THIS QUESTION IS FOR ALL THE HEAD NURSES, NURSES IN HD UNITS AROUND THE COUNTRY. I WORK IN A CENTER IN QUEENS NY; OUR NURSE ARE INSTRUCTED TO USE EPOGEN SINGLE VIALS FOR MORE THAN ONE PATIENT. WE HAVE FORMULA WHICH IS USED, FOR EXAMPLE IF A PATIENT'S ORDERS 6000U THE NURSE DIVIDES THE AMT BY 4.4; THE RESULTS OF THIS CALCULATON IS WHAT THE PATIENT RECIEVES. I DO NOT BELIEVE THE CORRECT DOSE IS GIVEN. OUR CENTER USES 4000U VIAL SINGLE DOSE, AND 20000 MULTI DOSE VIALS. ON TOP OF THIS I BELIEVE THE PATIENTS ARE GETTING BILLED FOR EACH VIAL AS IF THEY WERE GETTING THE COMPLETE AMOUNT. CAN ANYONE RELATE SIMILAR EXPIRENCE OR ADVISED ON WHO TO CONTACT NEXT. THANK YOU...CONCERNED RN NY

I can't speak about dosing or billing but there have been several outbreaks for septicemia due to pooling of the remaining EPO in a single use vial. There is a preservative in the multi dose vial but not the single.

Call your Department of Health Services that oversees and surveys dialysis units. Call CMS and file a complaint. There are big bonuses for whistleblowers with fraud and willful intent to harm patients. If you give the medication, knowingly what is happening, you are as guilty when it comes out in the open

On our survey by DHS, an immediate jeapordy was called to corred the use of a single vial for multiple patients. The vial clearly states "Single Use". This is a fraud. We are now only multiple use vial unit, and I for one am proud of our company.

CMS is fully aware that single dose vials are reentered. Patients are billed only for units administered not the whole vial. CDC wrote very strick guidelines for reentry of single dose vials after the outbreak of serritia in that clinic that was pooling EPO from multiple vials into one vial and storing it overnight. Do not understand the scenario that Nephrotaz explained.