The Effects Of Washing On EpiPen Epinephrine Auto-injector Device Integrity And Function

Abstract

Prescribing information for EpiPens indicate that the carrier tube is not waterproof. No studies have shown the effects of submerging an EpiPen in water. We aimed to determine the function and integrity of EpiPens after enduring a washing machine cycle. For 68 pairs of same-dose, same-lot, post-consumer expired EpiPens (15 0.3 mg and 53 0.15 mg), one was washed in its carrier tube through the colors cycle of a top-loading washing machine, while its pair was kept at usual conditions. Both were then fired into meat. The increase in meat mass and decrease in device mass were measured to estimate the mass of solution fired. Paired t-tests were used to determine if the average difference in mass between washed devices and control devices differed between washed and unwashed devices. Linear regressions were used to assess the effects of device dose (0.3 mg vs 0.15 mg) and expiration date on the difference in outcomes in each pair of devices. Additional washed and unfired devices were dissected to assess for moisture (using Chorophenol red strips) and damage. Washed devices fired a greater mass of epinephrine solution into the meat and devices lost more mass during firing, versus controls (t-test p-values <0.0001). Ten washed devices failed to deploy the needle cover after firing. The effect of washing did not differ by dose or expiration date. Fifteen dissected devices had dry needles and plungers. Washing EpiPens impaired their function. These devices should not be used if accidentally placed through a washing machine cycle.