ISIS Leadership has been in direct communication with CDC officials to address CMS and CDC public health concerns correlated with the widespread clinical practice of using single dose medication vials (SDV) for multiple patients. Both CDC and ISIS place patient safety first and share concern regarding numerous recent iatrogenic infectious outbreaks associated with pain intervention procedures. In conference calls with CDC officials in Washington DC and Atlanta, the CDC has shared epidemiological and infectious disease data with ISIS. Both ISIS and the CDC find the severity and frequency of infectious disease outbreaks associated with pain interventions concerning, and the data compelling.ISIS is working with the CDC to collectively address numerous issues associated with these outbreaks – beyond SDVs alone. The fiscal burden of the policy related to SDVs, compounded by the current lack of medication packaging in reasonably priced smaller quantities, has been discussed in detail. The CDC understands the implications of the policy on ISIS members. Several alternatives are now being explored that allow for compliance with the policy in a cost effective manner. We are committed to working with the CDC to improve patient safety while simultaneously providing our membership with educational resources and reasonable options to lower the incidence of infections related to spinal interventions. Please look for additional information on this issue in future ISIS communications.