Phospho soda, produced by the C.B. Fleet Company of Lynchburg, Virginia, since 1893, was an over the counter saline laxative used to cleanse the bowel prior to a colonoscopy, an endoscopic procedure that is used to examine the colon and part of the small bowel.
Each 15-mL serving of Fleet Phospho-soda contains 7.2 g monobasic sodium phosphate monohydrate and 2.7 g dibasic sodium phosphate heptahydrate in a stable, aqueous solution.
In March 2003, Dr. Glen Markowitz, a renal pathologist at Columbia University, reported his findings of kidney damage to Fleet when he performed kidney biopsies and first diagnosed the condition as nephrocalcinosis, now known as acute phosphate nephropathy.
Symptoms of acute phosphate nephropathy include feeling ill, drowsiness, lethargy, decreased urine, or swelling of your ankles, feet and legs. Early stages may not be symptomatic and may only be diagnosed by blood tests to measure kidney function (serum creatinine and blood urea nitrogen).
In December 2005 the FDA issued its first public warning regarding the use of sodium phosphates for bowel cleansing because of the risk of kidney damage.
Fleet removed Phospho Soda from the market on December 15th of 2008 maintaining that since it was an OTC product it could potentially be used in amounts that could be harmful to the user.
It is important to note the FDA warning went out to all manufacturers of products similar to Phospho Soda including Salix Pharmaceuticals who market two sodium phosphate prep medications for colonoscopies called Visicol and OsmoPrep.
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