Birmingham IV Infections Update

The Alabama Department of Public Health and the Centers for Disease Control and Prevention have been investigating the outbreak of Serratia marcescens in five hospitals around Birmingham and one in Prattville. It is linked to bags of TPN, total parenteral nutrition -- a supplement given intravenously to patients too sick to eat -- mixed by Meds IV and sent to those hospitals in January, February and March.

A failure in the sterilization process at a Birmingham pharmacy appears to have caused the infection that sickened 19 people in Alabama hospitals, nine of whom died, the Alabama state health department said Thursday. Investigators found exact matches of the bacteria on a water faucet, a container and a device used to mix intravenous nutritious supplements at Meds IV. But there are still questions about how the contamination occurred.  "We've identified the weak point in the chain where infection occurred," State Health Officer Don Williamson said. "We're now trying to figure out exactly what happened."

Samples of the bacteria were taken from Meds IV's compounding room, grown out and run through a genetic fingerprinting process. The same strain found in the TPN and in 12 patients turned up on the water tap and mixing equipment. Samples weren't available from six patients and one is still in process, the health department said.

S. marcescens also grew from samples taken from a bag of amino acids used to make the TPN, but that culture hasn't been fingerprinted yet. Investigators suspect it will match and was tainted at the pharmacy.
Williamson said Meds IV staff used tap water to wash the mixing vessel before rinsing it with sterile water. Then the amino acid solution, which was mixed from a powder and sterile water, was also contaminated by touching the equipment. That amino acid mixture is supposed to be run through a filter small enough to catch the bacteria, but for some reason, that didn't work. At this point, he said, it's not clear what went wrong, and whether the problem lies in the process itself, a flaw in the filtering equipment or in human error.

Investigators are working with the Alabama Board of Pharmacy and federal Food and Drug Administration to find out more about what went wrong. Williamson said investigators plan to look at patients who received TPN in those six hospitals but did not show signs of infection and is working with the FDA to get samples of other recalled products made by Meds IV. Fortunately, it does not appear that there is any additional contamination.

We are currently investigating this recall and are available for a  free consultation regarding a Meds IV lawsuit. Call 1-866-515-8880 (toll free) or email booths@pittmandutton.com