The blame game is on … from Capitol Hill to the Wall Street Journal to the halls of your local operating room, everyone is buzzing about who is responsible for the epidemic of drug shortages. According to the University of Utah Drug Information Service, the number of active drug shortages by the end of 2012 was 299. At the last ASA annual meeting in Washington, D.C., special sessions addressed the New England Compounding Center crisis, and anesthesia providers openly vented their frustrations. Unfortunately, no one party can completely shoulder the blame. The creation, manufacturing, distribution and regulation of pharmaceuticals is a complex process. Any step in this process may result in shortages.

The process starts with the availability and quality assurance of raw materials. Next, drug manufacturing can be plagued with quality issues, including contamination of equipment or products, defective products, equipment malfunctions, packaging or labeling irregularities or...

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