See current compatibility chart.

There is no dead space in the pen needles. The design of the pen needles has accounted for the residual volume in the cannula as part of the delivered dose.

The sterilization process uses cobalt-60 (a radionuclided cobalt) and does not add any cobalt to the product; The sterilization process is simply an exposure to the gamma rays emitted by the cobalt which kills bacteria.

This type of sterilization process is approved by the FDA for food sterilization of chicken, fruit and spices.

However, our cannula is made from Type 304 Stainless steel. This grade of stainless is composed of many substances including carbon, manganese, chromium, nickel and others in various percentages. This does not DIRECTLY add cobalt into the material BUT it could be contained in the nickel at a residual level of about ~0.2%. The amount of nickel in 304 stainless is about 10% so the potential amount of cobalt in the need would be about 0.02%. The cobalt which may be contained in the nickel is simple cobalt, not cobalt-60.

So the answer is there is no cobalt from the sterilization process but there could be a very small amount in the needle due to the nickel.

One other thing to consider with this patient could be a nickel sensitivity as well.

The pen needles should be dispensed as a box of 100. The package is not intended to be broken. Plans will pay for the box of 100; the pharmacist needs to enter it so that it reads as a 30 day supply, realized that the patient will not get if refilled for another 60 days or so.

Please inform the customer that we can forward this information and get the matter resolved. Ask the customer to let us know if this issue continues/reoccurs. Please get the caller’s name and get the pharmacy’s complete address and phone number. Forward the information to local country marketing lead.