Category Archives: Public Safety

say no to drugs

Quick Overview of the Opioid Crisis

On October 26, 2017, President Trump announced that his Administration was declaring the opioid crisis a national Public Health Emergency under federal law, effective immediately. “I am directing all executive agencies to use every appropriate emergency authority to fight the opioid crisis,” the President said.

Declaring the Opioid Crisis a national Public Health Emergency legally authorizes federal, state, tribal, and local authorities to allocate existing personnel and resources toward opioid prevention efforts.

It also waives some key legal inhibitions, ramps up critical public health surveillance, and facilitates greater coordination across federal agencies. Mainly, these agencies and authorities are focusing on the developing the following three solutions:

Money.

 Innovation costs money. All the organizations and government, pharma, and medicine that are working to stem the flow of the opioid crisis need money to put their ideas into practice, so directing funds to all the people working to solve the opioid crisis is going to be a primary concern. Where exactly is the money going to be spent? Each agency has their own list of needs.

Some of the money is to be used for creating more access to addiction treatments, as many patients with opioid addictions simply cannot afford the detox and addiction treatments currently available.     

Another costly way to reduce opioid death is furnishing emergency personnel with naloxone, which is the primary treatment for opioid overdose. Naloxone is costly. The government can force Pharma to slash prices. We’re still working on that- it hasn’t happened yet.

Regulation-.

First of all, going after the bad guys who are importing opioids in an unregulated manner. To this end,  Trump signed the INTERDICT Act in January, 2018. This law directs the Department of Homeland Security to provide additional tools and resources to detect and intercept the supply of illicit fentanyl.

Trump spoke about handing out the Death Penalty to drug dealers.

He also is still emphatic about strengthening the wall between the U.S. and Mexico, which supplies a lot of the US’s illicit drugs.       

Regulation also includes the FDA’s efforts to create better guidelines, reporting systems, and a way to regulate the prescribed opioids in the U.S. Patients requiring certain medications containing opioids are already having a more difficult time getting their prescription refilled, and they are not happy. They are forming groups and creating petitions for medical opioids that will not interfere or limit the patient’s medical treatments.

Education.

 Many addictions start without the knowledge of the person developing the addiction, or without the knowledge of people around them that could have prevented or assisted with the addiction. Explaining the effects of drugs to teenagers is always appropriate.

Giving patients good information about their prescribed medication, and creating a list of alternative ways to treat, control and handle pain is another way to reduce opioid addiction numbers.

Proper disposal of opioids is a very big step toward decreasing the numbers of opioid addiction and death, and it is something everyone can do.

Follow us for more information on the latest innovations, solutions, and news about the opioid crisis.

The DEA and Google both provide locators to find your nearest prescription drug take back locations.

Check out The DEA and Google pages below. They contain tools and more info on the ever growing efforts to help people properly dispose of their unused prescription drugs. This is certainly part of the bigger plan to help end the opioid crisis.

DEA’s Prescription Drug Take Back Location Tool

Google’s Prescription Drug Take Back Location Tool

We are MedWaste Management – California’s medical waste disposal experts!

Established in 2008, MedWaste Management brings great benefit to the healthcare industry and the general public alike. We publish this blog to to spread useful and practical information to help people stay safe, smart and healthy!

Call us with any questions or to start service at (866) 254-5105. We are always happy to speak!

Check out our services and other great resources in the links below.

Medical Waste Disposal Services 

MedWaste’s Blog Index

Medical Waste Regulations

MedWaste’s Product Store 

Home Generated Medical Waste Drop-Off Points In California

eye dropper close to eye

Puriton Eye Relief Drops Can Harm Your Eyes.

Kadesh Incorporation Issued a Voluntary Nationwide Recall of Puriton Eye Relief Drops. The complete statement can be found on the FDA’s recall page.

The recall was due to non-sterile conditions during production.

When the FDA inspected the production site, the investigators discovered that the necessary production controls and conditions for sterility were not being observed.

Opthalmic drugs are required to be sterile in particular, because using a non-sterile eye drop can potentially threaten the vision of the consumer due to the risk of an eye infection. Also, the pH factor of the eye drops can cause direct destruction of tissues in the anterior chamber, cornea, and even deeper in the eye.

This can potentially cause scarring, vision loss, or glaucoma.

To date, there have been no reports of adverse effects related to the Puriton Eye Relief Drops.

Purtion Eye Relief Drops is an over-the-counter homeopathic eye drop product. Its uses include temporary relief of burning and irritation of the eye due to dryness and temporary relied of discomfort due to minor irritations to the eye, like wind and sun exposure. Other uses were the relief of redness, watery eyes, inflamed eyes, itching, burning, tearing eyes, eye pain, and lubricant.

Kadesh, Inc. of Garden Grove, CA is voluntarily recalling all lots of Puriton EyeRelief Drops , 0.5 oz. (15ml) bottle, UPC 7 36972 1679 0, to the consumer level.

It is packaged in a 15 ml plastic bottle, and was distributed nationwide through the company’s online stores and the retail distributors they work with. All distributors and customers are being notified by letter and Kadesh is arranging for the return of all the recalled products.

As of now, the product cannot be found anywhere online, neither on the Puriton website nor online markets like Amazon.

Anyone who has recalled eye drops should stop usage or sale of the product.

Consumers with questions regarding this recall can contact the Recall Department at contact@puriton.us, available Monday through Friday, from 9 am to 6 pm (Pacific Time).

Product may be returned to Kadesh Inc. by mail:

4731 Lincoln Way, Garden Grove, CA 92841.

Anyone who experienced any problems that may be related to the use of the non-sterile product should contact their healthcare provider.

Adverse reactions or quality problems associated with the use of this product may be reported to FDA’s MedWatch Adverse Event Reporting program either by phone, on line, by regular mail or by fax.

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We are MedWaste Management – California’s medical waste disposal experts!

Established in 2008, MedWaste Management brings great benefit to the healthcare industry and the general public alike. We publish this blog to to spread useful and practical information to help people stay safe, smart and healthy!

Call us with any questions or to start service at (866) 254-5105. We are always happy to speak!

Check out our services and other great resources in the links below.

Medical Waste Disposal Services 

MedWaste’s Blog Index

Medical Waste Regulations

MedWaste’s Product Store 

Home Generated Medical Waste Drop-Off Points In California

 

dangerously high blood pressure

Losartan: Another Blood Pressure Medication Is Being Recalled

The FDA is recalling Irbesartan and Losartan, more angiotensin II receptor blockers (ARBs), after discovering traces of NDEA in them.

This new recall is for Losartan sold by Sandoz.

The recall is only for the 100mg/25mg tablets and does not involve other versions of the losartan drug.

This recall impacts less then 1% for the total losartan drug products in the US market. However, it is only the tip of the iceberg for pharmaceutical products  from the same manufacturer found tainted with amounts NDMA and NDEA that are not safe by the FDA’s standards.

The active ingredient in the recalled lot of losartan tested positive for NDEA.

NDEA is a suspected human and animal carcinogen. It was found within an ingredient that was made and supplied by the Zhejiang Huahai Pharmaceutical Company Co. Ltd. This same company supplied the tainted active ingredient used in the recalled lots of valsartan.

After the European Medicines Agency, (EMA), and then the FDA, confirmed the presence of NDMA and NDEA impurities in Valsartan, the FDA launched an investigation, including an inspection of the Zhejiang Huahai facility. They found traces of both NDEA and NDMA.

At the end of September, the FDA placed the Chinese company on an import alert, which means that any  active pharmaceutical products or finished products from the company would not enter the United States.

Valsartan is used in blood pressure medication and some vaccine products, among others.

The FDA is testing all ARBs- for NDEA and NDMA impurities and is keeping an ongoing list of recalled medicines and those that are not going to need to be recalled.

In August, 2018, FDA Commissioner Scott Gottlieb, M.D., and Janet Woodcock, M.D., director of the Center for Drug Evaluation and Research, released a statement on the FDA’s ongoing investigation into valsartan impurities and recalls.

They described what caused the impurity in the drugs, what the FDA is doing about it, and the risk assessment for patients who have been taking the tainted drug.

The scientists working for the FDA estimated that,  “if 8,000 people took the highest valsartan dose (320 mg) from NDMA-affected medicines daily for four years, (this is the amount of time they estimated the affected drugs were being marketed), there may be one additional case of cancer over the lifetimes of these 8,000 people beyond the average cancer rate among Americans.”

That estimate was based on the highest daily dose, however many people may have taken lower doses, and therefore their risks would be less.

FDA expects the actual cancer risk to most consumers to be lower than the estimate.

The losartan recall is for lot number JB8912. If you are taking losartan, you can check the lot number on the bottle and see if the numbers match.

If your drug is on the recall list, the FDA suggests that you continue to take it until you can get a replacement from a Doctor or Pharmacist.

Questions regarding this recall can be directed to Sandoz Inc. at 1-800-525-8747 Monday-Friday 8:30 AM – 5:00 PM (EST) or email usdrugsafety.operations@novartis.com.

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We are MedWaste Management – California’s medical waste disposal experts!

Established in 2008, MedWaste Management brings great benefit to the healthcare industry and the general public alike. We publish this blog to to spread useful and practical information to help people stay safe, smart and healthy!

Call us with any questions or to start service at (866) 254-5105. We are always happy to speak!

Check out our services and other great resources in the links below.

Medical Waste Disposal Services 

MedWaste’s Blog Index

Medical Waste Regulations

MedWaste’s Product Store 

Home Generated Medical Waste Drop-Off Points In California

food poisoning, listeria

Product Recall: Fried Onions with Listeria and Salmonella

Possible Salmonella and Listeria Monocytogenes contamination is affecting multiple products and crossing State lines.

The reason for the recall was contaminated ingredients sold and shipped by McCain Foods. Initially, they identified the contamination in their onion ingredients.

First, “Out of an abundance of caution”,  Hy-Vee recalled the following products from all of its stores:

Hy-Vee Bacon Wrapped Cowgirl Chicken Grillers, Hy-Vee Fire Roasted Tomato, Spinach, Mozzarella Twice Baked PotatoHy-Vee Cowgirl Chicken Griller PattyHy-Vee Gourmet Steakhouse Mushroom & Swiss BurgerHy-Vee Ground Beef Sliders Mushroom & Swiss

The impacted products had a “Best If Used By” date of Oct. 22, 2018, or sooner

The instructions for customers who bought any of the recalled products was to avoid consuming them, throw them out, or return them to the local Hy-Vee store for a refund.

Questions about Hy-Vee recalled products will be addressed 24 hours a day with Hy-Vee Customer Care representatives at 1-800-772-4098.

The FDA has a full list of the Hy-Vee recalled products on their site.

Since then, the recall has spread to a dozen U.S. food manufacturers including Bakkavor Foods, Envolve Foods and Ruiz Food Products. The food makers notified the U.S. Department of Agriculture about products they shipped that could include ingredients such as corn, diced onions and other vegetables possibly tainted with bacteria – all provided from McCain Foods.

McCain Foods, which has headquarters in Canada and offices in Illinois, said they identified a potential health risk related to their fire roasted, caramelized, or sauteed frozen vegetable and fruit products that were produced at their Colton (California) facility.

Included in the recall:

Salads, wraps, burritos and pizza sold at Harris Teeter, Kroger, Whole Foods, 7-Eleven, Ralphs, Trader Joe’s, Walmart, Simple Truth, and other major retailers.

The Fresh Market said they removed some pizza and pasta salad products and self-serve portions from the shelves of 161 stores in 22 states.

For a complete list of affected products, check the USDA’s current recalls site.

According to McCain Foods and the USDA, there have been no confirmed reports of adverse reactions due to consumption of any of the recalled products as of now.

Listeriosis is a food-borne infection caused by Listeria bacteria that is commonly found in water, soil, and feces. Humans are infected when they consume foods that harbor the bacteria.

The most common foods to cause listeriosis outbreaks are deli meats and unpasteurized dairy products. However, many other foods have also been found to spark outbreaks, including caramel apples, cantaloupe, and cabbages fertilized by sheep manure.

Adults who are healthy and have strong immune systems are less at risk of listeriosis. Pregnant women are more susceptible to infection and can pass the infection to the fetus or suffer complications or miscarriage. Other people who have an increased risk of Listeria infection are the elderly, children or people who are immuno-compromised.

Severe Listeria infections can cause gastroenteritis (“stomach flu”), bacteremia, sepsis, meningitis, pneumonia, osteomyelitis and endocarditis.

An estimated 1,600 people get Listeriosis each year in the U.S., and about 260 die from it, according to the CDC. 

Listeria and Salmonella infections usually resolve on their own without treatment. The best defense is prevention. Heat all foods that may be harboring bacteria.

There are also natural remedies that assist with the symptoms and with overcoming the infection that have been proven useful.

With proper rest, care and in the worst case, with treatment, This Too Shall Pass.

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We are MedWaste Management – California’s medical waste disposal experts!

Established in 2008, MedWaste Management brings great benefit to the healthcare industry and the general public alike. We publish this blog to to spread useful and practical information to help people stay safe, smart and healthy!

Call us with any questions or to start service at (866) 254-5105. We are always happy to speak!

Check out our services and other great resources in the links below.

Medical Waste Disposal Services 

MedWaste’s Blog Index

Medical Waste Regulations

MedWaste’s Product Store 

Home Generated Medical Waste Drop-Off Points In California

 

a sign declaring the national prescription drug take back day

The National Prescription Drug Take Back Day Is This Saturday, Oct. 27th of 2018!

This Saturday, Oct. 27th of 2018, the DEA has organized a National Prescription Drug Take Back Day throughout the entire Country. This is one way of helping to deal with the opioid crisis that has been declared a national crisis recently.

MedWaste Management will provide continued coverage of take back event as well as other efforts being made to help with our opioid crisis.

The DEA and Google both provide locators to find your nearest prescription drug take back locations.

Check out The DEA and Google pages below. They contain tools and more info on the ever growing efforts to help people properly dispose of their unused prescription drugs. This is certainly part of the bigger plan to help end the opioid crisis.

DEA’s Prescription Drug Take Back Location Tool

Google’s Prescription Drug Take Back Location Tool

As President Trump signed legislation providing resources to help end our opioid crisis, representatives of companies pledging to help stood behind.

You can watch footage of the President with others discussing our opioid crisis and about the things that our Country is doing to stop it, including prescription drug take back events, and more responsible doctor prescribing.

Behind him stood representatives of companies pledging to help with the crisis. Representatives from Google, Walgreens and CVS were there, among others, promoting tools to help dispose of prescription drugs safely and securely. (22.00 minutes into the video)

We are MedWaste Management – California’s medical waste disposal experts!

Established in 2008, MedWaste Management brings great benefit to the healthcare industry and the general public alike. We publish this blog to to spread useful and practical information to help people stay safe, smart and healthy!

Call us with any questions or to start service at (866) 254-5105. We are always happy to speak!

Check out our services and other great resources in the links below.

Medical Waste Disposal Services 

MedWaste’s Blog Index

Medical Waste Regulations

MedWaste’s Product Store 

Home Generated Medical Waste Drop-Off Points In California

Household Hazardous Waste Sign

Drug Take Back And Sharps Collection Day In Napa County

Drug Take Back And Sharps Collection Day In Napa County – Saturday, October 27, 2018, from 10am to 2pm, at numerous Napa County locations.

The Police Departments and Sherriff’s offices in Napa County, along with Kaiser Permanente and the Drug Enforcement Administration (DEA), will host unused medication and sharps (used syringes and needles) collection events on Saturday, October 27, 2018, from 10am – 2pm, at numerous locations around Napa County.

Residents in the area are encouraged to bring their unused or expired over-the-counter and prescription medications to one of six collection locations throughout Napa County. It is recommended that any personal information on medication containers be removed or blacked out before dropping off. Additionally, these one-day collection sites can legally accept federally-designated “controlled” substances that include many highly addictive prescription medications such as morphine and OxyContin, as well as illegal narcotics such as LSD and ecstasy.

Home generated medical sharps (needles, syringes, epinephrine auto-injectors, etc.) will be accepted for disposal at all of the October 27th sites as well. State law prohibits the disposal of home generated sharps in trash or recycling containers. Improper disposal of home generated sharps is a health and safety threat to children, home health care providers, trash & recycling workers, and pets through accidental needle stick injuries. Sharps that are not disposed of properly can also end up on beaches and riverbanks, waterways, parks and more. Ideally, sharps should only be transported in an approved container obtained from a physician or pharmacy. A tightly sealed, leak- and puncture-resistant container with a lid, such as a bleach bottle, coffee can, or other similar container, is an acceptable alternative for transportation of sharps to the event. These containers should be labeled as “sharps.”

These collection sites accept sharps and unused or expired over-the-counter and prescription medications, and “controlled” substances that include many highly addictive legal and illegal drugs.

“Many people don’t realize that flushing medications down the toilet or putting them down the drain can lead to water pollution and harmful effects on aquatic life,” said Stephanie Turnipseed, Pollution Prevention and Outreach Coordinator with the Napa Sanitation District. “Medication can pass right through the wastewater treatment process and enter our waterways, so the best thing to do is to bring your medicines to a take-back event or one of the year-round drop-off locations for safe disposal.”

In addition to the environmental impact of improperly disposed medications, prescription and over-the-counter drugs that languish in home cabinets are highly susceptible to misuse and abuse. Rates of prescription drug abuse in the U.S. are alarmingly high, as are the number of accidental poisonings and overdoses due to these drugs. Studies show that the majority of abused prescription drugs are obtained from family and friends, including from the home medicine cabinet.

This service is free and anonymous.

October 27th Medication And Sharps Collection Event Sites:

American Canyon Police Department

Address911 Donaldson Way E, American Canyon, CA 94503

Napa County Sheriff’s Office

Address1535 Airport Blvd, Napa, CA 94558

Kaiser Permanente Medical Offices – East Parking Lot

Address3285 Claremont Way, Napa, CA 94558

 

Yountville Police Department

Address1950 Mulberry St, Yountville, CA 94599

St. Helena Police Department

Address1480 Main St, St Helena, CA 94574

 

Calistoga Police Department

Address1234 Washington St, Calistoga, CA 94515

Can’t make the collection event on October 27th?

Those unable to take items to the event can dispose of unwanted pharmaceuticals (uncontrolled substances only) and home generated sharps year-round at the Napa-Vallejo Household Hazardous Waste Collection Facility located at 889A Devlin Road, next to the Transfer Station in American Canyon. The facility is open every Friday and Saturday from 9am to 4pm.

For “uncontrolled” substances and sharps, there are several local year-round opportunities for safe and legal disposal, which can be found online at www.naparecycling.com/medicine.

Mail back services are available for your home generated sharps. Additional year-round options for residential medical sharps can be found online at www.naparecycling.com/medical-sharps-disposal or call the Napa County Department of Public Works for more sharps disposal information at 707-253-4094.

We are MedWaste Management – California’s medical waste disposal experts!

Established in 2008, MedWaste Management brings great benefit to the healthcare industry and the general public alike. We publish this blog to to spread useful and practical information to help people stay safe, smart and healthy!

Call us with any questions or to start service at (866) 254-5105. We are always happy to speak!

Check out our services and other great resources in the links below.

Medical Waste Disposal Services 

MedWaste’s Blog Index

Medical Waste Regulations

MedWaste’s Product Store 

Home Generated Medical Waste Drop-Off Points In California

suspicious package illustration

Hazardous Mail

Hazards are Everywhere.

We already know this. They are in the air, in our house, in our trash… and  now, hazardous mail. We may be either receiving or sending hazardous mail on a regular basis.

Have you ever ordered bleach through a delivery service? Imagine if it spilled on the delivery guy.

When we think of a mailman having a bad day, we usually imagine an aggressive dog at one of the delivery addresses or a long block, heavy packages, and a heat wave. We don’t usually think of severe bodily injury and hospital stays.

But the Postal Service does.

The USPS spends $101 million annually to screen every piece of first-class mail sent or received by U.S. households and mail sent to federal addresses in Washington.

With tens of thousands of postal facilities to protect, the U.S. Postal Inspection Service has responded to more than 52,000 calls about suspicious mail since 2001. Inspectors respond to about 10 calls daily. Most are false alarms.

The Postal Service now relies on both human checks and machine screenings to track suspicious mail. Shift supervisors receive regular updates on evolving threats. Postal Inspectors practice regularly with local law enforcement agencies in anticipation of an attack.

Employees are trained to be on the lookout for envelopes without a return address, an invalid Zip code, or weird or scribbled jargon.

Sharp objects protruding through boxes or dust or liquids leaking from envelopes is also a potential threat.

Questionable pieces of mail are supposed to be turned over to inspectors for further screening.

Hazardous, Resticted, Harmful:

To put it simply:

Some Things cannot be sent in the mail.

Those Things fall into one of the above categories: Hazardous/Harmful, Restricted, or Perishable/NonMailable Things.

If you need to send something that falls into the above categories, you need to label it properly. Ask for help to do this, because the labeling and shipping protocols are long and complicated.

If you send a Hazardous, Restricted, or Harmful Thing in the mail without following the correct protocol, you will be slapped with a very large penalty.

Hazardous Material:

A Hazardous Material is any article or substance designated by the U.S. Department of Transportation as being capable of posing an unreasonable risk to health, safety, or property during transportation.

In international commerce, hazardous materials are known as “Dangerous Goods.”

Every hazardous material is assigned to one of these nine hazard classes:

Class 1: Explosives.

Class 2: Gases.

Class 3: Flammable and Combustible Liquids.

Class 4: Flammable Solids.

Class 5: Oxidizing Substances, Organic Peroxides.

Class 6: Toxic Substances and Infectious Substances.

Class 7: Radioactive Materials.

Class 8: Corrosives.

Class 9: Miscellaneous Hazardous Materials.

Some of the nine hazard classes are further separated into divisions based on their physical or chemical properties. For postal purposes, Exhibit 331 summarizes the mailability of hazardous materials by hazard class.

In general, if it can kill or injure another person, it is Hazardous Mail. If it is likely to destroy, deface or otherwise damage the mail, postal equipment or other property, it is Harmful Mail.

Harmful matter includes, but is not limited to:

  1. All types and classes of poisons, such as caustic poisons (acids and alkalis), and oxidizers. Controlled substances are also included in this class.
  2. All poisonous animals, except scorpions mailed for medical research purposes or for the manufacture of anti-venom (or antivenin or antivenene); all poisonous insects; all poisonous reptiles; and all types of snakes, turtles, and spiders.
  3. All disease germs or scabs.
  4. All explosives, flammable material, infernal machines, and mechanical, chemical, or other devices or compositions that may ignite or explode. Highly flammable liquids, gases or solids, or any material that under conditions that take place during transportation can cause fire through friction, absorption of moisture, or spontaneous chemical changes or from retained heat from manufacturing or processing, including explosives or containers previously used for shipping high explosives with a liquid ingredient (such as dynamite), ammunition, fireworks, radioactive materials, matches, or articles emitting obnoxious odors.

Watch out for items that include these words on their description. There’s a strong likelihood you can’t just pop them in a box and stick them in the mail:

Acidic, Caustic, Combustible, Communicable, Corrsoive, Explosive, Flammabe, Compressed gas, Radioactive, Poison. Toxic, Infectious, Volatile.

The USPS and UPS have an updated list of items you can’t put in the regular mail on their websites.

Restricted Matter:

Restricted matter includes articles on which mailing restrictions have been imposed for reasons other than risk of harm to persons or property involved in moving the mail.

Motor vehicle master keys, abortive and contraceptive devices, odd-shaped items in envelopes, locksmithing devices and intoxicating liquors are examples of restricted items.

Perishable Matter:

Perishable matter is anything that can deteriorate in the mail and thereby lose value, create a health hazard, or cause an obnoxious odor, nuisance, or disturbance, under ordinary mailing conditions.

Examples of perishable matter include mailable types of live animals, food items, and plants.

The Postal Service provides these labels and tags for sticking on the outside of mail containing bees, live animals, or perishable matter:

  1. Label 27, Bee Ware!
  2. Label 28, Live Animals.
  3. Tag 9, Perishable — Do Not Delay.
  4. Label 127, Surface Transportation O

Perishable matter that is not restricted, (like cookies that can go stale) may be sent at your own risk as long as it is packaged properly and if it can possible be delivered within appropriate and reasonable time limits to prevent deterioration.

So probably you’ll have to forego sending that potato salad to China.

Acceptability for Mailing Hazardous Mail:

The USPS works with shippers wishing to mail various unconventional and even harmful substances. There is a protocol in place for mailing Hazardous, Harmful, Restricted and Perishable Materials.

Acceptability for mailing hazardous materials depends on many factors. A partial list of considerations would be: The container fluid/vapor capacities, the ability of the complete mail piece to contain the material, and the method of absorbing and containing the material in case of accidental leakage of the primary receptacle.

Normal conditions for transport should always be taken into consideration. All shippers who offer packages containing liquids, for example, must be trained to understand and apply the stringent standards for vibration, pressure and temperature because of the higher risk and possible dire consequences. This is especially critical when it comes to shipments by air.

To determine mailability of a specific material, a mailer must submit a material safety data sheet (MSDS) and the following information to the PCSC:

  1. Common and proper shipping name of the material, hazard class, and the assigned United Nations (UN) or North American (NA) identification number.
  2. Chemical composition by percentage of weight.
  3. Flashpoint.
  4. Toxic properties.
  5. Irritant action when inhaled, swallowed, or with contact to skin or eyes.
  6. Special precautions necessary to permit handling without harm to USPS employees or damage to property or other mail.
  7. Explanation of warning labels and shipping papers required by local, state, or federal regulations.
  8. Description of the proposed packaging method, including the addressing, required markings, and documentation.
  9. Volume of material per mailpiece, proposed number of pieces to be mailed, class of mail, and post office(s) of mailing.

The postal service will then determine if you can mail the Thing, in what kind of container, and which labels you would need to affix to it.

Full responsibility rests with the mailer to comply with all Postal Service and non–Postal Service laws and regulations in the mailing of hazardous material.

Anyone who mails, or causes to be mailed, a nonmailable or improperly packaged hazardous material can be subject to legal penalties.

Fines or Imprisonment.

Civil penalties are assessed for knowingly violating a hazardous material transportation law or a regulation, order, special permit, or approval issued under that law.

The following updated civil penalties apply to violations occurring on or after October 1, 2012:

The maximum civil penalty is increased from $55,000 to $75,000 for knowingly violating federal hazardous material transportation law.

The maximum civil penalty for knowingly violating laws and regulations that result in death, serious illness, severe injury to any person, or substantial destruction of property is increased from $110,000 to $175,000.

The $250 minimum civil penalty has been eliminated.

The civil penalty for violations related to training has reverted to $450.

When someone breaks the rules, it puts us all at risk. The consequences for doing so should be substantial enough to discourage misconduct.

(Quoted from PHMSA administrator Cynthia Quarterman)

Here’s an example of the fines you may have to pay:

Amazon improperly shipped a package containing flammable liquid adhesive by air via FedEx. FedEx employees discovered a gallon container of the adhesive that was leaking.

The adhesive is classified as a hazardous material under the DOT regulations.

Amazon sent the shipment without the requisite shipping papers or emergency response information. They did not mark, label or properly package the shipment. Obviously, they also failed to properly train their employees in preparing hazmat packages for shipment by air.

They were fined $91,000.

There have lately been other civil suits about improperly sent mail, with similar fines.

Just saying.

It’s all in the packaging, people. If you need to send something, make sure you know what container is considered appropriate and which labels need to be on there.

Hazardous Mail, Harmful Mail, Restricted Mail, and Perishable Mail, can all end up with you in jail or owing flamboyant fines to the Postal Service.

Although the Postal Service makes every effort to inform its customers about the mailability of harmful Things,  it is the responsibility of the mailer to fully meet all requirements prior to mailing. 

So, be responsible.

If the product you are shipping may pose a risk to life, limb or property, check to make sure how it can be made mailable. There are a lot of lists of all the stuff you can’t mail. Peruse them at your leisure.

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We are MedWaste Management – California’s medical waste disposal experts!

Established in 2008, MedWaste Management brings great benefit to the healthcare industry and the general public alike. We publish this blog to to spread useful and practical information to help people stay safe, smart and healthy!

Call us with any questions or to start service at (866) 254-5105. We are always happy to speak!

Check out our services and other great resources in the links below.

Medical Waste Disposal Services 

MedWaste’s Blog Index

Medical Waste Regulations

MedWaste’s Product Store 

Home Generated Medical Waste Drop-Off Points In California

Smoking factories and skeleton

It’s A Dangerous World Out There (And In Here)

The environment is full of toxins. Petrochemicals, Carcinogens, Halogens, Xenoestrogens– there are so many names and categories for so many chemicals that are out there, waiting to make us ill.

They are in the air we breathe, the water we drink, the foods we consume, and the products we use.

In 2006, the Centers for Disease Control reported that the average American has 116 our of 148 synthetic compounds in his or her body, including dioxins, polycyclic hydrocarbons, and organochloride pesticides.  The average umbilical cord contains 217 neurotoxins, 208 of which are known to cause birth defects.

There are about 80,000 chemicals in commercial use in the United States, and only about 2% of those have been assessed for their safety.

The Environmental Working Group, a U.S. environmental health research and advocacy organization, keeps an updated list of the worst offenders. We encounter many of them daily.

Environmental toxins can cause organ failure, developmental problems, cause cancer, and act as endocrine disruptors. (More on that in another article.)

Or, they can do all three.

Let’s talk about cancer, the scariest end result of toxic exposure. So many chemical compounds out there are being vilified as causing cancer. The truth is, they may all be implicated in the development of cell dysfunction that can lead to cancer- but the road is too long to follow it back. When people are diagnosed with cancer, Scientists can’t usually point to a specific chemical and say, “This is what caused it.”

The human body has defenses to guard against all sorts of harmful exposures. For example, damage to DNA cells can lead to cancer, but often, DNA damage can be repaired.

But the thing about cancer is, it starts years before the actual diagnosis. Let’s say somebody’s body is less able to deal with incoming toxins and the DNA doesn’t get repaired.

It’s the unrepaired DNA damage that can lead to mutations in genes or the cellular structure. Mutations in certain genes or cellular structure can cause cancer.

You can also inherit mutations when your parents have been exposed to toxins. The time between the first, slight cell damage and actual cancer has a long latency period, which makes it hard to tell which exposure to which toxin led to the mutation.

Remember that there are 80,000 different chemicals we people are exposed to over our lifetime. This is why it is hard to determine whether a specific chemical causes cancer.  

Having said that, the Cancer Panel Report and the ATSDR single out Asbestos, Arsenic, Beryllium, Vinyl Chloride, Radon, formaldehyde, and benzene as known human carcinogens.

What Is Asbestos?

Asbestos was adapted and widely used in building materials for its fire and chemical proof properties. It also has soundproofing and insulating qualities. Asbestos has been used in thousands of products which are still found in millions of homes today.

Asbestos is a risk when its fibers become airborne after it’s been disturbed in some way. If inhaled, these fibers can lodge themselves in the lungs, causing scarring and abnormal cell growth, leading to a number of cancers, including mesothelioma.

Common asbestos-containing products that can be found in the home include: Insulation materials for pipes and furnaces, attic insulation, shingles, siding and roofing tiles, soundproofing, plaster and joint compounds, casings for electrical wires, some floor tiles and flooring adhesives, and some plastics and paints/adhesives.

Researchers began to find links between asbestos and Cancer already in the 1950’s, but a lot of the products are built into homes and haven’t been removed.

Reducing Asbestos Exposure:

Asbestos is not a problem if left undisturbed. It’s only harmful when it’s airborne. If you suspect a product or home contains asbestos, it is important that you don’t touch or disturb it in any way. It is especially critical to take care if you are planning to remodel or if you find any damaged building materials in your home.

Check with your children’s school. Many schools use older buildings.

According to law, every school in the US is required to have a detailed asbestos management plan, in accordance with The Asbestos Hazard Emergency Response Act (AHERA).

Schools should inspect their building for asbestos, and re-inspect it at least every three years. They need to provide training in asbestos awareness to custodial staff, and if asbestos is found on premised, write up a detailed plan on how they will get rid of it using people who are trained and certified to handle asbestos properly.

What Is Arsenic?

Arsenic is toxic, bio-accumulative and carcinogenic. It is a metalloid element that occurs in nature, in both organic and inorganic compounds. Organic arsenic is “natural” and therefore less toxic than the inorganic arsenic.

Arsenic was used as a straight-out poison in the olden days. At a concentrated dosage, it is lethal.

Lesser dosage and exposure to arsenic via water and foods can lead to (a)  Various kinds of cancer (lung, bladder, liver and kidney), (b) reproductive and developmental issues; (c) cardiovascular disease; (d) reduced intellectual function in children and (e) possibility of diabetes and high blood pressure.

There are two inorganic arsenic species that are found predominantly in groundwater.

Arsenic poisoning via groundwater has become a worldwide problem. See Bangladesh. The worst toxic exposure issues are usually traced back to the groundwater.

When contaminated groundwater is, or even was, used for irrigation, people can be exposed to arsenic via foods that were grown in soil that was saturated with arsenic-laced groundwater.

It’s all in the water, folks… and then it’s in the soil. And then, it’s in the foods.

The elevated level of arsenic in soil has resulted in elevated concentrations of arsenic in food crops, such as rice and some vegetables. There are different levels of arsenic in the vegetables’ roots, stems, or grain parts. Just like in humans, arsenic bio-accumulates in crops, so the arsenic level depends on the duration and level of exposure.

Then, if cows or other cattle eat the arsenic-laced crops— guess where the arsenic ends up.

Another way the arsenic reaches us humans.

To recap:

Arsenic exposure can occur via water, soil, crops (vegetables and grains), milk, and meat.

On top of that, According to the FDA, poultry farmers are allowed to feed arsenic to birds, for “growth promotion, feed efficiency, and improved pigmentation.” The arsenic affects the blood vessels in chickens and turkeys, causing them to appear pinker and therefore fresher.

“When the Minnesota-based advocacy group Institute for Agriculture and Trade Policy tested conventional poultry, it found the poison (arsenic) in 55 percent of chicken parts tested, with the highest amount–21.2 parts per million–occurring in generic brands.

If you want to know how safe that is, the EPA considers 10 parts per billion in drinking water to be high enough to pose a cancer risk. The chickens tested had up to2,000 times more of these cancer causing arsenic levels!

The European Union has outlawed the use of arsenic since 1999.

Reducing Arsenic Exposure:

According to the Institute of Agriculture and Trade Policy “American- grown rice contains 1.4 to 5 times more arsenic on average than does rice from Europe, India and Bangladesh— scientists think the likely culprit is the American practice of growing rice on former cotton fields contaminated with long-banned arsenic pesticides.”

Scientists at Consumer Reports recommend restricting rice and rice-based hot cereal, ready-to-eat cereal, rice pasta, and rice cakes to two to three servings a week for adults, and one to one-and-a half servings a week for children.

Thoroughly rinsing and cooking your rice with six cups of water to one cup of rice and then draining the excess water can reduce inorganic arsenic content by about 30 percent.

Additionally, purchasing foreign rice can be a safeguard.

Choose organic poultry. In order to use the label of USDA-certified organic chicken, it is legally prohibited to use arsenic in the feed. (The poultry must also be free of pesticide, chemical fertilizers, hormones, and antibiotics, among other requirements.

What Is Beryllium?

Beryllium is used industrially in three forms: as a pure metal, as beryllium oxide, and most commonly, as an alloy with copper, aluminum, magnesium, or nickel. Beryllium oxide (called beryllia) is known for its high heat capacity and is an important component of certain sensitive electronic equipment.

Workers in industries where beryllium is present may be exposed to beryllium by inhaling or contacting beryllium in the air or on surfaces.

Inhaling or contacting beryllium can cause an immune response that puts you at risk for developing a debilitating disease of the lungs called chronic beryllium disease (CBD). Beryllium-exposed workers may also develop other adverse health effects such as acute beryllium disease and lung cancer.

Reducing Beryllium Exposure:

Follow workplace protocol!

What Is Vinyl chloride?

Most of the vinyl chloride produced in the United States is used to make a polymer called polyvinyl chloride (PVC), which consists of long repeating units of vinyl chloride. PVC is used to make a variety of plastic products including pipes, wire and cable coatings, and packaging materials. Other uses include furniture and automobile upholstery, wall coverings, housewares, and automotive parts. At one time, vinyl chloride was used as a coolant, as a propellant in spray cans, and in some cosmetics.

The U.S. Department of Health and Human Services has determined that vinyl chloride is a known carcinogen. The International Agency for Research on Cancer has determined that vinyl chloride is carcinogenic to people, and EPA has determined that vinyl chloride is a human carcinogen.

Use of Vinyl Chloride has been highly restricted so it’s not very likely to be a major concern today. Inhalation causes a large variety initial symptoms way before there is damage to internal organs or cells. You’d notice if you’ve been exposed to Vinyl Chloride.

Vinyl Chloride also has an easily detectable smell.

There is Vinyl Chloride in cigarette smoke.

PVC products tend to have phthalates in them too, which are endocrine disruptors. It would be smart to avoid phthalates as well.

Phthalates are chemicals used to soften plastics. They are found in a wide variety of products, including shampoo, cosmetics, lotions, bottles, nail polish, and deodorant.

At one time most flexible plastics contained high levels of phthalates. Fortunately, they are being phased out in the US and Europe due to emerging recognition of their risks.

The National Institute of Environmental Health Sciences
(NIEHS), part of the National Institute of Health, has found that pre-natal
exposure to phthalates is associated with adverse genital development and can significantly reduce masculine behavior in boys. This is true for all endocrine disruptors, but phthalates are documented.

Women with high exposure to phthalates while pregnant report significantly more disruptive behavior in their children, while other research by NIEHS has found phthalate exposure can lead to thyroid dysfunction in adults.

Fortunately if exposure is decreased, phthalates quickly exit the body. Studies found that phthalate levels in the urine decreased by
53-56% within three days of stopping exposure.

Reducing  Phthalate Exposure:

  •  Minimize use of plastics with the recycling code #3.
  •  Use PVC-free containers. Buy plastic wrap and bags made from polyethylene and use glass containers. If you do use plastic containers, do not heat or microwave them.
  •  Choose phthalate-free toys. Many large toymakers have pledged to stop using phthalates, but be sure to look for toys made from polypropylene or polyethylene.
  • Purchase phthalate-free beauty products. Avoid nail polish, perfumes, colognes, and other scented products that list phthalates as an ingredient. Many scented products simply list “fragrance” as an ingredient, which often incorporates a number of different chemicals including phthalates. Try to minimize these products, or for more information on phthalate-free cosmetics and personal care products, visit the National Campaign for Safe Cosmetics and the Environmental Working Group, which maintains a database on cosmetic products and their ingredients.

What Is Radon?

Radon is a colorless, odorless, radioactive gas. It comes from the natural decay of uranium or thorium found in nearly all soils and it typically moves up through the ground and into the home through cracks in floors, walls, and foundations. It can also be released from building materials or from well water. Radon breaks down quickly, giving off radioactive particles. Long-term exposure to these particles can lead to lung cancer.

The U.S. Environmental Protection Agency estimates that radon causes about 21,000 lung cancer deaths in the United States each year. 1 in 20 homes in the United States have elevated levels of radon present.

Radon exposure is the second leading cause of lung cancer after smoking and the leading cause among non-smokers.

Radon Mitigation is the process of decreasing radon in homes found to have elevated levels present.

Reducing Radon Exposure:

  •         Get your home air checked. It is simple and inexpensive.
  •         If you use a well, check your water.

What Is Formaldehyde?

Formaldehydeis a known human carcinogen. It is a colourless, flammable, strong-smelling chemical that is used in building materials and in the manufacture of many household products. It also occurs naturally in the environment and is produced in small amounts by most living organisms as part of normal metabolic processes.

Formaldehyde sources in the home include pressed-wood products such as particleboard and plywood, glues and adhesives, permanent press fabrics, cigarette smoke, and fuel-burning appliances. In addition, formaldehyde is commonly used as an industrial fungicide, germicide, and disinfectant, and as a preservative in mortuaries and medical laboratories.

Research studies of workers exposed to formaldehyde have suggested an association between formaldehyde exposure and several cancers, including nasopharyngeal cancer and leukemia.

Reducing Formaldehyde Exposure:

  •         Use “exterior-grade” pressed-wood products to limit formaldehyde exposure in the home.
  •         Ensure adequate ventilation and moderate temperatures.
  •         Reduce humidity levels with air conditioners and dehumidifiers.
  •         Go natural and grow plants in your home.

What Is Benzene?

Benzene is a colourless liquid that evaporates quickly. It is naturally found in crude oil and is a basic petrochemical (Petrochemicals are endocrine disruptors.) It is also a known human carcinogen.

Substantial amounts of data link benzene to aplastic anemia, bone marrow abnormalities, and leukemia — particularly acute myeloid leukemia (AML) and acute non-lymphocytic leukemia (ANLL).

Benzene is found in tobacco smoke, gasoline (think car exhaust), pesticides, synthetic fibers, plastics, inks, oils, and detergents.

Benzene has also been found in some dryer emissions from scented laundry detergent and dryer sheets

It has been in soft drinks, although they have since reformulated to exclude it.

About 50% of the benzene exposure in the US results from smoking tobacco or from second-hand smoke.

Reducing Benzene Exposure:

  •         Don’t smoke and try to avoid second hand smoke.
  •         Ensure adequate ventilation in your home.
  •         Use non-scented laundry detergents.
  •         Keep plants in the home.

Poison is in the dose. Environmental toxins cause serious health concerns when there is an accumulated exposure. The more prolonged or excessive the exposure is, the worse the effect.

Ironically, prolonged, acute stress can also disrupt endocrine function, cause organ failure, hinder development and is implicated in cancer! So don’t stress out about all these toxins in your environment.

Using a plastic cup every once in a while is not going to kill you.

It’s impossible to completely avoid exposure to known human carcinogens.

However, a few simple steps can go a long way towards protecting you and your loved ones.

*Don’t smoke.

*Don’t expose yourself to secondhand smoke.

*Get your home air and water checked for radon.

*Use a water filter. An air filter is great too.

*Check your home for asbestos materials.

*Keep your home well-ventilated.

*Use less products with “fragrance” as a listed ingredient.

*Keep plenty of plants in your home.

*Decrease use of plastic. Transition to glass, stainless steel, and porcelain containers, mugs and glasses.

*Eat more organic poultry and produce. Wash all produce. If possible, purchase only organic options from the Dirty Dozen.

*Transition to less processed foods and products. The less processed, the better.

   There’s no need to freak out over occasional exposure to environmental toxins. Just look for simple ways to reduce your everyday exposure. Make changes slowly, one at a time, in a manageable way, and you will decrease your risk with minimal stress to yourself and others.

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We are MedWaste Management – California’s medical waste disposal experts!

Established in 2008, MedWaste Management brings great benefit to the healthcare industry and the general public alike. We publish this blog to to spread useful and practical information to help people stay safe, smart and healthy!

Call us with any questions or to start service at (866) 254-5105. We are always happy to speak!

Check out our services and other great resources in the links below.

Medical Waste Disposal Services 

MedWaste’s Blog Index

Medical Waste Regulations

MedWaste’s Products Store 

Home Generated Medical Waste Drop-Off Points In California

man behind mask

Doctor, I’m Just Not Myself.

Medical Identity Theft is on the rise.

Security experts say that cyber criminals are increasingly targeting the $3 trillion U.S. healthcare industry. 

According to a survey by the Ponemon Institute Think Tank, the percentage of reported criminal cyber attacks on healthcare organizations has risen to 40 percent in 2013 from 20 percent in 2009.

What Are They Doing with the Stolen Data?

Typically, medical fraud scams involve provider billing and over billing.

You probably heard about medical billing scams. That’s because government and health insurance providers have a checks and balances system of sort in place to prevent fraudulent billing, and they catch it quickly. Then they report it. Then the media gets a whiff of it. They we hear all about it.

Other sorts of Medical Identity Theft are not identified so quickly by a patient or their provider, giving criminals years to milk credentials.

Medical data is more valuable to fraudster than credit cards, which tend to be quickly canceled by banks once the fraud is detected.

Take Ronnie Bogle, a museum supervisor from San Jose, California. He had his medical identity stolen for more than a decade, across several states.

His brother  Gary was stealing his identity to get healthcare.

Gary had a simple routine. He’d move to a new place, get a photo ID, then present the ID along with Ronnie’s Social Security number at hospitals and clinics to get treatment. He often claimed to be uninsured when he sought care. After treatment, the bills got sent to his house, not Ronnie’s.

Ronnie discovered what Gary was up to when he applied for a new credit card. He was turned down. His credit report had a lot of unpaid debts- from his brother’s hospital visits and treatments over the years.

“He destroyed my credit history multiple times,” Ronnie said.

It took Ronnie Bogle two years to straighten out his credit card and get his brother’s bills off his financial record. Eventually, Gary was arrested and pleaded guilty to 10 counts of criminal impersonation in California. He’s facing more charges in Washington state for allegedly stealing his brother’s identity there, too.

Here’s some other ideas on what Medical ID thieves can do with your data:

  1. They can bill your health plan for fake or inflated treatment claims. This kind of fraud is called Insider Fraud, because the crooks are usually employees inside the healthcare system who know how the billing system works.
  2. They can get medical treatment for free, courtesy of your policy. They take on your identity, go to the Doctor, Hospital, or Clinic, and the bills get sent to your health insurance provider.
  3. They can obtain drugs. Medical personnel with access to your data can use your identity to get prescription drugs to sell or use themselves. For example, pharmacists can bill your policy for narcotics. Nurses can call in a prescription in your name, then pick it up themselves.
  4. They can sell your patient information on the black market.
  5. They can set up fake clinics using the data stolen from many patients, then bill insurance companies for fake treatments. They can buy medical equipment for the fake clinic, then sell it on the black market.

  6. They can mess up your credit and your finances.
  7. The most dangerous aspect of medical identity fraud is when the thief’s record, history and diagnosis get mixed up with your records, delaying, tainting, and complicating your own care, even causing you to receive erroneous treatment if you need a hospital or clinic, based on the information in your file that’s about them, not you.

Imagine if a Medical Data thief uses your stolen insurance card to get diagnsis or treatment for diabetes. Your Doctor is going to want to see your toes the next time you come in.

Or, in a more extreme version, if a pregnant woman uses stolen data to get maternity care at the hospital near your home, you may be charged with neglecting “your” baby.

This is what happened to Anndorie Cromar.

The woman used Cromar’s data to sign into the maternity ward in a hospital near Cromar’s home. The baby was born with drugs in her system and Child Services were alerted. The State went after Cromar and threatened to take away the rest of her kids. She had to take a DNA test to get her name off of the infant’s birth certificate. The rest of her records took years to correct.

47 percent of victims of Medical Identity Theft that participated in a study by the Ponemon Institute said that their identity theft was perpetrated by a relative or someone else they knew. Twenty-four percent said they had a situation like Bogle’s, where a relative stole their identity without their knowledge or consent. Surprisingly, an additional 23 percent of respondents said they willingly shared their credentials with someone they knew. 

It’s “Friendly Fraud.”

Of those who said they shared healthcare credentials that way, 91 percent reported that
it was because the other person had no health insurance.

86 percent said it was because the other person couldn’t afford medical treatment.

Sixty-five percent said it was done in an emergency.

Unlike financial identity theft, there’s no straightforward process for challenging false medical claims or correcting inaccurate medical records.

If a thug steals your wallet and runs up your credit cards with expenditures, there are systems in place to keep it simple.

You need to request that the three major credit bureaus provide you a free credit report, place a fraud alert on your accounts, and work with your creditors to get inaccurate charges removed.

Identity theft is often discovered early on the financial side because credit card issuers have sophisticated systems for detecting fraud. Also, nearly all financial institutions use one or more of the three credit reporting agencies. There’s a centralized data base so it’s easier to track for fraud.

With medical identity theft, it’s not that simple. Your medical records are likely to be interspersed among a number of different providers, and there’s no merged or even single “medical records clearinghouse” that keeps them. You probably don’t have a complete copy of all your medical records. You can get a copy, but you may have to pay for it. When there’s an error on your record, you can add a correction, but you can’t delete any of it. 

Ironically, if you suspect that you are a victim of Medical Identity Theft, you may not be granted access to your own records. Once they are intermingled with another patient’s records, that person’s privacy must be protected under HIPAA.

Ponemon Institute found that it took an average of more than three months for victims to even detect the fraud and more than 200 hours to undo the mess.

65 percent of the medical identity theft victims surveyed by Ponemon said they spent an average of $13,500 to pay the healthcare bills run up in their name, to recover their health insurance, and to pay lawyer’s fees, among other things.

Prevention Is Easier:

  1. Read the Explanation of Benefits, or EOB, statement that your insurance provider sends you after you’ve received covered treatment. Confirm that the information about the date of service, type of service provided, and the provider are all correct.
  2. Request a complete list of payments made from your health insurance company on an annual basis. Review it.
  3. Be Aware when you are at the doctor’s office or pharmacy.
  4. Just like when you are using a credit card, pay attention to who’s nearby when you’re giving the staff your insurance card.

  5. Don’t leave your medical insurance card sitting around  for others to see.
  6. Shred documents associated with your health insurance, especially those containing your account number and personal information.
  7. Periodically, check for discrepancies with the Medical Information Bureau (MIB).  The MIB is like a “credit bureau” for health-related personal information. It has a comprehensive list of insurance companies that belong to it. Any time an individual applies for life or health insurance, this information is probably reported to the MIB.
  8. Get a current copy of your medical records. Most Doctor’s offices will be able to easily provide records for the last couple of years. For a full file, you may need to pay. Keep them in case they are tampered with in the future.
  9. Exercise your right for a free annual copy of your credit report.  Most Medical Identity Theft is noticed when the claim makes the transition to the billing department. If you have an unpaid medical bill on your credit report that you don’t recognize, you’ve probably a victim of Medical Identity Theft.
  1. Don’t post news of an upcoming surgery on Facebook or other social media outlets.

  2.  A good rule of thumb for social media in general is, if you’re not comfortable having the information plastered on a billboard, don’t put in out there on the World Wide Web.

The more interaction you have with the healthcare system, the more vigilant you ought to be. Some people are more susceptible to Medical Identity Theft than others. People on Medicare, whose Social Security number is on their medical card, are a gateway to all kinds of fraud. Older people are more susceptible to scams because they tend to give away personal health information  indiscriminately. Children’s health records are very attractive to Medical Identity Fraudsters, because a child is not likely to be checking their credit report for a while, so unpaid medical debts can go unnoticed for longer. New mothers, surgery patients, and people with chronic conditions like diabetes – or serious illnesses, like cancer, are also vulnerable, because they interact with the system a lot. The more interaction you have with the healthcare system, the more opportunity there is for records to be breached. Last but not least, millenials and anyone who casually posts a lot of personal information online. Medical Identity Fraudsters are very good at collecting information from social media or other apps and putting it together with other data they have on you, like an address or date of birth.

What to Do If You Are a Victim of Medical Identity Theft:

  1. File a police report.  Send a copy of the report to your insurer, medical providers and all credit bureaus.
  2. Call your insurance company.  You will be put in contact with the fraud department. They’ll disable your health insurance account, give you a new account and card, and assist you with the process of dealing with any billing, collections or records issues.
  3. Request access to your medical records.  If you even suspect you’re a victim of Medical Identity Theft, get a copy of your records from your doctor, hospital, pharmacy or laboratory. Correct errors immediately.
  4. Contact the three major credit bureaus, your bank or financial institutions, and your credit card issuers.  Inform them that your medical identity has been stolen. Place a fraud alert and freeze your credit so the scam doesn’t complicate your credit score any further.
  5. File a medical identify theft complaint.  File a complaint with the Federal Trade Commission (FTC) or call the FTC’s toll free hotline at (877) IDTHEFT.
  6. If you are refused access to your medical records, appeal.  To appeal, follow the steps outlined in your medical provider’s notice of privacy practices. If you still aren’t satisfied, file a health-privacy complaint with the U.S. Department of Health and Human Services or call 1-800-368-1019.

The effects of Medical Identity Theft are far-reaching, costing the victims time, money and aggravation. Awareness is growing by the day. In terms of prevention and support, there is more work to be done to safeguard healthcare consumers from Medical Identity Theft. Experts are working on new ways to prevent it. They are using software that prevents fraud in billing and training staff and consumers to notice warning signs and ask for photo IDs.

There will be more extensive verification screening in the future, like the use of fingerprints.

Hopefully, in the future, we will see a decline in the occurence of Medical Identity Theft with minimal inconvenience to Doctors, patients, and insurance companies.

_______

We are MedWaste Management – California’s medical waste disposal experts!

Established in 2008, MedWaste Management brings great benefit to the healthcare industry and the general public alike. We publish this blog to to spread useful and practical information to help people stay safe, smart and healthy!

Call us with any questions or to start service at (866) 254-5105. We are always happy to speak!

Check out our services and other great resources in the links below.

Medical Waste Disposal Services 

MedWaste’s Blog Index

Medical Waste Regulations

Medical Waste Products 

Home Generated Medical Waste Drop-Off Points In California

blood pressure meter

Product Recall: Valsartan

Teva Pharmaceuticals USA today confirmed a voluntary recall to the consumer / user level of 29 lots of single and 51 lots of combination valsartan medicines .

The products subject to recall  are packed in bottles. These lots were distributed Nationwide to Teva’s Direct Accounts (Wholesale/Distributor/Retail/Repackagers/VA Pharmacy, et. al).

These were distributed under the Actavis label in the U.S. They are being recalled due to the detection of trace amounts of an unexpected impurity found in an active pharmaceutical ingredient (API) that was manufactured by Zhejiang Huahai Pharmaceutical.

Teva is not the only company to recall Valsartan. Major Pharmaceuticals, and Solco Healthcare are also recalling Valsartan/ Hydrochlorothiazide due to the same impurity detected.

The FDA action came after 22 other countries issued recalls involving 2,300 valsartan batches sent to Germany, Norway, Finland, Sweden, Hungary, the Netherlands, Austria, Ireland, Bulgaria, Italy, Spain, Portugal, Belgium, France, Poland, Croatia, Lithuania, Greece, Canada, Bosnia and Herzegovina, Bahrain and Malta.

What Is Valsartan?

Valsartan is used for the treatment of hypertension (high blood pressure) and for the treatment of heart failure. It is also indicated as a treatment for left ventricular failure and left ventricular dysfunction following myocardial infarction. In combination with hydrochlorothiazide, it is used in the treatment of hypertension.

Why Is It Being Recalled?

The impurity detected in the API is N- nitrosodimethylamine (NDMA), which is a substance that occurs naturally in certain foods, drinking water, air pollution,  and industrial processes. It can be used to make liquid rocket fuel, softeners and lubricants, among other products. It can also be unintentionally produced through certain chemical reactions and is a byproduct from some pesticide manufacturing, the making of rubber tires or fish processing.a

N- nitrosodimethylamine (NDMA) has been classified as a probable human carcinogen as per International Agency for Research on Cancer (IARC) classification.

The toxin affects the liver and causes liver fibrosis or scarring and liver tumors in rats.Exposure to high levels of NDMA may cause liver damage in humans, according to the US Environmental Protection Agency.

To date, TEVA has not received any reports of adverse events related to this recall.

What Should You Do?

Don’t stop taking your blood pressure meds!!

First of all, not all medicines containing valsartan are involved in the recall.

Check the FDA recall site or call your pharmacy to find out if the bottle you have is from a contaminated lot before taking further action.

Valsartan alternatives are available.

Patients should contact their pharmacist or physician who can advise them about an alternative treatment prior to returning their medication. Patients who are on valsartan should continue taking their medication, as the risk of harm to a patient’s health may be higher if the treatment is stopped immediately without any alternative treatment.

Questions, concerns, adverse reactions or quality problems experienced with the use of this product may be reported to Teva directly at 888- 838-2872 or to the FDA’s MedWatch Adverse Event Reporting program either online, by regular mail or by fax.

_________

We are MedWaste Management – California’s medical waste disposal experts!

Established in 2008, MedWaste Management brings great benefit to the healthcare industry and the general public alike. We publish this blog to to spread useful and practical information to help people stay safe, smart and healthy!

Call us with any questions or to start service at (866) 254-5105. We are always happy to speak!

Check out our services and other great resources in the links below.

Medical Waste Disposal Services 

MedWaste’s Blog Index

Medical Waste Regulations

Medical Waste Products 

Home Generated Medical Waste Drop-Off Points In California

 

 

e-cigarette, vaping

The Scoop on E-Cigarettes

E-cigarettes are battery-operated devices that  look like a real cigarette: kind of pen-shaped. Some look a bit different- those with refillable tanks, for example .

There are nearly 500 brands of e-cigarettes on the market, in more than 7,000 flavors.

All brands have the same basic mechanism:

  • They have containers filled with liquid, ingredients vary with the brand or type.
  • A heating device turns the liquid into vapor that you inhale when you take a drag.

Using an e-cigarette is  called “vaping.”

Are They Safe?

The FDA was given the power to regulate the manufacturing, labeling, distribution and marketing of all tobacco products in 2009 when President Obama signed into law the Family Smoking Prevention and Tobacco Control Act and in 2010 a court ruled that the FDA could regulate e-cigarettes as tobacco products.

It wasn’t until 2016 that the FDA finally announced a rule to regulate e-cigarettes. Under the final rule, the FDA plans to ban the sale of e-cigarettes to anyone under the age of 18.  The rule also requires all makers of e-cigarettes sold after February 15, 2007 to go through a “premarket review.” This is the process that the FDA uses to determine whether potentially risky products are safe. However, companies are allowed to have anywhere from 18 months to two years to prepare their applications. And it will take another year for the FDA to actually approve these applications. So don’t expect e-cigarettes currently on the market to be officially allowed to be sold by the FDA for another couple of years.

The popularity of electronic cigarettes  has outpaced available scientific data.

Research is still preliminary and answers may vary slightly. Overall, here are some points all experts agree on.

E-cigarettes are not safe, regardless of how they are marketed to appear to the public. Yes, they may be safer than conventional cigarettes, but they are not safe on their own merit.

The e-cig works by heating a liquid to generate an aerosol (we call it “vapor”) that is inhaled by the user. The e-liquid in the cigarette (or “e-juice”) is commonly made of nicotine, propylene glycol, glycerine and flavorings.

E-cigarette users who use e-cigarettes that contain nicotine are exposed to its potentially harmful effects. Nicotine is associated with cardiovascular disease, potential birth defects, and poisoning, among other deleterious effects.

Normal usage of e-cigarettes generates low levels of formaldehyde.

Degraded products will produce very high levels of formaldehyde in the vapor. Most users will detect the degradation and avoid using the degraded product, but there is still a slight risk.

Formaldehyde is a well-known carcinogen. Exact measurements have not been established. Too much formaldehyde inhalation will cause respiratory symptoms like itchy nose and throat, coughing, and nosebleeds. It may be implicated in respiratory diseases like asthma. A little exposure once in a while will usually fade, but continuous exposure to high levels of formaldehyde might increase the chance of getting cancer even at levels too low to cause noticeable symptoms. 

Metal parts of e-cigarettes in contact with the e-liquid can contaminate it with heavy metal toxins. 

One of the flavors used in e-cigs is diacetyl, a harmful chemical which causes a lung disease known as ‘popcorn lung’, among other harmful effects.

No long-term data is available on the overall effects of e-cigs on the lungs. In particular, the effects in people with respiratory diseases are still unknown. “No long term data” does not equal, “Safe to Inhale!” It merely states that there is no current information.

According to a study by VA San Diego Healthcare System and UC San Diego researchers, human cells exposed to the e-cigarette vapor showed several forms of damage, including DNA strand breaks. When the  DNA is harmed and the cellular repair process doesn’t work right, it raises the risk of cancer. The affected cells were also more likely to launch into apoptosis and necrosis, which lead to cell death. The team used normal epithelial cells, which line organs, glands, and cavities throughout the body, including the mouth and lungs.

The San Diego team found that the nicotine versions caused worse damage, but even the nicotine-free vapor was enough to damage cells. Nicotine free e-cigarettes caused 50 per cent more DNA breaks, while those containing nicotine raised the damage margin three fold.

They were able to identify that e-cigarettes on the whole have something to do with increased cell death but not necessarily the individual components that are contributing to the effect.

There is limited information available on the environmental issues around production, use, and disposal of e-cigarette cartridges. A 2014 review recommended that e-cigarettes should be regulated for consumer safety.

There is a concern that some of the mainstream vapor exhaled by e-cigarette users can be inhaled by bystanders, particularly indoors.

The liquid used in e-cigarettes is highly concentrated, so absorbing it through the skin or swallowing it is far more likely to require an emergency room visit than eating or swallowing regular cigarettes.

In 2012, less than 50 kids under the age of six were reported to poison control hotlines per month because of e-cigarettes. In 2015, that number rose to about 200 children a month, nearly half of which were under the age of two.

Is Vaping Better Than Smoking?’

E-cigarettes aren’t thought of as 100% safe, but most experts think they’re less dangerous than cigarettes, says Neal Benowitz, MD, a nicotine researcher at the University of California at San Francisco.

Tobacco smoke contains 100 known carcinogens, and 900 potentially cancer causing chemicals, none of which has been found in more than trace quantities in e-cigarette vapor.

Those present are mostly below 1% of the corresponding levels in tobacco smoke   Another review found that compared with cigarettes, e-cigarettes are likely to be much less, if at all, harmful to users or bystanders.

The e-cigarette aerosol can contain toxicants and traces of heavy metals at levels permissible in inhalation medicines, and potentially harmful chemicals not found in tobacco smoke- at concentrations permissible by workplace safety standards.

When vaping, there is no ash, tar, carbon and carbon monoxide entering inhaler’s lungs. However, chemical concentrations may exceed the stricter public safety limits. There is considerable variation between vaporizers in terms of quality of their liquid ingredients and thus the contents of the vapor.

A study funded by Cancer Research UK showed that when smokers switched completely to e-cigarettes, bodily level exposure to established and important smoking-related carcinogens and toxicants was reduced by between 56 percent to 97 percent.

 E-cigarettes are a safer alternative to smoking tobacco in the context of developing smoking-related cancer.

(Dual smokers and vapers, who vape where smoking is prohibited but smoke regular cigarettes as well, saw very different results. Vaping and smoking did not lower the level of toxins in the body and also had too many variables to produce entirely accurate study results.)

Dr. Lion Shahab reported that according to the study, smokers who switched entirely to e-cigarettes cut their intake of toxins and carcinogens. Levels of nicotine — the addictive ingredient in cigarettes — remained constant, but their intake of cancer-causing chemicals fell to levels found in people using nicotine-replacement therapies. E-cigs reduced toxin intake at a level comparable to those who quit smoking by using nicotine replacements like the patch, gum or lozenges.

Proffessor Kevin Fenton, National Director Health & Wellbeing at PHE, agrees: “Public Health England has always been clear that e-cigarettes are not 100 per cent safe, but our major world leading review, published recently, found that e-cigarettes carry a fraction of the risk of smoking.”

“Electronic cigarettes are a much safer alternative source of nicotine for smokers than cigarettes, but that doesn’t mean they are risk free and we would discourage anyone who’s not a smoker from using them,” says Kenneth Warner, a tobacco policy researcher at the University of Michigan. “The worst critics of e-cigarettes would probably argue they’re a half to two-thirds less dangerous. But from a practical view, they’re probably on the order of 80% to 85% less dangerous, at least.”

Can They Help Me Quit Smoking?

“We don’t have the definitive study on that,” Warner says. “My reading of the evidence is that it is quite convincing that e-cigarettes are helping some people quit smoking.”

The American Heart Association says e-cigarettes should only be used as a last resort way to quit.

There is research that supports the idea that e-cigarettes can reduce smoking urges and help motivated smokers quit.

Last year, two out of three smokers who combined e-cigarettes with expert support from a local service quit successfully.

E-cigs have been shown to be as effective as nicotine inhalers in reducing both craving and withdrawals effects. Another study found that e-cigs may be comparable, but not more effective, than other methods for smoking cessation, like nicotine patches and even placebo e-cigs.

Whether e-cigs can safely help people quit smoking remains to be seen. 

“We don’t know what is in e-cigarette vapor because the devices haven’t yet been fully regulated by the FDA,” says Norman H. Edelman MD, of the American Lung Association. “If you want to stop smoking, you may as well use an FDA-approved nicotine replacement, such as the patch or the lozenge. You can have more confidence because it’s been analyzed by the FDA, while e-cigarettes haven’t been analyzed by the FDA.”

Since e-cig manufacturers have not submitted an application to the FDA for their use in smoking cessation, e-cigs are not currently FDA-approved for such use

According to the FDA, there’s no evidence any e-cigarette is safe and effective at helping smokers quit.

The best thing a smoker can do is quit completely now and forever. The best way to succeed is to get help from your local stop smoking service. Smokers who have struggled to quit in the past could try vaping, and vapers should stop smoking.

Talk to your doctor about medications and other strategies that are proven stop-smoking tools. And if you need help quitting or reducing the number of cigarettes you are smoking, check out the smokefree.gov website.

_______

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Product Recall: MyNicNaxs.com

MyNicNaxs, LLC, Deltona, FL is voluntarily recalling all lots of dietary supplements distributed nationwide to consumers and stores. All lots means every bottle that went out of their warehouse, of every product they were selling.

Unfortunately, they are not the first company who needed to recall weight loss and sexual enhancement products. These niches seem to be rife with undeclared, misleading, and plain dangerous pills. Dozens of weight-loss and immune-system supplements on the market are illegally labeled and lack the recommended type of scientific evidence to back up their purported health claims.

Cautionary Tale

MyNicNaxs, LLC, Deltona, FL, is- or was- a company selling both dietary supplements for weight loss and sexual enhancement. Unfortunately, the dietary supplement (or “chinese medicine”) was  a misleading name for products that contained undeclared active pharmaceutical ingredients.

Drugs, in other words.

The FDA went to court to complain. First, they alleged that certain MyNicNaxs products are drugs under the FD&C Act because they are intended to cure, mitigate, treat or prevent disease.

Second, the drugs were misbranded because their labeling was false and misleading in that it didn’t  declare certain active pharmaceutical ingredients. The labeling failed to bear adequate directions for use, and/or the drugs are dangerous to health when used as recommended in the labeling.

The following permanent injuction required the defendants to stop distributing any unapproved new drugs or misbranded drugs. They were prohibited from receiving, manufacturing, holding and distributing any drugs or dietary supplements until the FDA puts out a written notification that they are in compliance of the FD&C Act and its regulations, and that they may resume operations.

The MyNicNax website is down, but the pinterest account is still up with photos of the products and promotional photos.

Harmful Substances

The FDA discovered the presence of Sildenafil, Sibutramine, Diclofenac and/or Phenolphthalein in the dietary supplements. This rendered the supplements as an unapproved drug for which safety and efficacy have not been established.

These products were distributed from January 2013, to December 2017, though the website http://www.mynicnaxs.com.

The undeclared drugs can cause serious health risk. A)Some of them are cancerous, and B)Taking drugs unknowingly can interfere and interact with other drugs the person is taking. Or can expose the consumer to a drug that is harmful or dangerous in their particular situation… a drug they would never take if they knew it was in the magic pill.

The following drugs were detected in the products:

Sibutramine is the active pharmaceutical ingredient in Meridia, a new drug approved by FDA for marketing in 1997 for prescription treatment of obesity and, subsequently, withdrawn from the U.S. market on December 21, 2010, after clinical data indicated Sibutramine poses an increased risk of heart attack and stroke.

Phenolphthalein is a known carcinogen (cancer causing agent) It was once an ingredient used in over-the-counter laxatives. It is no longer approved for marketing in the United States.

Sildenafil is the active pharmaceutical ingredient in Viagra (PDE-5 inhibitor), a drug approved by FDA for the treatment of erectile dysfunction. PDE-5 inhibitors may interact with nitrates found in some prescription drugs (such as nitroglycerin). PDE-5 inhibitors can lower blood pressure to dangerous levels.

Diclofenac is a non-steroidal anti-inflammatory drugs (NSAIDs) found in FDA-approved drugs that are used to treat pain and inflammation associated with several conditions. NSAIDs could lead to serious GI trouble, like bleeding, ulceration, and fatal perforation of the stomach and intestines.

Patients who are already taking medication that could cause bleeding may increase their risk for bleeding significantly.

This is a list of all the website products, as listed on the FDA website: 26 products in all that did not disclose drugs in the ingredient list on the bottle.

Product Description API Found in FDA Lab Results
Platinum Maximum Strength Blue Pill Version;
30 capsules; 500mg each
Sibutramine and Phenolphthalein
Platinum Maximum Strength Blue Pill Version;
30 capsules; 500mg each
Sibutramine and Phenolphthalein
Slimming Plus Advanced Weight Loss; 30
capsules; 500mg each
Sibutramine and Phenolphthalein
African Viagra – sexual performance
enhancement product; 4500mg x 2
Sildenafil
GINSENG – sexual performance enhancement
product; 300mg/tablet x 10 tablets
Sildenafi
African Superman – sexual performance
enhancement product; 2900mg x 8 tablets per
blister pack
Sildenafil
Old Chinese – sexual performance enhancement
product; 19800mg x 10 capsules
Sildenafil
Lean Extreme Max; 30 capsules; 400mg each Sibutramine
X-treme Beauty Slim; 30 capsules; 350mg each Sibutramine
African Superman – Top-Class Permanence
Tablet; 2900mg x 8 tablets
Sildenafil
Slim Evolution – 100% Natural Ingredients; 30
capsules; 350mg each
Diclofenac
Meizitang Strong Version capsules packed in a
non-flexible clear bottle with a green screw-on
top
Sibutramine
Magic Slim capsules packed in a non-flexible
white bottle with a white screw-on top
Sibutramine
Slim Xtreme capsules packed in a non-flexible
white bottle with a white screw-on top
Sibutramine
Meizi Evolution capsules were packed in a non-
flexible clear bottle with a blue screw-on top
Sibutramine
SlimEasy Herbs capsules packed in blister
packaging and placed in a white box with black
labeling
Sibutramine
Hokkaido – capsules packed in blister packaging
in pink box with black labeling
Phenolphthalein
Super Fat Burning Bomb capsules in blister
packs, packaged in a red box with black labeling
Sibutramine and Phenolphthalein
FRUTA Bio blister packs, packaged in a
yellow/green box with green labeling
Sibutramine and Phenolphthalein
JIANFEIJINDAN Activity Girl – blister packs,
packaged in a white/pink box with pink labeling
Sibutramine
Reduce Weight FRUTA PLANTA blister packs,
packaged in a yellow/green box with green
labeling
Phenolphthalein
Fat Loss Slimming Beauty – 30 capsules in
blister packs packaged in yellow/black box -500
mg
Sibutramine and Phenolphthalein
Fruta Planta -blister packs packaged in
yellow/green box with green labeling
Sibutramine and Phenolphthalein
Botanical Slimming – 100% Natural Soft gel; 30 soft gels; 650mg each packaged in a green bag with yellow and white lettering
Slim Body – Dietary Supplement;100% Herbal Slimming Formula; 30 capsules; 6x5x300mg blister packs, packaged in blue and red box

If you have bought any of these products, you are advised to immediately discontinue use.

There have been no reports of adverse effects so far. If you think you have experienced adverse effects, speak to your health care provider immediately. You should also report to the FDA MedWatch Adverse Event Reporting Program by filling out the online form, or sending the form by regular mail or fax.

For any questions regarding this recall, contact Mike Banner by phone 407-791-3597 or Chevonne Torres 386-337-8142, Monday to Friday, 09:00am-5:00 pm, Eastern Time.