Hermiston Herald
April 9, 2002:

Army using "outdated" antidote

By Frank Lockwood
of the Hermiston Herald

HERMISTON - For years, the Army has been re-labeling "expired" atropine,
placing new dates over the top of old expiration dates on the antidote
effective against nerve gas stored at Umatilla Chemical Depot.

The practice is OK, the government says, because the Army re-tests the
substances.

Relabeling is standard practice and has been reported numerous times by
hospital personnel over an 11-year period, but the practice caught someone's
attention after January's emergency preparedness exercise, and was written
up in a report by the Centers for Disease Control. The CDC has recommended
the relabeling be reviewed.

A letter from the U.S. Army Material Agency says that the material is tested
annually by the manufacturer, the stability test date is evaluated by the
Food and Drug Administration, and the material is considered suitable for
issue and use up to the retest date.

"I don't know why just now, but it finally caught someone's attention at the
Centers for Disease Control," said Ken Franz, manager of emergency services
at Good Shepherd.

Franz said he has drawn the issue of the expiration dates to "every
inspector" for 11 years, because, there are two standards. "At the hospital,
we have to check our own drugs daily to make sure they are not outdated,"
Franz said.

The Army replaces some of the hospital's old supply of Army atropine with
new medicine about every 18 months, but medicine on hand is always past the
original expiration date, Franz said. That creates a dilemma of sorts: "It's
against the law for me to have outdated drugs in the hospital," Franz said.
The Army drugs must be kept separate from other drugs that are stored in
the hospital.

Asked if the medicine with the changed expiration dates was still good,
Franz said, "I have to assume that it is. The dilemma is that, until an
event will happen, we will never know for sure."

In addition, the report said that no hospitals reported that their
pharmacies stocked additional supplies of atropine and pralidoxime for
ongoing treatment of hospitalized patients, though "auto-injectors" are
stored at the hospital.

Another problem is that, were there an accident involving nerve agent, the
hospital could be overwhelmed with requests for atropine by people having
false symptoms, as happened in the Tokyo subway terrorist attack several
years ago. Every asthmatic who felt symptoms might wonder if he or she had
been exposed, Franz said.

According Debbie Clay of the hospital's public affairs, it is difficult to
say how many people Good Shepherd is equipped to treat with anti-dote during
an emergency; it depends on the severity of the situation, wind speed and
direction, and on whether the people were lightly exposed or highly
contaminated.

If the patients were lightly exposed, the hospital might be able to treat
hundreds of people, whereas, if the patients were highly contaminated, they
might be able to treat only three or four. If someone were highly
contaminated, that person might require several injections of antidote over
a period of time. Good Shepherd would not necessarily have to treat every
victim, however, as other hospitals, including St. Anthony's Hospital in
pendleton and Pioneer Hospital in Heppner, are included in the training for
such events.

Frank Lockwood may be reached at 567-6457 or by e-mail at
flockwood@hermistonherald.com.