Health Care Professionals

Injectable Sodium Bicarbonate Shortage and Recall

Frequently Asked Questions

What if my organization is experiencing a low threshold level (next seven days)?

Starting on June 23, 2017, the ministry has asked all hospitals to report on inventory levels via the Hospital Inventory Survey.

The ministry shares these survey results to support local redistribution of inventory as needed.

Additionally, providers are encouraged to connect their LHIN directly if at any time their inventory drops below a seven-day supply.

If a facility is in critical need, the facility can contact Pfizer for an increased allocation at allocation@pfizer.com or by phone at 1-800-267-2553 ext. 4410.

How many health care organizations currently have less than a seven-day supply of a particular drug?

The ministry receives weekly reports from hospitals that have a seven-day or less supply, relative to their projected need. These numbers change daily, and the ministry works with LHINs to support redistribution as part of the inventory management framework. 

In addition, many hospital corporations are redistributing inventory across their sites or are connecting directly with local hospitals to arrange for sharing of inventory.

Has the ministry identified any therapeutic alternatives and if so, will the ministry share this information with health care stakeholders?

Health providers should consult with their colleagues and with their pharmacists in order to find appropriate alternatives for their patients. Decisions about alternative medications should be made by the prescribing clinician.

The ministry has also shared additional resources to support conservation efforts and the use of therapeutic alternatives.

What can I do as – a health care provider – right now to help alleviate this situation?

Actions that health care providers may take to conserve supply include:

To ensure patient safety, the ministry encourages health care providers to consult with their colleagues, including pharmacists, on the strategies to conserve supply, particularly regarding therapeutic alternatives and lower doses. Hospital pharmacists whose hospitals provide a drug information service may want to consult with this service.

The Joint Centre for Bioethics at the University of Toronto developed an ethical framework in 2012 to support decision making during a drug shortage that can be used for this shortage.

What is the purpose of the ethical framework?

The ethical framework is intended to provide high-level guidance as a shared foundation for decision making and deliberation within and across health sectors, health institutions, and health professionals in response to the drug supply shortage.

Does the ethical framework supersede the clinical judgement of healthcare professionals?

No, the ethical framework does not supersede the clinical judgement of healthcare professionals, the fiduciary duty to individual patients in their care, or their role as stewards of finite healthcare resources, nor does it replace or displace the permissions and constraints of applicable Ontario legislation.

What do we do with recalled / expired product?

Pfizer has provided direction on what to do with recalled product. If you have any inventory of the impacted lot, please stop use immediately. Please conduct an assessment of inventory and immediately send the completed product recall return form (provided with the recall notification letter) by fax to 1-800-420-2019, even if you do not have any recalled stock-on hand.

For additional information on the recall please contact Pfizer:

Will sterilization of recalled product be an option? Is it appropriate to extend the expiration date of product?

The ministry is not in the position to provide guidance on sterilization process or extension of product expiration.

Pfizer has confirmed that they do not have sufficient evidence to support the use of non–recalled 50ml vials past their intended expiration date, nor could it recommend methods (either heath treatment or filtration) to sterilize recalled vials.

For More Information

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