Oxygen companies accused of intimidating Mexican hospitals during the epidemic | global development

In March 2020, Benjamin Espinosa Zavala saw an entire floor in his small hospital in Guanajuato, downtown. Mexico, converted into Covid-19 wards. The hospital’s need for oxygen increased.

Deliveries from CryoInfra, part of infrared array array, sometimes slowing down to once every two days, and had to buy more to cover sudden gaps in supply. Prices have gone up.

In January, the hospital built an on-site oxygen generation plant – also known as pressure absorption (PSA) stations – at a cost of 3.5 million pesos (£125,000). It can fully supply the hospital and has already paid for itself in savings. PSA equipment provides 93% pure oxygen from the air, versus 99.5% purity from liquid oxygen suppliers.

The World Health Organization, UNICEF and the World Bank are helping hospitals in low- and middle-income countries build oxygen stations on site.

Grupo Infra notes that orders have decreased. Senior executives, managers, administrators, and physicians [from Grupo] “He came to the hospital to see the factory,” said Espinosa, general manager of the Celaya SA de CV Center for Medical Specialties in Guanajuato. “The officials who visited were very kind and polite. We were on good terms.”

Then, in June, Grupo Infra’s lawyers told Espinosa Hospital that it had breached its contract with the plant installation and faced a heavy penalty. If we stop buying from them, we face a fine of 1,300,000 pesos [£47,000]. ”

Espinosa objected, arguing that the hospital had never stopped buying the company’s oxygen, only reducing demand. “The contract does not say anything about the amount we are obligated to buy,” he said. Grupo Infra later wrote to him, increasing the penalty to over 10,000,000 pesos (about £400,000). He has been negotiating with the company since June, but no agreement has been reached.

A worker fills a tanker with medical oxygen at the Infra Group plant in San Miguel Exoxetla, Puebla, Mexico, March 2021
An oxygen tanker at the Grupo plant in San Miguel Xoxtla, Puebla. The company sent threats and warnings to hospitals that make their own oxygen supplies. Photo: Pedro Pardo/AFP/Getty Images

Grupo Infra and another oxygen supplier, Praxair Mexico – which together control 70% of Mexico’s medical oxygen market – have been accused of spreading fear, suspicion and misinformation, deterring hospitals from switching to cheaper and more convenient PSA stations and threatening legal action if they do so, according to an investigation.

The Bureau of Investigative Journalism claims that companies sent letters to Mexican hospitals containing misleading claims about factory safety.

Grupo Infra said its business is based on Mexican regulatory requirements and industry documents on the use of public service announcements, oxygen quality and transportation requirements. The company said it was not aware of legal action taken against any hospital for installing PSA equipment.

Praxair, and its German owner Linde, which had $27 billion in sales in 2020, did not respond to requests for comment.

Mexico has Fourth highest level in the world covid death toll 253000 Until now. Researchers believe that the true number could be nearly three times higher Test numbers are low.

The demand for oxygen increased. in a December 2020, cases in Mexico City Hospitals are flooded and the National Guard has been deployed to protect the oxygen delivery trucks.

Dr. Marta Hernández Vázquez*, director of a hospital in Michoacan, She installed a PSA plant in October 2020. Her facility treated several patients with respiratory issues and required up to 40 cylinders a month, at a cost of 30,000 pesos (£1,000). She said she was tired of relying on Grupo Infra and wanted a convenient and affordable supply. The PSA plant means the hospital needs fewer cylinders per month than the Grupo Infra.

Medicinal oxygen plant.
Medicinal oxygen plant. Grupo Infra has warned hospitals that its on-site production is against regulations and putting patients’ lives at risk. Photo: Jorge Abrego/EFE/Almy

On October 6, Hernandez received a letter from a Grupo Infra attorney warning that he would take his cylinders if the hospital used them at the same time as the oxygen produced on site. It also claimed that such plants “endanger human life,” that PSA plants do not comply with regulations, produce less quality oxygen than Grupo Infra, and can cause fires and explosions.

Hernandez sent the letter to Ignacio Andrade, a biomedical engineer at HC Promedical, who imported the plant from the United States. “The first time I read it, I said: I don’t want to sell it [plants] Anymore, because if they tell the truth, we will kill some people,” Andrade said. But the US manufacturer, AirSep, assured Andrade that the letter’s arguments do not reflect the truth.

Jim Stunkel, Vice President International Help, a non-governmental organization that builds oxygen plants around the world, said: “I can easily say that it seems clear that the points in the letter are intended to prevent the implementation of PSA plants.”

“What would put human life at risk is if a compressed gas supplier suddenly ‘withdraws their equipment’ from a hospital in the midst of a pandemic,” added Dr Paul Sonthal of another medical NGO, Partners In Health.

Praxair Mexico made similar claims in a letter to at least one hospital. It said using an on-site oxygen station was against the law and the hospital’s contract with the company. If it continues, Praxair will stop its supply of oxygen. The letter said oxygen from PSA plants could exacerbate respiratory diseases and cause “potential death”.

Grupo Infra told the office that it does not recommend the use of PSA devices in hospitals that have high-flow anesthetic and ventilator equipment and high-pressure rooms. “In our opinion, PSA equipment is suitable for hospitals located in hard-to-reach areas where the supply of cryogenic oxygen is complex. These hospitals typically focus on primary care and do not have intensive care equipment that, due to the medical equipment manufacturer’s composition, may require 99.5-purity oxygen %.

“It is important to note that according to current regulations … the minimum quality requirements that national and international products must meet, is the following: “93% Oxygen (Pharmacopoeia) is used exclusively for respiratory treatments. Do not allow the use of anesthetics, equipment, high-flow ventilation for patients and hyperbaric rooms.”

Hernandez continued to use the generator factory. She said she believed the contents of the letter were baseless and were intended to “pressure or intimidate me.” “We are very happy with the results [of the plant]She said. “It’s a relief to generate oxygen here.”

Andrade believes that at least five other customers at the hospital who received the same message have pulled out of installing PSA stations.

Leith Greenslad, Coordinator Every soul counts in the alliance, he said, “Receiving a long letter filled with legal jargon, serious medical claims, and high-tech engineering and infrastructure terms, is supposed to deceive the reader into giving it.”

People queue to buy oxygen in Tehuantepec, Oaxaca.
People queue to buy oxygen in Tehuantepec, Oaxaca. The shortage has seen prices skyrocket as those caring for sick relatives struggle to afford life-saving gas. Photo: Luis Villalobos/EPA

The coalition is writing to hospitals and government officials in Mexico to make it clear that the generation plants, and the oxygen they produce, are safe.

Mexico needs more than 100,000 cylinders a day, just for Covid-19 patients, as cases rise.

“This situation with Grupo Infra bothered me more than the drugs we ran out of because the fine was too big,” Espinosa said. He does not regret the installation of the oxygen station. “The pandemic came along and changed the game for everyone when it comes to costs.”

* Changing the name

Additional reporting by Rosa Forno

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