The two events were described as follows:
In a pain management clinic in Arizona in April, four patients received contrast material and saline combination for radiologic imaging to guide medication needle placement from the same single dose vial.
"Three patients with methicillin-resistant Staphylococcus aureus infections went to a local hospital four and eight days after their outpatient pain remediation procedures," the MMWR says. They required inpatient care for severe infections, including acute mediastinitis, bacterial meningitis, epidural abscess and sepsis. Hospitalization ranged from 9 to 41 days with additional long-term acute care required for one patient," the MMWR report said.
A fourth patient was found deceased at home six days after treatment, and while the cause of death was listed as multiple-drug overdose, "invasive MRSA infection could not be ruled out."
In an orthopedic clinic in Delaware in March, seven patients were hospitalized with septic arthritis or bursitis in their knee, hip, ankle, or thumb, requiring debridement and hospitalization for between three and eight days.
"The reuse of single-dose vials of the anesthetic bupivacaine for multiple patients was the only breach of safe practices identified during the investigation," the MMWR said. "When a national drug shortage disrupted the supply of 10 mL SDVs, office staff members began using 30 mL SDVs of bupivacaine for multiple patients," who each typically required between one and eight mL of anesthetic.