https://youtu.be/E6ifjSAkTTs
Filed under: General Problems | 3 Comments »
https://youtu.be/E6ifjSAkTTs
Filed under: General Problems | 3 Comments »
On December 30, 2020, Midwestern Pet Food, Inc. announced a recall of certain lots of Sportmix pet food products after FDA was alerted about reports of at least 28 dogs that have died and eight that have fallen ill after consuming the recalled Sportmix pet food. Multiple product samples were tested by the Missouri Department of Agriculture and found to contain very high levels of aflatoxin. Aflatoxin is a toxin produced by the mold Aspergillus flavus and at high levels it can cause illness and death in pets. The toxin can be present even if there is no visible mold.
FDA is issuing this advisory to notify the public about the potentially fatal levels of aflatoxin in pet food products that may still be on store shelves, online, or in pet owners’ homes.
FDA is conducting follow-up activities at the manufacturing facility.
This is a developing situation and the FDA will update this page with additional information as it becomes available.
Pets are highly susceptible to aflatoxin poisoning because, unlike people, who eat a varied diet, pets generally eat the same food continuously over extended periods of time. If a pet’s food contains aflatoxin, the toxin could accumulate in the pet’s system as they continue to eat the same food.
Pets with aflatoxin poisoning may experience symptoms such as sluggishness, loss of appetite, vomiting, jaundice (yellowish tint to the eyes, gums or skin due to liver damage), and/or diarrhea. In some cases, this toxicity can cause long-term liver issues and/or death. Some pets suffer liver damage without showing any symptoms. Pet owners whose pets have been eating the recalled products should contact their veterinarians, especially if they are showing signs of illness. You can find more pet safety tips at pet blog sites like HouseholdPets.co.uk
There is no evidence to suggest that pet owners who handle products containing aflatoxin are at risk of aflatoxin poisoning. However, pet owners should always wash their hands after handling pet food.
On December 30, 2020, Midwest Pet Food, Inc. announced a recall of nine total lots of Sportmix pet food products. FDA and the Missouri Department of Agriculture are working with the firm to determine whether any additional products may have been made with the same ingredients containing potentially fatal levels of aflatoxin. As new information becomes available, this product list may continue to expand.
The list of recalled dry pet food products announced by Midwestern Pet Food, Inc. on December 30, 2020 is:
Lot code information may be found on the back of bag and will appear in a three-line code, with the top line in format “EXP 03/03/22/05/L#/B###/HH:MM”
The affected products were distributed to online retailers and stores nationwide within the United States.
Don’t sell or donate the affected pet food products. Contact the manufacturer for further instructions. The FDA also encourages retailers to contact consumers who have purchased recalled products, if they have the means to do so (such as through shopper’s card records or point-of-sale signs).
If your pet has symptoms of aflatoxin poisoning, contact a veterinarian immediately. Even pets without symptoms may have suffered liver damage, so you may want to contact your veterinarian if your dog has eaten any of the recalled products. Provide a full diet history to your veterinarian. You may find it helpful to take a picture of the pet food label, including the lot number.
Don’t feed the recalled products to your pets or any other animal. Contact the company listed on the package for further instructions or throw the products away in a way that children, pets and wildlife cannot access them. Sanitize pet food bowls, scoops, and storage containers using bleach, rinsing well afterwards with water, and drying thoroughly.
There is no evidence to suggest that pet owners who handle products containing aflatoxin are at risk of aflatoxin poisoning. However, pet owners should always wash their hands after handling any pet food.
You can report suspected illness to the FDA electronically through the Safety Reporting Portal or by calling your state’s FDA Consumer Complaint Coordinators. It’s most helpful if you can work with your veterinarian to submit your pet’s medical records as part of your report. For an explanation of the information and level of detail that would be helpful to include in a complaint to the FDA, please see How to Report a Pet Food Complaint.
The FDA urges veterinarians treating aflatoxin poisoning to ask their clients for a diet history. We also welcome case reports, especially those confirmed through diagnostic testing. You can submit these reports electronically through the FDA Safety Reporting Portal or by calling your state’s FDA Consumer Complaint Coordinators. For an explanation of the information and level of detail that would be helpful to include in a complaint to the FDA, please see How to Report a Pet Food Complaint.
The information in this release reflects the FDA’s best efforts to communicate what it has learned from the manufacturer and parties involved in the investigation. The agency will update this page as more information becomes available.
Filed under: General Problems | Leave a Comment »
https://youtu.be/SKI9m8me6WM
Chronic pain comes in ALL forms and fashions. What hurts for one may be just fine for another. The sheer number of parts which construct & form our human body as we know it is quite mind-boggling. From the largest organ of our body; the skin to our bones, the muscles, nerves, glands, organs, 5 senses, ligaments, brain, eyes, legs, arms, feet … you name it — I could go on and on. It is just fascinating.
So when a body part fails to function as it should, and begins to cause pain, most around us don’t know (or don’t wanna know) how to deal with it. We need more empathy. By creating this short video, I hope it moves you enough to video your OWN pain, and tell the CDC EXACTLY what chronic pain FEELS like. Because apparently they don’t have a clue. Go to: www.VideoYourPain.com Advocate for your rights to proper pain medications!
Filed under: General Problems | Leave a Comment »
Filed under: General Problems | Leave a Comment »
International mail could be disrupted after the first of the year as deadlines haven’t been met as CBP and USPS try to comply with the STOP Act that aims to stem the flow of opioids like fentanyl into the United States, agency officials told senators.
In 2018, the Senate Homeland Security Subcommittee on Permanent Investigations issued a report detailing how online drug dealers based in China were exploiting a loophole in international mail that allowed packages to be shipped into the United States without advance electronic data (AED) through the U.S. Postal Service.
Based on the recommendations in that report, in October 2018 the Synthetics Trafficking and Overdose Prevention Act, or STOP Act, was passed by Congress, requiring AED on all packages entering the U.S. beginning in 2021. The Postal Service and CBP submitted a joint strategic plan for implementation to Congress in March 2019.
“The STOP Act required CBP to finalize regulations regarding how packages would be dealt with that had no AED, by October 2019. Those regulations weren’t even submitted to the Office of Management and Budget for review until August of 2020,” Portman said. “We were told those regulations have now been passed back to the Customs and Border Protection, CBP, people with comments, but we still don’t know when they will be final.”
The legislation required USPS to collect AED on 70 percent of all international packages and 100 percent of packages from China by the end of 2018, but in January 2019 those numbers were only 57 percent and 76 percent, respectively.
By January of this year, 67 percent of international packages coming into the U.S. had AED, but during the COVID-19 pandemic that has slipped to 54 percent as of October. When USPS must begin rejecting packages without AED as of Jan. 1, 2021, that could mean the Postal Service turns away about 4 million pieces of mail a month. “I can’t imagine other countries won’t retaliate by blocking at least some of the packages that the Postal Service sends abroad,” said Ranking Member Tom Carper (D-Del.).
“In my opinion, the Postal Service, and come January 20, the new administration will have been put in an impossible position. And this is all coming at a time when trends with respect to how drugs like fentanyl are getting here are changing,” Carper said. “According to CBP, significantly more drugs may be coming through land ports of entry along our southern border. And at the same time, seizures in the international mail have declined.”
Robert Cintron, vice president of logistics at the United States Postal Service, said seizures of opioids in international mail have dropped 93 percent this year, with an increase in fentanyl and other drugs coming into the United States via the Mexico border.
“From fiscal year 2017 to January, 2020, the AED percentage trend steadily increase. But AED progress reversed as the global pandemic impacted international shipments. Once international mail recovers, we expect AED will resume its upward trajectory,” Cintron said.
“We have made strides in AED compliance but on January 1, 21 days from now, it is probable and foreseeable that a portion of international packages will lack AED. This places us in a difficult position. If inbound shipments, even by professional moving services like Big T are not accompanied by AED, we face the prospect of disrupting inbound mail,” he added. “On the other hand, applying alternative procedures may require burdensome and labor-intensive procedures.”
Cintron said USPS looks to CBP “for guidance on whether it can afford remedial measures.”
Thomas Overacker, executive director of cargo and conveyance security in the Office of Field Operations at U.S. Customs and Border Protection, called AED “the backbone of CBP’s targeting efforts” that can “effectively interdict illicit goods, segment risk and facilitate legitimate trade.”
In fiscal year 2018, CBP seized 91.2 pounds pounds of fentanyl in incoming mail from China, compared to just over a pound in fiscal year 2020. The amount of fentanyl seized at ports of entry on the southwest border rose 54 percent from fiscal year 2019 to 2020, while the amount seized between ports of entry increased 258 percent.
“Nevertheless, China continues to present a unique set of challenges. It remains a major source country of chemical precursors, narcotic manufacturing equipment such as pill presses, other controlled substances, fraudulent documents, and counterfeit merchandise,” Overacker said. “The explosive growth of e-commerce and direct to consumer shipping, especially directly from foreign sellers, has resulted in exponential growth in the number of actors in the international supply chain.”
Overacker said CBP is “confident” that the regulation requiring AED for international mail “will be published soon.” The interim rule required USPS to collect a dollar processing fee for inbound express mail service and give half of that to CBP to enhance capabilities at international mail facilities.
“CBP, DHS Science and Technology, ONDCP and the U.S. Postal Inspection Service sponsored a contest called the Opioid Prize Challenge, offering a $1.55 million prize to develop a solution that could detect minute quantities of opioids and other specific contraband in the mail stream,” he said. “The prize winner was announced, last December, and CBP has awarded contracts to purchase and deploy this technology as part of an overall strategy to modernize mail processing capabilities, including a multimillion-dollar renovation for our international mail facility at the JFK International Airport.”
Portman chided CBP for being more than a year late on the deadline to finalize regulations on the refusal of packages. “There is no good solution, thanks to the reality that you do not have the regulations in effect and the reality that we have not been successful in requiring 100 percent AED, as required by law,” the senator said.
Cintron said that “absent any alternatives, the Postal Service is prepared to refuse any of the shipments coming into the country” come Jan. 1. “There will be some disruption, but we are, absolutely, prepared to do it,” he said.
“For us, AED is what we use to assess risk,” Overacker said. “Provided that the volumes are manageable, we think we can set, we can mitigate risk by doing enhanced scanning, use of canines or even physical inspection.”
“But that would be something that’s on the ground at the international service enters and our international mail facilities, for those personnel to determine what is manageable volume, depending on the, what the environment is like, coming January 1st,” he added. “And we will have to make day-to -day decisions on that, based on the volume of mail without AED or the volume of mail that is co-mingled.”
Filed under: General Problems | Leave a Comment »
According to this article https://community.aarp.org/t5/Medicare-Insurance/Avoid-Optum-RX-Worthless/m-p/2360940 OptumRx is the entity along with United Health that is endorsed by AARP . One has to wonder if the royalties that AARP gets from allowing United Health/OptumRx to use AARP’s name and AARP’s endorsement is more important than the actual good service that is provided to AARP members ?
Ohio Attorney General Dave Yost’s office says it may have uncovered evidence in a court battle to show that a pharmacy benefit manager knowingly overcharged a state agency.
Among hundreds of thousands of emails obtained from PBM OptumRX as part of the litigation was one that appears to acknowledge that the multibillion-dollar corporation was not following the terms of its contract with the Ohio Bureau of Workers’ Compensation.
Starting with its predecessor, a company called Catamaran that OptumRX acquired, the PBM administered prescription drugs for workers injured on the job. In all, OptumRX overcharged the bureau on more than 1.3 million claims for generic medications, the lawsuit says.
The contract, in effect from mid-2009 until the fall of 2018, called for the PBM to charge the lowest of four potential prices for generic drugs, including a measure from the Centers for Medicare and Medicaid known as the Federal Upper Limit, or FUL for short.
But in a series of May 2015 emails marked as “confidential,” John Spankroy, director of public sector account management for Catamaran, said the Federal Upper Limit was never applied, despite the contract.
He told Susan McCreight, senior director of public sector account management, “Per BWC contract we are supposed to be using pricing logic that includes lower of FUL for generics. None of the BWC price schedules has FUL as a cost source.”
In a separate email, Spankroy told Bryce Owens, the Illinois-based PBM’s manager for pricing and analytics, “We do not see FUL included as a cost source option.”
Spankroy also acknowledged: “BWC is not aware of this (yet).”
“The admission is highly relevant” to the central issue in the legal dispute: “whether OptumRX was required to follow the pricing terms included in the BWC contract,” said Yost’s legal team in a Dec. 16 court filing.
But Andrew Krejci, who is with Optum’s corporate communication office, says the federal FUL requirement was never part of the PBM’s agreement with the state.
“The plain language of the contract demonstrates that the lesser-of reimbursement methodology, which was agreed upon and utilized by the parties over the course of their almost decade-long relationship, incorporated three reimbursement options and CMS FUL was never one of them,” OptumRx said in a court filing.
More: Drug middleman fires back in workers’ comp suit
Krejci said, “We are honored to have delivered access to more affordable prescription medications for the Ohio Bureau of Workers’ Compensation and Ohio taxpayers. We believe these allegations are without merit.”
The bureau dropped OptumRX more than two years ago after a consultant determined the PBM was vastly overcharging the state.
The same consultant later discovered that PBMs — including OptumRX — in Ohio’s Medicaid program, which pays for health care of the poor and disabled, were charging three to six times the standard rate, enabling them to take home nearly $250 million in a single year.
According to the lawsuit, which seeks unspecified damages, OptumRx overcharged the bureau on 57% of 2.3 million prescription claims from injured Ohio workers between January 2014 and September 2018.
The case is before Judge Michael Holbrook of Franklin County Common Pleas Court.
drowland@dispatch.com
@darreldrowland
Filed under: General Problems | 3 Comments »
Filed under: General Problems | Leave a Comment »
When Joe Biden is sworn in as our 46th President, he had stated over and over again that he believes in doing what SCIENCE dictates should be done in regards to health issues. This article is FIVE YEARS OLD, but many outside of the CDC said that their opiate dosing guidelines “flies in the face of science” … Is this the point that the community should start reaching out to him and insisting that he does an EXECUTIVE ORDER to RESCIND the CDC opiate guidelines, because they did not follow the science and when he was VP in the Obama/Biden Administration.
https://www.statnews.com/pharmalot/2015/12/15/cdc-opioid-painkiller/
On Monday, the CDC released its draft guidelines for opioid prescribing, but now says the recommendations will be subject to further review, which will also incorporate public comments, resulting in the delay of the release.
The delay was first signaled yesterday when the CDC unexpectedly disclosed that public comments on its proposal would be accepted through Jan. 13. However, the agency will also tap the National Center for Injury Prevention and Control’s Board of Scientific Counselors, a federal advisory committee, to review the guidelines and public comments. Its first meeting is scheduled for Jan. 7.
The postponement follows complaints from representatives of other federal agencies and consumer advocacy groups that the CDC guidelines were based on weak evidence and would unfairly restrict some patients from obtaining needed pain relief. The agency was also chastised for using a “secretive” process to formulate the guidelines, which some critics argued had violated federal law.
The guidelines were assembled earlier this year in response to a long-running epidemic of opioid abuse and misuse. Every day, 52 Americans die from overdoses of opioid painkillers. And so, the CDC convened a group of outside experts to draft guidelines for primary care physicians, since family doctors and internists write the vast majority of prescriptions for these drugs.
The CDC guidelines call on doctors to prescribe opioids only after other therapies have failed. The proposal also suggests physicians start their patients on short-acting opioids instead of extended-release, long-acting opioids, and initially prescribe the lowest possible effective dosage. The overall theme is to bolster physician awareness of abuse problems and encourage greater monitoring.
These objections began percolating after the CDC disclosed the guidelines last fall. Earlier this month, the National Institutes of Health’s Interagency Pain Research Coordinating Committee met and decided to file an objection to the CDC. In particular, many of the participants expressed concern that the CDC relied on what was termed weak evidence for some of its recommendations.
“It flies in the face of science,” Myra Christopher of the Center for Practical Bioethics, a nonprofit patient advocacy group, said at the meeting. The organization, by the way, is one of at least three patient groups that participated in the meeting and receive industry funding. Meanwhile, the Center for Practical Bioethics receives at least some of its funding from pharmaceutical firms, including Purdue Pharma, a spokesperson from the drug maker said. The Center for Practical Bioethics did not respond to questions.
“CDC’s plan to issue its guideline in January was thwarted by a well-organized, industry-funded effort,” said Dr. Andrew Kolodny, chief medical officer at Phoenix House, a nonprofit that runs alcohol and drug abuse treatment and prevention programs, and the head of Physicians for Responsible Opioid Prescribing, an education and advocacy group. A PROP member helped draft the guidelines.
Nonetheless, officials from other federal agencies also complained. The level of evidence cited to support the guidelines “is low to very low and that’s a problem,” said Sharon Hertz, who heads the FDA Division of Anesthesia, Analgesia and Addiction Products. And Richard Ricciardi, a health scientist at the Agency for Healthcare Research and Quality, called this “an embarrassment to the government.”
A CDC spokeswoman noted that other federal agencies were “a part of the review process and cleared the guidelines.” Nonetheless, the remarks by Hertz, in particular, were a reminder that the FDA and CDC are sometimes at odds over balancing pain relief and reducing abuse. The FDA, for instance, this summer approved a long-acting version of OxyContin for children as young as 11 years old.
Meanwhile, the CDC delay apparently reflects a desire to comply with the Federal Advisory Committee Act, which governs how expert groups are formed to provide official advice. The Washington Legal Foundation, a nonprofit that has often sided with the pharmaceutical industry in marketing matters, last month wrote the CDC to argue the agency violated the law.
The CDC is “certainly moving in right direction now,” said Richard Samp, the WLF’s chief counsel.
Filed under: General Problems | 6 Comments »
This article by Steve Forbes, it seems to have been composed by a person who really can’t make up their mind as to which side of the war on drugs/pts they want to be on. Whatever law firm that Walmart has hired, it would seem like they have done a lot of wide & deep research concerning the shenanigans that the DEA has done over the decades to put on the image that they are really interested and dedicated in fighting/winning the war on drugs/pts.
About one year ago, the Alaska Board of pharmacy sent a letter to all pharmacies/pharmacists State, Pharmacy Board tell pharmacies: ‘Fill legitimate opioid prescriptions’
If Walmart comes out ahead on this lawsuit, could be a significant indicator that the denial of pain pendulum is starting to swing in the opposite direction. There is a phrase in the Controlled Substance Act – “corresponding responsibility” … it has been interpreted by the DEA and Pharmacy Boards that it means that both the prescriber and pharmacist are responsible for a controlled substance being prescribed or dispensed to a person without a valid medical necessity. I have often stated that this phrase should be a “two-way street” … to date there has been little concern if a dose DOES NOT GET INTO THE RIGHT HAND… the only concern is if a dose GETS INTO THE WRONG HAND. It would appear that everyone involved has little concern if a legit pt does not get their medically necessary medication… it is just collateral damage that ALL WARS HAVE… something like deaths from “friendly fire” !
One thing that I did not see in this article and it may have been in the filed lawsuit – about the discrimination and civil rights violations that the DEA is causing to untold hundred of thousands or millions of chronic pain pts. If Walmart prevails, this could be one small step for chronic pain pts… in getting adequate pain management. It could also be the genesis of a tsunami of law firms and lawsuits against many healthcare organizations and practitioners.
https://www.foxbusiness.com/politics/walmart-doj-opioid-lawsuit-dea
It’s a story that unfortunately never gets old: Career bureaucrats failing in their mission to address a major public policy issue try to shift the blame, shirk the responsibility and scapegoat the innocent.
In the case of the opioid epidemic, those bureaucrats are at it again. Despite the massive failure of the Drug Enforcement Agency (DEA) to recognize and deal with the enormous growth in the production of opioids (which is literally their job – to regulate production levels), and despite their crisis-fostering failure to end prescribing by problematic doctors (again, literally their job), the DEA is targeting pharmacists and pharmacies for blame.
Enter the Department of Justice with a headline-seeking, deep-pocket-targeted pending lawsuit.
But for once, one of their targets is fighting back. The Wall Street Journal reported in late October that Walmart had filed a preemptive lawsuit against the Department of Justice and the Drug Enforcement Agency ahead of a potential opioid-related suit by the DOJ.
In a suit filed last month in federal court, Walmart, which runs over 5,000 pharmacies, argued that DOJ lawyers are planning to target them without being able to cite any actual law or rules that they are violating.
The company is seeking a declaration from a federal judge that the government has no legal basis for such a lawsuit.
Walmart, as it argues in its filing, is caught between a rock and a hard place on the issue of filling opioid prescriptions.
On one hand, federal government lawyers have targeted them for filling customer prescriptions from certain doctors, arguing that pharmacists at Walmart should have inserted themselves into the doctor-patient relationship and refused to fill legitimate (no evidence of fraud or forgery) prescriptions despite having no knowledge of the patients’ medical history, treatment or illness.
On the other hand – as Walmart extensively details – if they refuse to fill legitimate prescriptions, they risk having their licenses revoked. In fact, many states have already taken action against Walmart for refusing to fill opioid prescriptions.
All pharmacies lose whichever choice they make.
Walmart is asking the court to resolve these conflicting demands by declaring that the Controlled Substance Act “does not require pharmacists to second-guess a registered and licensed doctor’s decision that a prescription serves a legitimate medical purpose.”
As Walmart said in its lawsuit, “[i]n the shadow of their own profound failures, DOJ and DEA now seek to retroactivity impose on pharmacists and pharmacies unworkable requirements that are not found in any law and go beyond what pharmacists are trained and licensed to perform.”
In their threatened action against Walmart, some DOJ career lawyers have identified hundreds of doctors whose written prescriptions they claim shouldn’t have been filled by Walmart pharmacies.
Yet, 70% of these very doctors continue to be actively registered with the DEA. So, government officials cannot even take action against the doctors they claim are writing suspicious prescriptions, but they threaten private companies for not stopping those very same doctors.
DEA needs to do its job and crack down on doctors abusing their privileges, not target pharmacies for not doing the job DEA failed to do.
These threats are made worse by the fact that these government officials cannot point to any laws or official DEA guidelines that are being violated.
According to Walmart, the claims are based instead on alleged “violations” of informal letters and PowerPoint presentations. It should also be noted that by their own rules, DOJ is not allowed to base a case on such unofficial guidance.
The full power of federal law enforcement should not be unleashed on the basis of bureaucratic presentations!
Walmart is asking the court to declare that DOJ and DEA “must follow their own regulations and may not base any enforceable legal positions on the alleged violation of agency guidance rather than obligations found in a statute or duly promulgated rule or regulation.”
Clearly, the likely action by the Justice Department is not about addressing the real issue or enforcing the law, it is about shifting blame – and finding deep-pocketed targets to shake down.
Walmart should be commended for calling their bluff and taking steps to ensure that those responsible for fighting this crisis implement clear rules and regulations for pharmacists across the nation.
The opioid addiction crisis has been crying out for leadership by our government agencies and it’s time put an end to their blame games and hold them accountable for real action.
Walmart’s turn to the court is a bold and important move by the company to stop this intimidation effort. Pharmacies and pharmacists – whether Walmart or small corner pharmacy – deserve clarity, resolution and simple justice.
Steve Forbes is chairman and editor-in-chief of Forbes.
Filed under: General Problems | 1 Comment »
https://www.foxnews.com/health/excedrin-recalled-faulty-packaging-child-poisoning-concerns
Multiple brands of the over-the-counter headache medication Excerdrin are facing a recall after many bottles were found to have holes in the bottom, prompting child poisoning concerns.
The U.S. Consumer Product Safety Commission on Wednesday announced that some 433,600 units of Excedrin products are subject to the recall, including Excedrin Migraine Caplets, Excedrin Migraine Geltabs, Excedrin Extra Strength Caplets, Excedrin PM Headache Caplets, and Excedrin Tension Headache Caplets.
The holes in the affected bottles could pose child safety issues, as “children could access and swallow the contents, posing a risk of poisoning,” per the recall announcement. “These products contain the substances aspirin and acetaminophen, which must be in child-resistant packaging as required by the Poison Prevention Packaging Act (PPPA).”
The recall, which involves 50, 80, 100, 125, 200, 250 and 300-count bottles of the above-listed Excerdrin brands, were sold at pharmacies, department stores, grocery stores and beyond from March 2018 to Septemeber of this year. The products were also sold online.
ALMOND KRINGLE SOLD AT TRADER JOE’S FACES RECALL OVER UNDECLARED PECANS
Those who purchased one of the affected bottles may be eligible for a refund. Consumers who find a hole on the bottom of the bottle can contact the manufacturer, GSK Consumer Healthcare, for information on how to obtain a prepaid shipping label to initiate the refund.
LEAN CUISINE RECALLS SELECT FROZEN CHICKEN MEALS AFTER COMPLAINTS OF PLASTIC IN PRODUCT
“Bottles without a hole can be retained and used as directed,” per the recall announcement.
For a full list of recalled items, click here.
Filed under: General Problems | Leave a Comment »