Use for expired Epi-pens

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I am imagining that most of you, like me, have a collection of expired Epi-pens or Twinjects. I was recently asked by the head nurse for our school district if she could have them for training purposes. I am keeping a few for my own practice and training purposes, but I am happy to find a use for the others. It seems that the more they have, the more teachers, nurses, and health aids will get to practice. I am thrilled that they are willing to do this.

On Feb 17, 2008

I had never thought of this, either, until the head nurse in our school district asked the same thing of me. She said they give those using it a more realistic idea of how the epipen works vs the trainer that comes with the epipen, which is empty. I was more than happy to share-it kills two birds with one stone; you get rid of the old epipens and it enables others to be trained on usage.

On Feb 17, 2008

I would [i]never[/i] give prescribed medication to someone else. I don't care if it is a nurse. She of all people can figure out the best tools for teaching epi use. But I'm fairly certain that giving injectible medication, even expired, to [b]anyone[/b] else, is [i]illegal[/i]. It is intended for the patient only. I would not want to be responsible for any misuse. That is a potent medication with notable side effects. The company makes a safe trainer available...[i]for training purposes[/i].

Call your state or local officials for dates for collecting old or unused medications. Or simply [i]train[/i] with those meds, every time you have one that expires. I see them as a wonderful tool for OUR family.

Sorry to disagree.

On Feb 17, 2008

I have only had 4 expired epi's so far. Two of them my husband and I used at home (in an orange of course) and the other two went to my daughter's threeschool teacher and assistant. I was there when they practiced but I do not think this illegal. I may be incorrect in that, but the medication was not injected into anyone else. I definetly see these as an important training tool, but I can find plenty of people that come in contact with my daughter that I would want them to have first dibs at the expired epi's, rather than giving them away to "outsiders." (But I don't have a collection of them either.)

We also have trainers, but as wonderful as they are to have, in my opinion, I find it quite different than the feel of the real epi-pen. These have worked great for presentation purposes to pass around and get the feel of, but I was so glad to be able to provide the expired epi's for the teacher and assistant who would probably be the ones to use it at school. Next year I hope to be able to provide her preschool teacher and assistant with expired epi's to practice with.

Kara

On Feb 17, 2008

It's not about whether or not they [i]inject[/i] the medication. It is all about [i]possession[/i]. In most states, it is illegal to simply possess prescribed drugs and not be the person for whom the prescription was written.

The offense of giving someone else a prescribed medication that is yours (your child's) can be called various things....in NY, I [i]think[/i] it's called 'criminal diversion of prescription medication'. But hey, don't take my word for it, google any state and I'm sure you'll find the laws against it.

Why take the liablity, let them use the [i]trainer[/i], it's what it was made for. And at least with the trainer, you can actually practice the entire technique, from symptom recognition to 'giving' the epi (trainer) in the outer thigh.

On Feb 17, 2008

Since the nurse has permission to use these devices per the doctor's orders there would be no criminal activity.

I've demonstrated with the expired epis using an open cardboard box - everyone was fasciated to see the medicine shoot across the inside of the box and see the needle come through.

On Feb 18, 2008

I would not do this. My concern would be LIABILITY if there was any accidental injection (SINCE epi's should never be injected in hands). It is not worth the risk -- and I too am surprised a nurse would agree to this.

On Feb 19, 2008

How can there be liability? You have to leave a fully functioning, up to date epi in their hands to begin with in order to potentially save your childs life don't you? They could accidently inject themselves with that one at any time. The fact that they accept responsibility to inject your daughter in case of exposure would release you from any liability. I think practicing with older ones a great idea

On Feb 19, 2008

krusty is right - it is ILLEGAL to SELL, GIVE or TRANSFER possession of ANY prescription - it is a FEDEREAL OFFENSE! and you can be put in a FEDERAL prision as a result. it doesnt matter if the medicine is injectible, liquid, pill, etc., it is still illegal. even if its just an advil 600mg that you give someone so they dont have to take 3 otc pills, its still illegal. i work at a law firm and if anyone wants to know, id be happy to look up the consequences of "sharing" epis.

i am horrified that people would even consider this, and should probably be reported for it! i agree that for the sake of argument, it is best for people to get the feel of a real epi - but are you kidding?!?!?!

on top of it being illegal to do this, were something to happen and someone was accidentally injected or WORSE, *YOU* could be held criminally and civilly liable for these actions! i will take an example to a *VERY* extreme and highly unlikely outcome, but lets just say for example the nurse stockpiled epis and then administered multiple ones to someone, causing an epinephrine overdose and kills someone. since you supplied some/all of the "murder" weapon, you could be criminally found an accomplice, and civilly you could lose everything from the lawsuit that would obviously arise.

this is the worst idea anyone could have. i agree the trainers dont give you the actual feel, but its close enough that there is absolutley NO reason to share these with others!!!!!

On Feb 20, 2008

Ok,this is something I am no longer even considering doing. I had not given the epipens to the nurse yet. Will definitely not do so now. I called my pharmacy and asked them what to do with the expired epipens. If anyone has used epis they want to get rid of I recommend they do the same. I don't feel like these are safe to stockpile and leave in my house, either. JMO, I do wish they had trainers available that had something like sterile water in it so people could get a feel. Even if they were made available for situations like for school personnel to learn under the supervision of a nurse. I know healthcare professionals learn to give injections by injecting syringes filled with sterile saline into an orange. There is a real difference.

I am thankful that there is even a question of how to get rid of unused expired epipens because it means they did not need to be used!

On Feb 20, 2008

I agree with everything Resa said. Can't think of anything else I need to say!

Thankyou to the above posters for your insight on the legality issues of this. I had never given that a thought although with my other meds I have. For some reason Epipens just "seem" different. (Poor excuse I know)

I too wish for a better way to train people. As always, it is my childs best interest I think about.

Kara

On Feb 20, 2008

i feel comfortable with the trainers. i agree they are not the most ideal, but it will do the trick, and i always remind people its more of a jab than just pushing it, if that makes sense.

i called my pharmacy asking what to do with my expired ones and they literally had NO suggestions (my guess is a liability on their part - ie, if they said use them to get a feel for it and something went wrong, theyre the ones who said try it out). as far as having sterlie water ones... great idea, but again, i would sure HATE to grab the wrong one in an emergency, think i dosed DS with epi but grabbed the no-med one on accident.

in any event... what i did with my expireds was to take them to all of the people that had the best chances of using it (me, mom, his in-home daycare babysitter), and took a lemon (i have a gigantic lemon tree, it came in handy what can i say?) and gave one to each. its been awhile since id actually used one (i had to administer one to a child i babysat probably 5-6 years ago)... and i forgot how freakin scary they sound! hardcore stuff, lemme tell ya!

On Feb 21, 2008

Originally Posted By: kandebuttahfly

it is ILLEGAL to SELL, GIVE or TRANSFER possession of ANY prescription - it is a FEDEREAL OFFENSE! and you can be put in a FEDERAL prision as a result. it doesnt matter if the medicine is injectible, liquid, pill, etc., it is still illegal. even if its just an advil 600mg that you give someone so they dont have to take 3 otc pills, its still illegal. i work at a law firm and if anyone wants to know, id be happy to look up the consequences of "sharing" epis

Originally Posted By: kandebuttahfly

what i did with my expireds was to take them to all of the people that had the best chances of using it (me, mom, his in-home daycare babysitter), and took a lemon (i have a gigantic lemon tree, it came in handy what can i say?) and gave one to each.

hmmmmm...

On Feb 21, 2008

if what I am gathering is that you're calling me a hipocrite, I would be more than happy to explain further as it seems i didnt clarify properly. I didn't GIVE them to anyone and let them out of my sight for people to do god-knows what with (as was suggested earlier by handing over an arsenal to a nurse who will do who-knows what with). I watched as each epi was safely discharged and i PERSONALLY disposed of them in a safe and acceptable manner. for starters, there is no difference in myself and mom mom administering the epi, as we both live with my PA child who is too young to administer it himself. secondly as for the sitter, *I* discharged the epi in front of her and showed her how to properly dispose of it. Hopefully that clarifies any miscommunication that may have transpired.

and furthermore, none of these people work for a government agency which should KNOW better than to request prescription drugs if not for the liability issues alone!!!!!

On Feb 21, 2008

Originally Posted By: kandebuttahfly

I didn't GIVE them to anyone and let them out of my sight ..... I watched as each epi was safely discharged

Originally Posted By: kandebuttahfly

for starters, there is no difference in myself and mom mom administering the epi, as we both live with my PA child who is too young to administer it himself.

I'm a little confused. Exactly when does it become a FEDERAL OFFENSE then, when the epi leaves your sight? Is that what the law states? Is it ok to give to Mom but not Grandma or Teacher or Care Giver or School Nurse? I guess I would like some legal clarification on that. We give our epis (non-expired) to whomever is currently watching our 3yo daughter and I would hate to be in danger of being thrown in FEDERAL PRISON.

TH

On Feb 22, 2008

you may not hand over ANY medicine for any purpose other than it is intended to anyone other than the prescribee. obviously a 3 year old can not self-administer an epi, in which case it is more than acceptable to give it to the caretaker, but ONLY for use as needed! you cant just give someone something for other purposes (ie a nurse for training purposes).

myself and my mom are kam's primary caregivers as he and i live with grandma. let me try to use an example with a diff medicine - lets say your child was on antibiotics for an ear infection, obviously it is okay to send the meds to daycare for the teachers/director to give him/her at lunchtime. that being said - lets say you didnt finish your round of antibiotics (which hopefully everyone knows is BAD anyways), but would you just leave it at school, share with someone else or give it to the nurse so she can perfect her medicine measuring skills? what would happen if there was a mixup in the nurses office a couple weeks later and your old penicillen just got given to another child instead of their prescribed amoxycillan and that child had an allergic reaction? bad for kid, bad for nurse, REALLY bad for school district! as i hopefully made it perfectly clear earlier, these are VERY DRAMATIC examples and im sure it wouldnt happen, but i guess in the instance i mentioned before, you could theoretically be held liable for it. that being said, would you actually have charges pressed for nt picking up the rest of your unused antibiotics? probably not... but i would imagine if something went afoul with injectible meds that affect the (nervous? respiratory? circulatory?? - im new to the whole epi world so i dont know what specifically it targets)... it *may* be a different story. my mom always made me get 250,000/500,000 coverage for my auto insurance because if something bad ever happened, she didnt wanna lose her house, etc... i always thought she was being a paranoid freak and that couldnt happen, until i started working here, (doing insurance defense) and people would lose their cars, homes, property, have wages garnished, etc., all because of *careless* mistakes. every single person on this board knows that a careless and often times well-intentioned mistake can be life threatening, if not fatal - it seems like just about everyone has had an all-to-close call with their kids' FAs...imo, better to be safe than sorry - even if it is a stretch that anything could actually happen - why thake the chance?

ps - since i work at a law firm i should prob throw in a disclaimer down here saying im NOT a lawyer, i just work for many. im not a rock star, i just play one on tv :P

On Feb 22, 2008

Thanks for clearing things up for me. I now understand what you are saying about the liability issue if there's an accident - and that's definitely something I will consider from now on. I would, however, also be interested in knowing FOR SURE if giving a used epi to a school nurse was in fact illegal. If it is, then I won't even consider it. If it is strictly a liability issue, well then I can still weigh that risk against the benefit of having my daughter surrounded by "epi-experience" people. I'm not saying I'll do it anymore, but I can't say for sure yet. We all weigh risks against rewards all the time, as I'm sure you know.

Anyways, thanks for your input. TH

On Feb 22, 2008

go grab any prescription for anything from your cabinet - every single prescription container should clearly state somewhere on the warning label that federal law prohibits the sale or transfer of the drug to or for use by anyone other than the patient. (and that means not only the act of transferring, but the other person consuming it as well).

I am swamped at work today, but this should cover the applicable law, and is copy/pasted from the FDA website from sections 4 (law) and 7 (penalties) of prescription drug marketing act, and for the purposes of this conversation giving the epis to the nurse would be considered "trade" or "transfer".

""(c)(1) No person may sell, purchase, or trade or offer to sell, purchase, or trade any drug sample. For purposes of this paragraph and subsection (d), the term 'drug sample' means a unit of a drug, subject to subsection (b),which is not intended to be sold and is intended to promote the sale of the drug. Nothing in this paragraph shall subject an officer or executive of a drug manufacturer or distributor to criminal liability solely because of a sale, purchase, trade, or offer to sell, purchase, or trade in violation of this para- graph by other employees of the manufacturer or distributor. "

"PROHIBITED ACTS.-- Section 301 (21 U.S.C. 331):

"(t) The importation of a drug in violation of section 801(d)(l), the sale, purchase, or trade of a drug or drug sample or the offer to sell, purchase, or trade a drug or drug sample in violation of section 503(c), the sale, purchase, or trade of a coupon, the offer to sell, purchase, or trade such a coupon, or the counterfeiting of such a coupon in violation of section 503(c)(2), the distribution of a drug sample in violation of section 503(d) or the failure to otherwise comply with the requirements of section 503(d), or the distribution of drugs in violation of section 503(e) or the failure to otherwise comply with the requirements of section 503(e).". (b) PENALTIES.-Section 303: "(b)(1) Notwithstanding subsection (a), any person who violates section 301(t) because of an importation of a drug in violation of section 801(d)(l), because of a sale, purchase, or trade of a drug or drug sample or the offer to sell, purchase, or trade a drug or drug sample in violation of section 503(c), because of the sale, purchase, or trade of a coupon, the offer to sell, purchase, or trade such a coupon, or the counterfeiting of such a coupon in violation of section 503(c)(2), or the distribution of drugs in violation of section 503(e)(2)(A) shall be imprisoned for not more than 10 years or fined not more than $250,000, or both

On Feb 23, 2008

I would just like to point out that one should never accept legal advice from an internet message board, whether or not the person providing the information claims to be a lawyer (and I understand the above poster *works* at a law firm and does not claim to be a lawyer).

The above quoted provisions are from the Prescription Drug Marketing Act of 1987. Although technically not part of the law, the Act begins:

"To amend the Federal Food, Drug, and Cosmetic Act to ban the reimportation of drugs produced in the United States, to place restrictions on the distribution of drug samples, to ban certain resales of drugs by hospitals and other health care entities, and for other purposes."

The full text of the amendments can be found here: [url="http://www.fda.gov/opacom/laws/PDMA.html"]FDA Amendments[/url]. Of particular interest is Section 2 "Findings" where Congress makes clear that the concern is the safety of the drug supply and the problem of reimportation of drugs, among other things.

The amendment addresses the issue of drug imporation, "drug samples" and what can/cannot be done with them. Drug samples are specifically defined in the above post and does not apply in these circumstances because epi-pens are intended to be sold (the above language says a drug sample is "a unit of drug...not intended to be sold").

Essentially, all of the language quoted from the Prescription Drug Marketing Act is completely irrelevant to the situation being discussed. That is not to say giving expired epi-pens to a school nurse does not raise legal concerns under some *other* law or statute. But just not the one quoted above.

On Feb 29, 2008

I simply take my expired pens to our Drs office and they go into the sharp medical waste disposal container.

By justlearning on Oct 12, 2010

I have donated my dead mother's meds for cancer to an animal shelter, I was told I could do this by her dr when I asked him what should be done with thousands for dollars in meds that she did not need anymore he said humans could not have them but animals could, I called the shelter they were happy to get it. Should I be in prison? I think not!

By HookwormIsHope on Oct 16, 2010

Wait...You gave the nurse expired EpiPens, and she used them, actually injected the Epinephrine into someone who was not PA, to train them? Why doesn't the trainer work just as well? I'm a little confused...and to me that sounds a little bogus.

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