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CAMC combats shortage of medicine for infants

By Candace Nelson

CHARLESTON, W.Va. - A vital medication that helps the most vulnerable babies is in shortage across the nation and Charleston Area Medical Center's Women and Children's Hospital is feeling the effects.

An intravenous solution of trace elements -- made up of four minerals -- is similar to a multivitamin. It contains zinc, copper, manganese and chromium, and it is that specific combination that's in short supply.

It is administered to babies in the neonatal intensive care unit who are unable to breastfeed or consume formula. The trace elements supply the baby's daily nutrition.

Healthy newborns do not need trace elements, as they are able to get it from breast milk or formula.

"Unfortunately, there is only one manufacturer for the combination product, which is what we use," said Jennifer Gorrell, the director of pharmacy at Women and Children's Hospital.

"It's unclear as to why they're not manufacturing the product anymore. They don't have any in the supply chain, and there is no release date for when they'll produce again."

Gorrell said hospital officials have been dealing with the shortage for several months and realized it would be a long-term problem in February or March.

"Over the past two to three years, it's unfortunately been a trend with medications," Gorrell said. "This is just another shortage we're dealing with. Hundreds of drugs are on the shortage list, and this is one ... We deal with this every day, and we continue to deal.

"We do everything we can to take care of our patients in light of drug shortages," she said. "We have taken measures to conserve what drugs we have and provide to the sickest of sick -- and those tend to be areas in the NICU."

While the hospital prefers to use the combination product that has all four minerals, Gorrell said a six-month supply of each individual component has been secured for future use.

Gorrell said the hospital cannot secure much more than that because of the product expiration dates. Officials also don't want to cause a shortage of the individual components, or take them away from another hospital that may need the medication immediately.

"The convenience of having all four in one product is beneficial," Gorrell said. "But the four individual components are sometimes difficult to obtain. We haven't had that issue yet ... but it's impossible to predict which drugs will and will not be on shortage. There is a concern. But it's something we worry about and face every day."

Gorrell said the most important is the zinc supplement, which helps to promote wound healing and skin development. It's especially important for premature babies, whose skin can be fragile.

"These minerals are all needed for a body to do what it needs to do every day," Gorrell said.

Long-term effects for babies who need the medication but don't receive it include the lack of ability to heal wounds and reproduce skin. There could be longer-term ramifications to the immune system as well, Gorrell said.

As a level-three NICU and the state's only freestanding women and children's hospital, CAMC treats the sickest of the sick babies in the area, she said. The 28-bed intensive care unit is full nearly every day.

In 2011, 401 babies had been through the NICU, which takes newborns from all over southern West Virginia, said CAMC spokesman Dale Witte.

Thomas Memorial Hospital hasn't had to use this particular combination of trace elements, said Paige Johnson, director of marketing and public relations.

At Wednesday's Board of Trustees meeting, Ed Welch, chairman of CAMC's quality committee, brought the issue to the table, noting the severity of the situation.

"One problem we were alerted to was trace elements are given to the neonatal population at Women and Children's," Welch said. "These trace elements are not as available as they were before. So we are now rationing those elements as to who can receive them. The forecast is that sometime this year, they may disappear altogether."

And infants who need these treatments and cannot receive these treatments have long-term lasting negative consequences.

"This obviously is not a CAMC problem; this is a national problem that we do not have sufficient medication available or being produced for us to be able to take care of this population," he said.

For more information on current drug shortages, visit For more information on CAMC, visit

Contact writer Candace Nelson at or 304-348-5148. Follow her at ;


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