Counterfeit Tourniquets: A Life-Threatening Issue for First Responders

 As one of Australia’s leading medical equipment suppliers, we are deeply concerned about the growing issue of counterfeit tourniquets being supplied worldwide. These fake devices are ending up in the hands of first responders around the globe and pose a serious risk to patient safety, and even potentially costing lives in emergency situations.

Our motto: “depend on us when lives depend on you” means that we aim to provide the highest standard of equipment that can be relied upon when you need it most, so it actually blows our minds that anyone would invest in a cheap replica of any life-saving device. This blog post aims to shed light on this critical issue and provide factual information to help you make informed decisions when it comes to your gear.

 

The Danger of Counterfeit Tourniquets

A tourniquet is a critical life-saving device designed to stop severe arterial bleeding. The stakes are extremely high, and every component of an authentic Combat Application Tourniquet (C-A-T) or SOF®️ Tactical Tourniquet has undergone rigorous testing and continuous improvement to ensure optimal performance. While cheap replicas flooding the market may appear similar to the untrained eye, they are often produced using inferior materials (to keep costs down!). Consequently, many of these imitations have reportedly failed when needed most. Let’s discuss some of the devastating consequences of a failed tourniquet application:

  1. Fake tourniquets can be challenging to apply correctly (especially in high-stress situations), leading to a slower response time and ineffective treatment.
  2. When a counterfeit tourniquet fails during application, your patient can experience continued rapid blood loss, potentially leading to hypovolemic shock and death.
  3. A failed tourniquet application means valuable time is wasted, delaying effective treatment. In emergency situations where every second counts, this delay can be critical!

This excerpt is from Pubmed Case Report Oct 2, 2024. Limb Hemorrhage Control Failure with Counterfeit Tourniquet: A Ukrainian War MEDEVAC Case Report

“We describe one case where the delayed mechanical failure of a Combat Application Tourniquet (CAT)-like tourniquet caused the death of a Ukrainian soldier during evacuation to an urban trauma center. In April 2022, a 19-year-old male underwent a bilateral below-the-knee amputation from an antipersonnel landmine. Massive hemorrhage prompted the use of bilateral CAT-like tourniquets. During transportation, the right tourniquet's windlass broke, resulting in a brisk hemorrhage. Due to the high patient-to-healthcare-personnel ratio, the bleeding remained unaddressed for an unknown amount of time, resulting in death from hemorrhagic shock.”

 

Issues Surrounding Counterfeit Tourniquets

 As Doc Miles from North American Rescue rightly explains, “there's been a lot of counterfeit C-A-T® tourniquet production that has gone on out of China. And these tourniquets have been flooding the market.” While these counterfeit TQ’s often look remarkably similar to genuine products, they are made with inferior materials. Let’s discuss some of the reported ways that these fake’s can fail:

  1. Ineffective tensioning: The buckle system doesn't hold tension properly, meaning that it slides around and loosens easily when you are trying to take out the slack.
  2. Poor quality fabric: There have been reports of these tourniquets being made with coarser fabric, with uneven and fraying edges right out of the packaging.
  3. Lack of retention clip: Many fakes have been reported to lack a retention clip to secure the windlass, making it hard to maintain tension once applied and increasing the risk of delayed tourniquet failure.
  4. Flimsy metal: Many reports mention the windlass and buckles being made of poor-quality metal, which snaps under force.

 

How to spot a fake:

  1. Course fabric used for the strap
  2. Uneven cutting and fraying at the ends of the strap
  3. Poor stitching, with the label only attached on two edges
  4. Basic labelling without an item number, date of manufacture and patent number.
  5. Scratches and chips on the buckles, right out of the package.
  6. Buckles that don’t tension properly, allowing the strap to slide around easily
  7. Missing retention clip for securing the windlass
  8. Poor quality metal windless and buckles that snap under force

 

 

The Growing Threat of Counterfeit Tourniquets

Whilst the distribution of counterfeit tourniquets is growing exponentially due to the ease of online shopping and worldwide shipping, this is not a new issue. This bulletin from the State of New Hampshire Department of Safety was issued way back in 2015:

“Recently a New Hampshire provider experienced a catastrophic failure of what is believed to be a counterfeit Combat Application Tourniquet (C-A-T) device. When applying the device the windless failed by snapping in half. A second device was attempted and again the windless failed. The provider was able to eventually control the hemorrhage through other improvised equipment.”

This has become such a huge, life-threatening concern around the globe that North American Rescue (NAR) recently partnered with CAT resources to obtain a General Exclusion Order, which gives USA Customs and Border Protection the right to search cargo that's entering the United States, and if they see anything that looks like a C-A-T® tourniquet, they can seize it.

Here in Australia, Tourniquets are classified as medical devices and must be included in the Australian Register of Therapeutic Goods (ARTG) before they can be legally supplied in Australia. However, with the rise of online marketplaces more and more fake TQ’s are ending up on Aussie soil. And while we love a good bargain as much as you do, we know that the potential cost savings of counterfeit gear are far outweighed by the risks they pose to patient safety and survival.

We also know there’s still many people who don’t realise the importance of purchasing approved tourniquets, or may not know how to distinguish genuine products from counterfeits… So, we need your help to get the word out!

 

As official distributors in Australia for two of the world’s most respected tourniquets - Combat Application Tourniquet (C-A-T) and SOF®️ Tactical Tourniquet – we recommend the following:

  1. Always purchase tourniquets from authorised distributors or reputable medical supply companies.
  2. Be wary of prices that seem “too good to be true”.
  3. Regularly inspect your tourniquets for signs of wear or damage.
  4. Never reuse a tourniquet in real-life scenarios. You can purchase a blue tourniquet for training purposes.
  5. Stay informed about product recalls and alerts in the medical equipment industry.

 

 

 

 

Saving Lives with Genuine Tourniquets

The issue of counterfeit tourniquets is more than just a matter of intellectual property rights or lost revenue for manufacturers. It's a critical public health concern that could mean the difference between life and death in emergency situations.

Remember, when you choose a tourniquet, you're not just buying a piece of equipment – you're investing in a life-saving tool that you or someone else may depend on in a critical moment. As medical professionals and first responders, we have a responsibility to ensure we're using the best possible equipment, but this isn't just a message for those in the medical field! Anyone who keeps a first aid kit at home, in their car, or at their workplace should be aware of this issue and take steps to ensure they have genuine, reliable tourniquets.

 

Share this information with your colleagues, friends, and family. Check your own equipment and encourage others to do the same. By raising awareness and making informed choices, we can help ensure that when a tourniquet is needed, it will perform as intended – saving lives and preventing tragedy.

 

Stay Safe,

Team TacMed.

 

References:

Pubmed Case Report Oct 2, 2024. Limb Hemorrhage Control Failure with Counterfeit Tourniquet: A Ukrainian War MEDEVAC Case Report

North American Rescue Oct 26, 2024. General Exclusion Order Blocks Importation of Counterfeit Tourniquets

State of New Hampshire Department of Safety July 20, 2015. Clinical Bulletin. Counterfeit Combat Application Tourniquet (C-A-T)

 

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