Study Compares Equashield and BD Drug Transfer Devices

The Journal of Oncology Pharmacy Practice has published the results from a comparative study of Equashield’s closed system transfer device (CSTD) versus Becton Dickinson (BD) syringes with the Phaseal closed system.

The study found that BD’s syringe plunger allowed repeatedly for high levels of syringe plunger contamination by hazardous drugs under routine drug preparation conditions, while Equashield results demonstrated undetectable concentrations of contamination. This makes Equashield the only available transfer device proven to protect medical professionals from plunger contamination.

“When Equashield was first launched, we were immediately impressed with the system’s innovative design and its ability to minimize dangerous exposure compared to other CSTD solutions,” said lead study author Stephen T. Smith, MS, FASHP, executive director of pharmacy services at the Barbara Ann Karmanos Cancer Center in Detroit, Mich. “The results of our study confirmed this empirically.”

The study, entitled “Syringe plunger contamination by hazardous drugs: A comparative study,” was conducted at the Karmanos Cancer Center in Detroit. Stephen T. Smith and Mark C. Szlaczky, R.Ph., Pharm.D., performed comparative contamination level tests of 60 ml BD syringe plungers with PhaSeal CSTD versus the 60 ml Equashield syringe plungers. Each syringe had Cyclophosphamide (a typical toxic chemotherapy drug) drawn in and expelled repeatedly under conditions of routine pharmacy compounding and transfer procedures.

ChemoGlo, a specialized third-party laboratory, tested the 48 containers with wipe samples in its laboratory at detection level sensitivity of 10 ng and found BD syringes were contaminated in significant measures compared with undetectable contamination in the Equashield syringe plungers. Results demonstrated significant cyclophosphamide contamination levels on 11 out of 12 BD syringes, whereas all 11 Equashield CSTDs had undetectable concentrations.

“We believe that cyclophosphamide infiltrates on to the plungers of standard BD syringes by reacting and creating a layer on the inner walls of the syringe barrel,” the authors wrote. “The very minimal distance or direct contact between the plungers to the contaminated walls ‘allows’ cyclophosphamide to ease its way on to the plunger.”

The BD syringes use a standard open syringe barrel with a regular four-rib plunger structure, common to most single use syringe systems. To prevent plunger contamination, Equashield has a thin metal rod plunger and an encapsulated syringe barrel with an airtight seal.

“Like in previous studies, this study again found high contamination levels on the standard BD syringe plungers, a fact that suggests that Cyclophosphamide infiltrates the BD plungers during use of these syringes even with CSTDs. This poses a significant route of exposure to hazardous drugs that can contaminate an entire work area,” explained Marino Kriheli, co-founder of Equashield. “Equashield’s solution, on the other hand, has been clinically proven to prevent this contamination and create a safer environment for pharmacy personnel and nurses, as well as patients and their families.”

The full study is available online and in an upcoming print issue of The Journal of Oncology Pharmacy Practitioners, the official publication of the International Society of Oncology Pharmacy Practitioners.

Port Washington, N.Y.-based Equashield makes fluid drug admixing and transfer systems. BD makes a range of medical devices and is based in Franklin Lakes, N.J.