Hospitals Confront Toxic Chemicals in IV Therapy
All patients face some risk with IV therapy, but the neonate and pediatric population, the elderly, and oncology patients are especially vulnerable due to their immunocompromised status.
A key concern is exposure to DEHP, a chemical found in some IV products that acts as an endocrine disruptor. Despite being banned from children’s toys, DEHP is still present in medical devices, raising concern particularly for pediatric and breast cancer patients due to its hormonal impact, said Anita Zado, Vice President Clinical Services with Capstone Health Alliance.
“It has been proven time and time again that DEHP increases the risk around these patients,” she said.
During a recent podcast with The Journal of Healthcare Contracting, the sister publication of Repertoire Magazine, Zado and several other clinical supply chain leaders from hospitals and health systems said that hospitals must engage multiple departments to manage risks, communicate changes, and ensure safe product use. These leaders discussed patient safety and environmental sustainability, as well as how they were assessing new patient safety legislation in California, the Toxic Free Medical Device Act or AB 2300, and its potential impact on the IV therapy products they utilize at their facilities. The panelists were:
- Angelique Vuilleumier, Senior Director, Supply Chain Legacy Health
- Anita Zado, Vice President Clinical Services with Capstone Health Alliance
- Grace Kistner, Project and Policy Analyst
- Lobel Lurie, Manager, Clinical Value Analysis, Strategic Sourcing with Cone Health
- Jennifer Browne, Corporate Director, Value Analysis with LifeBridge Health
Chemicals of concern
DEHP is LifeBridge Health’s primary chemical of concern due to its well-documented health risks, Browne noted. In addition to DEHP, her health system also aims to minimize exposure to mercury, other phthalates, latex, and even anesthetic gases – especially when these pose risks to vulnerable patient populations.
She said that while some chemical effects, like latex-induced anaphylaxis, are immediate and well-known, others may have long-term or hidden impacts on the body. This uncertainty reinforces the importance of educating healthcare providers and staff to understand what chemicals are in the products they use and to make informed, cautious choices when those chemicals can’t be completely avoided.
Vuilleumier shared that her health system is focused on reducing exposure to a broad range of chemicals of concern, including antimicrobials, BPA, anesthetic gases, and chemicals used in labs, cleaning, disinfection, and sterilization. Their goal is to protect patients, staff, and the environment from health risks such as cancer, reproductive harm, and respiratory issues, while also supporting sustainability efforts.
Legacy Health collaborates with Practice Greenhealth and participates in their chemical reporting programs. They also work closely with their GPO, sitting on its sustainability committee to exchange strategies with other health systems. Their GPO helps identify contracts that involve chemicals of concern, allowing Legacy to consider alternative suppliers through RFPs (Requests for Proposals).
AB 2300
Kistner, a registered nurse and policy analyst in California, shared her strong support for AB 2300, a bill addressing the use of toxic chemicals – specifically DEHP– in medical products. She explained that these chemicals, commonly found in IV and respiratory tubing, can leach into patients’ bodies, posing serious health risks such as cancer, reproductive harm, and neurological issues. Most nurses are unaware of these risks, despite being directly exposed themselves.
Kistner also highlighted the environmental impact of plastic waste in healthcare, noting that incinerating medical plastics releases toxic dioxins into the environment.
“It’s also in our broader environment,” she said. “This is a community and population health issue. It goes beyond the bedside.”
Lurie believes AB 2300 has the potential to support patient safety initiatives, but its success depends on strong partnerships with industry. She stressed the importance of transparency from manufacturers, particularly in clearly communicating their efforts to eliminate or reduce DEHP in medical products.
When suppliers clearly label products as not made with DEHP and share their action plans, it builds confidence and reduces the burden on healthcare systems to verify safety – ultimately protecting patients more effectively. Lurie concluded that holding industry partners accountable and communicative is essential for the law to truly advance patient safety across health systems.
The importance of supporting sustainability initiatives
Zado acknowledged the current challenges in supply chain – such as product shortages and tariff impacts – but emphasized that health systems with well-structured Environmentally Preferable Purchasing (EPP) programs are leading the way in sustainability. She highlighted that integrating clinical and supply chain teams can promote safer products, reduce waste, and improve ethical procurement, contributing to better patient outcomes, cost savings, and environmental health. She noted that the future lies in value-based supply strategies that align cost control with sustainability.
Kistner reinforced this by stressing that health systems can act proactively – they don’t need to wait for legislation like AB 2300 to make sustainable changes. She pointed to California healthcare leaders who eliminated toxic chemicals like DEHP before being required to, achieving both better patient outcomes and financial savings. She advocated for aligning sustainability with the Quadruple Aim – improving care, outcomes, provider well-being, and cost – through collaborative, informed decision-making.
Commitment to safer products
Panelists praised B. Braun for its early and sustained leadership in removing DEHP and PVC from many of their IV therapy products, emphasizing the positive clinical, financial, and sustainability impacts on their health systems.
Vuilleumier said Legacy has used B. Braun’s IV products not made with DEHP and PVC for years. In a recent 2024 RFP, B. Braun was again selected due to their alignment with governance priorities like environmental sustainability, patient safety, and cost-effectiveness. Zado has worked with B. Braun since 2010 and commended their long-standing commitment to safer products without added cost. Lurie said B. Braun products were successfully introduced during an IV shortage caused by a hurricane, leading to strong clinical acceptance and familiarity. Browne appreciates B. Braun’s leadership in removing DEHP, noting it is a differentiator in the marketplace.
Indeed, as healthcare systems work to safeguard vulnerable patients, reduce harmful chemical exposure, and meet evolving legislative standards, collaboration across clinical, supply chain, and industry partners is more essential than ever. With leaders embracing transparency, sustainability, and innovation, the path forward points to a future where patient safety and environmental responsibility go hand in hand.