Amid a national shortage of a critical medicine, US hospitals are hoarding vials, delaying surgeries, and turning away patients, The New York Times reports. The medicine in short supply: solutions of sodium bicarbonate—aka, baking soda. 
 
 The simple drug is used in all sorts of treatments, from chemotherapies to those for organ failure. It can help correct the pH of blood and ease the pain of stitches. It is used in open-heart surgery, can help reverse poisonings, and is kept on emergency crash carts. But, however basic and life-saving, the drug has been in short supply since around February. 
 
 The country’s two suppliers, Pfizer and Amphastar, ran low following an issue with one of Pfizer’s suppliers—the issue was undisclosed due to confidentiality agreements. Amphastar’s supplies took a hit with a spike in demand from desperate Pfizer customers. Both companies told the NYT that they don’t know when exactly supplies will be restored. They speculate that it will be no earlier than June or August. 
 
 As hospitals and pharmacists struggle with the sodium bicarbonate shortage, experts note that it’s just the latest example of stocks of inexpensive, essential generic medicines hitting alarming lows. For example, there was a sodium bicarbonate scarcity in 2012 and a similarly alarming shortage of saline solution in 2014. 
 
 Further Reading Dangerous shortage of essential antibiotics is all about $$ Experts blame the shortages on a combination of factors, including problems getting raw materials, issues with aging facilities where many old drugs are manufactured, and consolidation in the industry that reduces the number of potential suppliers. There’s also the concern that because generic drugs are unlikely to drive profits, drug companies may not make necessary investments to maintain supplies. 
 
 But when there isn’t a steady supply, patients suffer. With the shortage of sodium bicarbonate, hospitals are postponing surgeries and chemotherapy treatments. A hospital in Mobile, Alabama, for example, postponed seven open-heart surgeries and sent one critically ill patient to another hospital due to the shortage. 
 
 The Food and Drug Administration is working with Pfizer and Amphastar to try to mitigate the effects of the scarcity. A spokesperson for the agency said that it is “exploring all possible solutions to this critical shortage, including temporary importation, to help with this shortage until it’s resolved.” 
 
 In recent years, the agency has been addressing the problem of shortages and has made progress. In 2011, there were 251 shortages, while there were only 23 in 2016. There are currently 50 drugs listed in short supply. ||||| PEORIA — A national shortage of a common drug is prompting hospitals to conserve their supply for only the most necessary applications. 
 
 While The New York Times has reported that a shortage of sodium bicarbonate has forced some hospitals to delay chemotherapy treatments and operations or send patients across town, both OSF HealthCare and UnityPoint Health-Peoria say that in light of the shortage, the hospitals have been conservative with their supplies without resorting to such drastic measures. 
 
 "Our supply has been trickling in, and we are maintaining critical operations," said Rhonda Georgieff, manager of pharmacy supply chain operations at OSF. "We are just experiencing major delays and back orders, or order that may come in only partially filled." 
 
 While sodium bicarbonate solution is a simple drug — sodium bicarbonate in its solid form is known as baking soda — its use in medicine is more complicated than restocking at the local grocery store. The solution, delivered via IV, must be sterile and of certain chemical composition. Only two suppliers in the United States offer the drug, and one is having production issues and the other isn't able to absorb the increased demand. 
 
 While the drug is simple, it's also critical to some hospital operations. It's used to lower the pH of blood that has become too acidic, in emergency and operating rooms, as an antidote to certain poisons, with certain types of chemo and to reduce pain, the Times reported. 
 
 But it's limited availability may be due in part to its affordability. Manufacturers don't bother with generic forms of cheap drugs like sodium bicarbonate, Georgeiff said. Combine reduced profit incentive for U.S. manufacturers with increased oversight of overseas manufacturers, and shortages are bound to happen. 
 
 Sodium bicarbonate is just one of dozens of drugs listed in shortage by the FDA and American Society of Hospital Pharmacists. Hospitals and pharmacies are well practiced in conserving medications in short supply, often without any noticeable change in operations as far as patients can tell. 
 
 "We expect this situation to continue for another month. Hopefully, not longer," Georgieff said. 
 
 Laura Nightengale is the Journal Star's health and lifestyle reporter. She can be reached at 686-3181 or lnightengale@pjstar.com. Follow her on Twitter @lauranight. ||||| In January, as the date of Christopher Sepulvado’s execution approached, the Louisiana Department of Corrections did not have the drugs it needed to carry out his death sentence. 
 
 So the state turned to a supplier that uses hydromorphone to relieve patients’ suffering, not to kill them: Lake Charles Memorial Hospital. 
 
 “We assumed the drug was for one of their patients, so we sent it. We did not realize what the focus was,” said Ulysses Gene Thibodeaux, a board member for the private, nonprofit hospital and chief judge of the Third Circuit Court of Appeal. 
 
 “Had we known of the real use,” he said, “we never would have done it.” 
 
 The Department of Corrections bought 20 vials of the drug on Jan. 28, a week before Sepulvado’s scheduled execution, according to a document provided by the state in a lawsuit challenging its lethal-injection practice. 
 
 Until now, the source of those vials has not been publicly known. 
 
 Thibodeaux said it’s routine for hospital pharmacies to supply drugs to other pharmacies, including those run by the state, for their patients. 
 
 “We never inquire into the purpose for it. We assume it’s for legitimate and noble purposes,” Thibodeaux said. “We have assurances from our CEO, who is a very forthright guy, that this will not happen again.” 
 
 State officials with the Louisiana Department of Corrections did not respond to repeated requests to comment for this story. Sepulvado’s lawyers declined to comment. 
 
 Sepulvado wasn’t executed on Feb. 5. After a botched execution in Oklahoma, the state agreed to delay his execution for six months as it considered alternative methods. A status conference on his lawsuit has been set for November. 
 
 Drugs expired as execution was delayed 
 
 Sepulvado was convicted in 1993 for killing his six-year-old stepson by beating him with a screwdriver and submerging his body in scalding water. Over the years, his attorneys have delayed his execution by arguing that the state’s death penalty practices could violate his constitutional protection against cruel and unusual punishment. 
 
 This is part of a continuing investigation into Louisiana’s execution methods. 
 
 Highlights of our coverage: 
 
 Louisiana’s death-penalty protocol uses same drugs as lengthy Arizona execution 
 
 State failed to turn over key public records about execution drugs 
 
 State has explored illegally obtaining drug for upcoming execution 
 
 With lethal-injection drugs hard to get, states turning to custom pharmacies 
 
 State’s supply of drug for executing prisoners has expired, says attorney for death-row inmate 
 
 After several delays, his execution was rescheduled for early February. Three weeks before the state was supposed to carry out his death sentence, it didn’t have the drug it needed. Its supply of pentobarbital had expired in September. 
 
 Throughout the fall, the state had scrambled to procure lethal injection drugs. Other states were having trouble finding them, too, after drug manufacturers refused to sell to prisons and current supplies started to expire. 
 
 At one point, the Louisiana Department of Corrections considered ordering pentobarbital from an Oklahoma compounding pharmacy — which would have been illegal because the pharmacy wasn’t licensed in Louisiana. 
 
 Then, nine days before Sepulvado’s Feb. 5 execution date, the state announced it had approved another method to put him to death. The new combination was hydromorphone and midazolam, the same drugs that had just been used in the prolonged execution of Ohio inmate Dennis McGuire. 
 
 Drug obtained days before scheduled execution 
 
 There was one problem with the alternate method: The state Department of Corrections apparently didn’t have hydromorphone, either. However, it did have midazolam, a sedative commonly in stock at pharmacies. 
 
 A few days later — five days before the execution — Department of Corrections spokeswoman Pam Laborde said the agency had the two drugs it needed to kill Sepulvado. 
 
 The department wouldn’t say where they came from. A federal judge ordered it to reveal the supplier to Sepulvado’s lawyers, but the department requested the information remain under seal. 
 
 Now, two people — Thibodeaux and a source that refused to be identified — say the state got its hydromorphone from Lake Charles Memorial Hospital. The Lens also reviewed a document that confirmed the source of the drug. 
 
 According to documents shared with Sepulvado’s lawyers, the drugs were sent to Elayn Hunt Correctional Center’s Medical Unit, which the state describes the site as a “medical facility for seriously or chronically ill offenders.” 
 
 Properly permitted hospital pharmacies like the one at Lake Charles Memorial can legally supply medications to other pharmacies, as long as the drugs are for a hospital patient, according to Malcolm Broussard, executive director of the Louisiana Board of Pharmacy. 
 
 The supplying pharmacy wouldn’t need a prescription for that particular patient. Those rules apply even to highly regulated drugs such as hydromorphone, he said. 
 
 Broussard said he didn’t know enough about this particular transaction to comment on it. 
 
 Richard Dieter, executive director of the Death Penalty Information Center, said he wasn’t aware of a hospital supplying a lethal-injection drug. But it isn’t surprising, he said, because hydromorphone is “more commonly used and would be available … unlike some lethal injection drugs.” 
 
 Nationwide, drug suppliers concealed as drugs become hard to find 
 
 Around the country, states have moved to conceal the sources of their execution drugs. 
 
 Deborah Denno, a professor at the Fordham University School of Law and an expert on the death penalty, said states are becoming more secretive because the death penalty is becoming more controversial. 
 
 “The stakes are higher because the drug supplier is … more vulnerable,” Denno said, pointing to several lengthy executions this year in Ohio, Oklahoma and Arizona. 
 
 “They’re being secretive because they know they couldn’t carry out executions otherwise,” she said. “Look at the botches in 2014 alone.” 
 
 Louisiana’s tactics have changed in the past year and a half. 
 
 In 2013, the state identified the source of its execution drug, but refused to say when it expired. 
 
 State officials told The Lens repeatedly that there were no records showing the expiration date of its pentobarbital. Documents later made public showed that wasn’t true; the state apparently violated open records law by withholding the information. 
 
 Since then, the state has disclosed expiration dates but has argued that the source of the drugs is confidential. A state law says that the identities of people involved in executions cannot be publicized; the state Department of Corrections has argued that the law extends to drug manufacturers and suppliers. 
 
 That’s why the state redacted the supplier of the hydromorphone in documents shared with Sepulvado’s lawyers. 
 
 Oddly, however, the state didn’t redact the name of the pharmacist at Lake Charles Memorial who handled the order. 
 
 Should the hospital have known what the drug was for? 
 
 Denno said some states have resorted to unorthodox tactics as lethal injection drugs become harder to obtain. But she’s never heard of a state getting its drug from a hospital. 
 
 “There’s so much secrecy involved in all of this that it’s really hard to tell where the drugs are coming from,” Denno said. 
 
 She said Lake Charles Memorial Hospital should have known the state prison was looking for hydromorphone to carry out an execution. 
 
 If suppliers like the hospital don’t want to be involved in executions, she said, they could require a contract when selling drugs that could be used in the death penalty. That contract would specifically prohibit the drug’s use in executions. 
 
 That’s what drug manufacturers such as Hospira and Lundbeck have done, which sparked the shortage of lethal-injection drugs. 
 
 “It’s a slippery slope for a hospital to be the supplier,” Denno said. “They are enabling execution, no matter which way you slice it.”
– The "simplest of drugs" is in short supply at hospitals around the country, causing crucial surgeries and other treatments to be reprioritized, and it's a cheap drug whose main ingredient may be found in your own pantry, the New York Times reports. That drug is sodium bicarbonate solution, aka baking soda, which is used in chemo regimens, as a poison antidote, and to help patients whose blood has veered into acidic ranges, among other uses. But the nation's two lone suppliers, Pfizer and Amphastar, are suddenly unable to give medical facilities what they need, causing those facilities to hoard what's left in their own cabinets. "Does the immediate need of a patient outweigh the expected need of a patient?" says the head pharmacist at a hospital in Mobile, Ala., calling it a "medical and ethical question that goes beyond anything I've had to experience before." Supply problems can arise when things go wrong at the factory level or when suppliers of the raw ingredients have issues, leaving hospital officials irritated at the short notice they receive about a dearth. Right now on the FDA website, there are dozens of drugs said to be "currently in shortage," many of them critical generic injectables. Some pharmacy officials even harbor suspicions that manufacturers aren't investing enough to ensure adequate supplies since, per Ars Technica, generic drugs aren't the moneymakers. Some hospitals have "compounding pharmacies" where they whip up their own generic drugs, but that doesn't solve the larger problem. "It is unbelievably frustrating," a University of Utah drug shortage expert tells the Times, which notes Pfizer and Amphastar can't guarantee more sodium bicarbonate supplies until at least June and maybe not until August in some cases. (The "cartels" some think control the market.)