Thursday, November 14, 2019

Fraud and counterfeiting in medical supplies


I've been looking into emergency medical products to control bleeding, following my recent spell in hospital and subsequent developments.  I've been very fortunate to have Kelly Grayson as a friend.  He's not only a very experienced paramedic, he's won national awards in that field, and is about as knowledgeable as you can get as to what works and what doesn't.  He's pointed me in the direction of what I need (tourniquets, larger hemostatic wound dressings, etc.), and I'm in the process of buying it now.

What's astonished me is the amount of fraud and counterfeiting going on in that field.  There are certain types of tourniquet (CAT and SOF, the latter often referred to as SOF-T) that are ubiquitous in the field, and dominate the market.  However, the number of knock-off copies of them is almost unbelievable.  A quick read through customer reviews on Amazon.com shows a number of complaints that what they received is of poor quality or shoddy manufacture, broke in use, etc.  I'm also told by some EMS personnel I know that what they order for use in their ambulances has to be carefully checked and re-checked, particularly when they order a resupply kit rather than individual items.  A number have complained to me that the kits are often filled with the cheapest crap the supplier can find, rather than the "good stuff".

On that subject, I've been advised not to buy a pre-packed kit, because the price is often much higher than if I bought high-quality individual components and packaged them myself.  It seems quality suppliers don't charge like that, but how does a non-expert such as myself know when a supplier is "quality", or less so?

I'm now going to equipment manufacturers' Web sites whenever possible, and getting my information straight from the horse's mouth, so to speak.  I'm also buying what I need direct from them when I can, because even if it costs a few dollars more, I'm guaranteed to get what I paid for, rather than a cheap knock-off product.  I'm building four emergency bleeding control kits, one for each vehicle, one for our home, and one to put in a small "to-go" duffel bag that will be permanently packed, ready for our not infrequent trips.  I thought that sort of care was excessive until a few days ago, when a very small wound took hours (and four dressings) to stop bleeding.  A bigger wound, such as in an auto accident, might kill me rather quickly unless I can control the bleeding at once.  These anticoagulant medications are sure effective, but also very worrying!

Across the medical supplies field, fraud and counterfeiting seem to be a growing problem.  Another example is CPAP masks and components.  Just look at how many customers complain that what they receive is a cheap copy, rather than the real thing, and doesn't work as well.  I had no idea of how prevalent such copying was, but it seems there's big money to be made by the unscrupulous, and they're crowding in.

Anyway, I just thought I'd put this out there.  If you buy or use emergency medical gear for any health problem, you might want to make sure you're getting what you pay for.

Peter

17 comments:

Steve said...

And the important question should be....who is manufacturing these "knock-offs".....the chi-coms?

Steve

Eric Wilner said...

It's been a problem in the electronics business for quite a while; if you're building devices for the demanding sort of customer, you need to manage your supply chain and document the provenance of every fiddly little component that goes into the assembly, because it's amazing what low-margin items get counterfeited.
And a couple of months ago I was shopping for socks on Amazon. Going by the reviews, several vendors are selling counterfeit Under Armour socks. Socks!
Sometimes the legitimate vendors make it easy. If you're shopping for a full-face respirator, you'll find that the 3M products are not only pricey but flagged as "professional use only; not for sale to the general public" - but there are plenty of Chinese knockoffs that look about right, and maybe claim to use the same filters, for sale to anyone, cheap. How well do they seal around your face? Do the filters fit properly, without leakage? No worries! It's not like you'll be using it for anything serious... right?
Yeah, most of this seems to be coming from China; I don't think the government there sees much incentive to police the ethics of its exporters... and Amazon happily hosts pop-up retailers that will disappear before the hordes of angry customers can assemble.
... Maybe look of the Archer series involving counterfeit chemo drugs....

Ray - SoCal said...

And there is the headache of fake reviews on Amazon, both positive and negative.

And the adulteration if many pharmaceutical products that are made in China.

C. S. P. Schofield said...

It’s exactly this kind of commercial shenanigans that causes people to think ”there should be some government agency to oversee this”, without thinking “now, how will adding a layer of officious government stooges help?”

*sigh*

Bob Gibson said...

Thanks for this. When the coagulant powder packs first came on the market a few years back they were IIRC FRN 20/ pack. I just picked some up at Wally World for (again IIRC) FRN 7. Now I gotta double-check . . .

Aesop said...

Amazon is Beyond Thunderdome's BarterTown: rife with people flogging cheap Chicom knock-off counterfeits at full-boat retail.

Don't buy that stuff on Amazon. Period.

There are quality go-to suppliers, or buy direct from manufacturers.
You can also ask the manufacturers who their authorized distributors are. They'll tell you.
Anyone else is selling knock-offs.

Galls, Dixie Medical, BuyEMP.com, and Chinook Medical (and not in that order, if I'm buying) are all reputable re-sellers.
Joe's FlyByNight Medical Supplies that has an Amazon account and no brick-and-mortar location, not so much.

Also, shop around.
Some people buy enough to get a price break, and pass that on.
Other people carry an item, but the mark-up is ridiculous, and someone else will have the same item for a substantial markdown.

If they're reputable, that's because of volume purchase discounts.
If they're not, it's because they're selling cheap Chinese sh..., um, fertilizer.

Old NFO said...

Excellent points!

Beans said...

For cpap, going through a supplier like American Home Medical or whomever your insurance provider recommends is a good first step. It may require your doctor writing a script for approval for the order, but quality and correctness is critical in the proper functioning of the masks.

Highly recommend you not buy off of Amazon or (fl)E-Bay unless you are absolutely positively sure that what you are buying is what you are ordering. And have the money to waste buying twice or three times in a valiant attempt to beat their system.

Anonymous said...

Peter, you're probably planning on doing this anyway, but just in case you're not, several of us would appreciate the list of make, model, etc. plus where you bought them for your emergency supplies kits. I've taken Kelly's "shooter trauma" class and I trust his judgement.

And, don't forget some sort of notification tool like a Medic Alert bracelet and a corresponding wallet or pocket info card. On agressive blood thinners, something as simple as a moderate fall or traffic accident can cause internal bleeding that may go unnoticed - and, hence, untreated - if responders aren't aware you're on anti-coagulants.

Sherm said...

I've a friend that sells first aid/ medical kits for out of the way places. She strives for professional grade supplies which means it ain't cheap. A basic first aid pouch is almost $200 and the larger kits range up to $1200.

http://www.wildernessmedical.com

BFR said...

In concurrence with Aesop, here are additional resources where I have purchased good quality products:


https://www.mountainside-medical.com/

https://www.tacmedsolutions.com/About-Tacmed

https://www.narescue.com/

(My CV includes more than 30 years of clinical/street-level/tactical public-safety (licensed) paramedicine.)

JNorth said...

Does Anyone know what, if any, of this stuff doesn't work at -40F or colder? If I keep a kit in my car in the winter that's what it needs to deal with. I know my epipen doesn't handle getting froze and for those stretch type tourniquets I wonder what temp they are certified down too but I just have NAR CAT-Ts anyhow.

Chas S. Clifton said...

You're not kidding about the bleeding. I had to provide first aid to someone who was taking a blood thinner (maybe Warfarin?) and had been bitten by a big angry dog -- his blood was just running like water. It made for an exciting few minutes for this amateur.

Tom in NC said...

Probably a bit TMI, but this link from UNC may be of interest - but for background only since many of the strategies noted are for medical professionals not for first aid.

https://www.med.unc.edu/emergmed/files/2018/04/Anticoagulation-Emergent-Reversal-Guideline-1.pdf

For shaving nicks, I always use an old time styptic pencil, which is usually aluminum sulfate - seems to help quite a bit for minor nicks even when on an anticoagulant

Borepatch said...

I find the Amazon reviews extremely helpful - the one star reviews. These can be faked, of course, but a one star review with specific information about what specifically was wrong is gold. These led me to buy new filters for my SoClean CPAP cleaner directly from the manufacturer (at 2x the cost of the knock offs) because I wanted something that would work.

Aesop said...

For reference, once upon a time (2014, in fact), I put together a gold-plated kit for Baby Brother.
Some of the links may be dead, but they'll point you in the right direction:

https://raconteurreport.blogspot.com/2014/02/shtf-medical-kit.html

OvergrownHobbit said...

Dear Mr. Grant. I hadn't visited your blog in a while, so I am very sorry to learn about your heart attack, and subsequent difficulties in recovery. I will certainly add you and Mrs.Grant to our God-blesses, and I hope you continue to get better.