedures involving the heart and blood vessels. It is particularly useful in cancer diagnoses.

There is a major shortage in the U.S.

The shortage was documented in the public press as early as May 25 and described nationally in The New York Times (“Patients Face Long Delays for Imaging of Cancers and Other Diseases”) on May 26. The picture and its caption are from that story. I took note to follow the story.

CNN had a piece on it this morning.

So, I searched for action being taken by producers, the medical community and the federal government.

You won’t like it.

Medical community.

  • The American College of Radiology posted a statement on May 6.  that declared the shortage an emergency;
  • The American College of Emergency Physicians posted an alert on May 13.  It noted

ACEP has discussed this issue with the FDA, but there does not seem to be a short term fix. We will continue to work with them until this is resolved.

  • American College of Cardiology June 2

“The current contrast shortage has potentially far-reaching implications,” says Wayne Batchelor, MD, FACC, chair of ACC’s Interventional Section. “Hospitals and outpatient diagnostic centers should become intimately familiar with their supply chain while employing strategies to preserve contrast and avoid waste.”

  • Sentara and Riverside posted a joint announcement on May 13 that they were monitoring the issue. They reported no major hindrance in serving patients at that time, but they mistakenly noted in that announcement that the GE plant in Shanghai had reopened. It had not. They were “working closely with our vendors and are optimistic that our supplies will return to normal soon.”  I have not checked the rest of the providers in Virginia.  Their situations will vary.

The federal government.

  • Naturally, I looked at the FDA website for the shortage information. Nothing;
  • CDC website. No hits on “iodinated contrast media”;
  • Then the Department of Health and Human Services. Nothing;
  • CMS? Nothing about the shortage of the media;
  • The White House website. “It seems we can’t find what you’re looking for.”  Thanks.

The state. I am informed reliably that VDH and VHHA are staying on top of it and polling the hospitals and other imaging centers to see where they are on this.

The largest maker of the imaging machines. On May 23, GE announced:

GE Healthcare continues to experience temporary supply disruption for its iodinated contrast media products. After having to close our Shanghai manufacturing facility for several weeks due to local COVID policies, we have been able to reopen and are utilizing our other global plants wherever we can.

Working with local authorities to enable increasing numbers of operators to return back to the plant in line with COVID protocols. The impacted facility had increased production output from 0% of capacity when the plant was closed to 60% by May 21, 2022. GE Healthcare expects the plant to be producing at 75% in the next two weeks;

Good to know.

On June 2,

GE Healthcare expects production capacity from its Shanghai facility to be close to 100% starting next week (Monday 6 June), following the easing of local COVID restrictions. This will enable us to re-stabilize our global supply of iodinated contrast media. We will continue to work with impacted customers to help them plan several weeks ahead as supply progressively recovers.

GE has a plant in Cork, Ireland, at which it is “expanding production.”

Then Agence France-Presse reported yesterday (Monday June 6) that “Shanghai Residents Chafe Under Fresh COVID Lockdowns.” No word on any effect on GE contrast media production.

I have no idea why the federal government apparently has made no public acknowledgement of this that I can find, much less taken an official position or acted to mitigate the shortages.

The GE iodinated contrast media plant in Cork is a four-hour drive from the Cootehill, Ireland, Abbott baby formula plant.

Even so, the FDA inspectors and the Military Airlift Command crews and aircraft dispatched to Ireland perhaps can double up on their work.

Another case of offshoring and just-in-time logistics meeting reality.