Robert Ostfeld, MD, an attending cardiologist at Montefiore Medical Center in Bronx, N.Y., now thinks harder about how doctors at his institution use heparin. Does a particular patient really need it? Would another product be more appropriate?

“We still have a supply of heparin, but we’re being very vigilant,” he said.

Dr. Ostfeld feels the need to be cautious because a major proportion of this drug’s supply has been pulled from the market. Following reports of hundreds of allergic reactions and at least 19 deaths, Baxter International Inc. recalled heparin sodium injection and flush products in January and February.

Before the recall, Baxter had made about half of the 1 million multidose heparin vials used monthly by the health care system. Large-volume parenteral solutions that contain a small amount of this medication are not affected, because the heparin in them is from another source, and no problems have been reported.

“The safety and quality of our products is always our highest priority, and we will continue to collaborate with the [Food and Drug Administration] as we work to determine the cause of the increased rate of adverse reactions and resolve this issue,” said Peter J. Arduini, president of Baxter’s medication delivery business.

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