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American Samoa dialysis patients on Day 3 without treatment

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PAGO PAGO, American Samoa » American Samoa residents who require dialysis were in their third day without the vital treatment Friday after a product recall closed their clinic, but so far none have sought emergency medical attention, the U.S. territory’s only hospital said.

A fresh supply of the product — a solution used in dialysis machines at LBJ Medical Center — was to arrive at the island later in the day. The clinic is set to reopen early Saturday after shutting down Wednesday morning.

In the meantime, its roughly 160 patients are being told to follow diet and fluid restrictions, and to go to the hospital emergency room with any complications. As of about noon Friday, none of them had gone to the ER, according to emergency room nurses.

How long a patient can safely go without dialysis depends on factors such as health condition and age, said Dr. Anjay Rastogi, director the dialysis program at the University of California, Los Angeles.

Generally, patients require the treatment three times a week, with some cases requiring four treatments, Rastogi said. Some patients can go a week without dialysis, but some with no kidney function can go only three or four days, he said.

"The short end of it, it’s very time-sensitive," Rastogi said, adding he’s especially concerned about those who might not have had dialysis since Monday.

He noted any contamination in the solution used for dialysis could be fatal.

Once the clinic reopens, Rastogi said he recommends the hospital have in place a system for triaging patients to determine who needs dialysis right away and who can wait a bit.

The recalled solution was from off-island supplier Fresenius Medical Care. Its North American headquarters is in Waltham, Massachusetts.

The recall occurred after sample testing showed the substance — NaturaLyte Liquid Bicarbonate Concentrate— might eventually develop bacteria levels that exceed acceptable limits, Fresenius spokesman Jon Stone said.

The company expedited the shipment of replacement liquid bicarbonate that’s expected to arrive Friday, Stone said.

Dialysis unit nurse manager Olita Tafiti said the clinic will reopen at 1 a.m. Saturday and will stay open all weekend for those who had appointments scheduled for Wednesday through Saturday. Regularly scheduled appointments will resume Monday.

Until Saturday, there are no other options for dialysis patients on the island with a population of about 55,000, roughly 2,300 miles south of Hawaii

Associated Press writer Jennifer Sinco Kelleher in Honolulu contributed to this report.

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