By now those that had criticised the European Medicines Agency’s (EMA’s) decision had gathered support from societies and petitions called for action. Possibly the most significant criticism of the decision was also published in 2017 when two studies revealed the staggeringly high percentage of non-adherence to the 2013 restrictions of hydroxyethyl starch (HES) in critically ill patients. 

2017 Hydroxyethyl starch timeline.

The evidence of non-adherence to the safety restrictions couldn’t be ignored by the EMA, and in 2018 the possibility of banning HES from the European market was reconsidered; but with experts continuing to support the use of HES opposing a ban, this consideration caused further heated international debate. 

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