Although lifesaving, chemotherapy drugs are potentially hazardous to the pharmacists and other healthcare workers who routinely handle them. Closed System Transfer Devices (CSTDs) are used to move these drugs from one container to another, while preventing contamination and occupational exposure due to aerosolization or needle sticks. A reliable CSTD system is crucial for any pharmaceutical company or medical center that uses potentially toxic drugs.
Equashield, a CSTD manufacturer based in the United States, has most recently developed the Equashield Pro, a smarter drug compounding system that combines the company’s CSTD technology with automation and image recognition to more quickly and accurately process hazardous drugs.
We asked Co-Founder and CEO Marino Kriheli more about the company and its newest automated drug compounding system.
Cici Zhou, Medgadget: Tell us about how and when Equashield was founded, and its journey to being the 200+ person company it is today.
Marino Kriheli: Equashield was officially founded in 2010 by Marino Kriheli, Tzahi Odiz, Eric Shem-Tov and Meron Mann. The company was born from PlastMed, an Original Equipment Manufacturer of medical devices, [which] specialized in complex fluid transfer systems. Equashield identified a niche in the transfer device market, specifically for the safe handling of hazardous drugs, following a 2004 National Institute of Occupational Health and Safety alert on the potential health risks of hazardous drug exposure.
The Equashield Closed System Transfer Device (CSTD) was designed from scratch to protect hospital pharmacists in compounding hazardous (chemotherapy) drugs, addressing all routes of exposure to hazardous drugs: syringe plunger contamination, connectors [with] drug residue, and escape of vapors. It proved so popular that the company had to move quickly to start filling orders for hospitals, including one of the top ten cancer centers in the US.
[In] 2014, Equashield introduced the EQUASHIELD II; its second-generation product to ensure foolproof use of the device, while still providing the same high level of protection. Both devices are cleared by the FDA under the ONB product code. Equashield CSTDs are now being used by hundreds of healthcare facilities in the US and across the globe. In 2016, Equashield entered the automation space with the introduction of the Equashield Pro, the first CSTD-enabled automated pharmacy compounding system.
Medgadget: How does the Equashield Pro work, and what advantages does it have over the current options?
Kriheli: The Equashield Pro is an Automated Pharmacy Compounding System specifically designed to facilitate the easy and affordable adoption of automation in the hospital pharmacy. Outfitted with Equashield’s flagship CSTD, the Pro provides a substantial layer of protection for healthcare workers when preparing hazardous drugs. There are several key advantages to the Equashield Pro:
- As noted, the Pro is the only compounding robot that is built from the ground up to incorporate a CSTD for enhanced protection during drug compounding.
- The incorporation of the CSTD also significantly speeds up operations. For example, with alternative systems, each vial has to be mechanically inserted into the machine and secured individually in its designated location. With vials coming in a variety of sizes and diameters, a robotic gripper must complete a time-consuming process to identify and grasp each vial before placing it on a scale for a lengthy and sensitive weighing process, before picking it up again for the next steps. With Equashield Pro, all vials are pre-attached to identical CSTD adaptors, easing the gripper’s process of retrieving vials. This allows large numbers of vials to be placed randomly on a tray for the gripper to pick up quickly and begin compounding, significantly speeding up the process. Easy identification of the correct vials is achieved through Equashield’s proprietary dose verification and image processing systems, preventing medication, dose and labeling errors throughout the compounding process.
- Other robotic systems do not enable parallel operation, creating bottlenecks as often only one dose may be compounded at a time and must be completed to its entirety before another can be prepared. The intuitive design of Equashield Pro facilitates parallel operations with eight simultaneous workstations; eliminating cumbersome restrictions for [the] pharmacist and allowing the equipment operation as desired.
- Finally, with a relatively small footprint, comparable in size to standard biological safety cabinets, it is easy to incorporate into existing hospital pharmacies without the need for the costly retrofitting of IV clean rooms.
Medgadget: At what stage is the Equashield Pro, in terms of number of users, development, and status of approval?
Kriheli: The Equashield Pro is fully developed, in compliance with all regulatory standards about robotics and is undergoing implementations in clinical practice. Purchase orders of the Equashield Pro have already been received from leading hospitals in the U.S. and Europe, including Austria, Italy, Greece and Spain. In keeping with the Equashield ethos, we are always innovating and already working on the next generation Equashield Pro. At this year’s American Society of Health-System Pharmacy (ASHP) Midyear Meeting, we’ll be showcasing the Pro’s capabilities and providing demos for attendees.
Medgadget: What are the future directions for Equashield as a company?
Kriheli: Equashield is on a rapid growth trajectory. Since our founding, we have developed a philosophical approach of need-based innovation. We’ve found areas in the safe handling market in particular that have been inadequate and developed the know-how to solve these problems… Our next growth spurt will utilize our expertise in state-of-the-art medical device manufacturing. We will apply the principles of innovation and know-how to answer new market needs to bring about novel technologies for safe and efficient care. Naturally, we can’t disclose the exact nature of our next developments for commercial reasons.