Dear Friends:
    I have to agree with Marie Biancuzzo on this topic when she writes:" I'm
not an attorney, but in no case would I feel comfortable using a piece of
equipment for something other than its intended use; especially when there
*is* a piece of equipment designed for the use. (e.g., the Evert-It, rather
than the cut-off syringe.) I'm just not willing to put myself at risk like
that. As for surgeons using improvised gadgets: I don't know if they do it
"all the time" but then, I don't pay their liability premiums, either."
    If there is any injury to a patient from the off-label use of a product,
the manufacturer's liability will not cover the practitioner. I also wonder
how much of what Dr. Jack says is based on the powerful initials (M.D.) after
his name that  permit many things that most of us on LACTNET can not do.
    Off-label use often uncovers new and wonderful things, when done in a
conscientious way, within a framework of careful monitoring and analysis.
Individual practitioners improvising with medical equipment or drugs is not
conscientious use. An example is Cytotec which is a GI drug now being used to
induce labor. Many are using it to start labor, there is no control or
standard of practice to analyze this off-label use, and some terrible things
have occurred.
    Warmly,
Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI, CSTP
Elkins Park (a suburb of Philadelphia, Pennsylvania; northeastern USA)
supporter of the WHO Code and the Mother Friendly Childbirth Initiative

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