HomeMy WebLinkAboutAppendix BAppendix B:
Notice of Public Hearing
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published August 14, 2023
MONDAY AUGUST 14 2013
I MIAMI HERALD
I 5A
Anesthesiologists in the United States and Canada are seeing more patients who take
weight -loss drugs, such as Wegovy or Ozempic, who may face life -threatening
complications during surgical procedures that require empty stomachs for anesthesia.
Popular weight -loss drugs like
Wegovy may raise risk of
complications under anesthesia
Mayo Clinic anesthesiol- doctors and patients
BY JON.- AreccrA ogist who is also deputy Novo Nordisk, which
Associate r1es editor -in -chief of the ]our- makes Ozempic, Wegovy
nal. and similar drugs, said the
Patients who take block- "When 90% of it is firm's clinical trial and
buster drugs like Wegovy gone, which is after three post -marketing safety data
or Ozempic for weight loss weeks, hopefully every- did not show that the medi-
may face life -threatening thing should go back to cations led to aspiration.
complications if they need normal," Jones said. But the dmgmaker noted
surgery or other pmce- Champeau and Jones that the medications are
dares that require empty both aclmowledged known to cause delayed
stomachs for anesthesia. there's not enough evi- emptying of the stomach
This summer's guidance dence to say for certain and that the labels wain of
to halt the medication for how long semaglutide possible gastrointestinal
up to a week may not go should be held to make side effects.
far enough, either. anesthesia safe. Many Sopping the medications
Some anesthesiologists patients won't see provid- for three weeks can cause
in the U.S. and Canada ers far enough in advance problems, too. Patients
say they've seen growing to stop the drug three with diabetes will need
numbers of patients on the weeks before procedures, another way to control their
weight -loss drugs who Champeau noted. blood sugar and those
inhaled food and liquid Aspiration occurs in one seeking to lose weight may
into their lungs while of every 2,000 to 3,000 regain some, Hobai said.
sedated because their operations that require Hobai suggests that
stomachs were still full — sedation, and almost half people using Wegovy and
even after following star- of patients who aspirate similar dings tell their
dard instructions to stop during surgery develop a doctors before sedation and
eating for six to eight related hmg injury. But discuss the risks and bene-
hours in advance. case reports show recent fits
The drugs can slow patients on semaglutide "If you're taking this
digestion so much that it had problems even when drug and you need an oper-
puts patients at increased they stopped food as long ation, you will need to have
risk for the problem, as 20 hours before their some extra precautions,"
called pulmonary aspim- procedures. he said
tion, which can cause "There's nothing that
dangerous lung damage, says if you fast twice as
infections and even death, long, it will be OK,"
said Dr. Ion Hobai, an Champeau said.
anesthesiologist at Mas- Among the several re-
sachusetts General Hospi- ports detailing potentially
tal in Boston. serious problems was one
"This is such a serious of Hobai's patients, a
sort of potential complica- 42-year-old man in Boston
tion that everybody who who recently began taking
takes this drug should Wegovy, had to be in -
know about it," said Ho- [abated and suffered re-
bai, who was among the spiratory failure that put
first to flag the issue. him in intensive care. He
Nearly 6 million pre- aspirated food that re-
scriptions for the class of mained in his stomach
drugs that include Wegovy despite fasting for 18
and Ozempic were written hours.
between January and May In Chapel Hill, North
in the U.S. for people who Carolina, a 31-year-old-
don't have diabetes, ac- woman on a low dose of
cording to Komodo Ozempic had fasted for 10
Health, a health care tech- hours before a routine
nology company. The endoscopy prior to ba-
drugs induce weight loss riatric surgery last fall.
by mimicking the actions The procedure had to be
of hormones, found pri- stopped because solid
manly in the gut, that kick food remained in her
in after people eat. They stomach and she was at
also target signals be- high risk for aspiration,
tween the gut and the the report said.
brain that control appetite Since then, doctors have
and feelings of fullness, seen dozens of similar
and by slowing how fast cases as use of the weight -
the stomach empties. loss medication has
In June, the American grown, said Dr. Elisa
Society of Anesthesiol- Lund, an anesthesiologist
ogists issued guidance at the University of North
advising patients to skip Carolina at Chapel Hill
daily weight -loss medica- School of Medicine. "It
tions on the day of surgery has exponentially in -
and hold off on weekly creased," she said.
injections for a week be- Hobai is completing a
fore any sedation pmce- retrospective study of
dures. Dr. Michael Cham- almost 200 patients tak-
peau, the group's presi- ing semaglutide. While
dent, said the action was it'll be published later this
based on anecdotal re- year, the work so far ap-
ports of problems — in- pears to confirm a small
eluding aspiration — from study from Brazil, he said.
around the country. In that study, about a
It's not clear how many quarter of patients taking
patients taking the anti- semaglutide had residual
obesity drugs may be food in their stomachs
affected by the issue. But during procedures requir-
because the consequences Mg sedation — even after
can be so dire, Hobai and stopping the drug for 10
a group of colleagues days.
decided to speak out. The American Society of
Writing in the Canadian Anesthesiologists advises
Journal of Anesthesia, doctors who are in doubt to
they called for the drug to treat patients who haven't
be stopped for even longer paused the drug as if they
— about three weeks be- have full stomachs, which
fore sedation. can mean using different
That accounts for how types of sedation protocols
long semaglutide, the or delaying procedures, if
active medication in We- possible. Jones added that
govy, remains in the body, research is urgently needed
said Dr. Philip Jones, a to update guidelines for
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CITY OF MIAMI, FLORIDA
NOTICE OF PUBLIC HEARING
NOTICE OF HEARING TO IMPOSE AND PROVIDE
FOR COLLECTION OF SOLID WASTE SPECIAL ASSESSMENTS
Notice is given that the Clty Commission of the Clty of Mlaml
will conducta public hearing to canslder imposing Sold Waste
special assessments for the provision of Solid Waste services
within the City of Kam for the Fiscal Year commencing
October 1, 2023 and ending September 30, 2024.
The hearing will he held at 10:00 a.rn. on September 09,
2023, In the City Commission Chambers of City Hall, 3500 Pan
American Drive, Kam:, Florida, for the purpose of receiving
puhllc comment on the proposed assessments. All affected
property owners have a right to appear at the hearing and to file
wort. .bjectlonswith the City Commission within twenty (20)
days of this notice. If a person decides to appeal any decision
made by the City Cammisslaners with respect to any matter
cansldered at the hearing, such person will need a retard of the
proceedings and may need to ensure that a verbatim record is
made, Including the testimony and evidence upon which the
appeal is to be made. In accordance with the Americans with
Disabilities Act, persons needing special accommodation a
sign language interpreter to participate inthis proceeding
should contact the Office of the City Clerk at (305) 250-5361,
TTY users may call via 711 (Florida Relay Service], at least seven
(7] days prior to the date of the hearing.
The assessment far each parcel of property will he based
upon each parcel's classification and the total number of
billing units attributed to that parcel. The total Solid Waste
estimated amount to he assessed and collected for the Fiscal
Year commencing October 1, 2023, Is 324.510 million, while
the full cast of Solid Waste services Is approximately 341.676
million. The fallowing table reflects the proposed Sal Id Waste
assessment schedule:
RESIDENTIAL PROPERTY RATE PER EACH
USE CATEGORIES DWELLING UNIT
Single Family & City -
I Defined Multi Family
$380.00
Copies of the Solid Waste Assessment Ordinance, Initial
Assessment Resolution and the preliminary assessment roll are
avallable for Inspection at the Office of the City Clerk of Miami,
Florida, 3500 Pan American Drive, Miarni, Florida.
Unless proper steps are initiated in aunt f
competent jurisdiction to secure relief within
twenty (20) days from the date of Clty Commission
action at the above hearing (Including the method
of apportionment, the rate of assessment and tl e
imposition of assessments), such action shall be
the final adjudcaton of the Issues presented.
The assessments ,wlll be collected on the same bl II
s ad valorem taxes. Failure to pay the assessment
result In either the commencement of
foreclosure proceedings or cause a tax certificate
to he issued against the property which may result
in a lass of title.
If you have any questions, please contact the. City
of Mlaml at (305) 416-1570, Monday through
Friday between 8:30 a.m. and 4:30 p.m.
TODD B. HANNON
CITY CLERK
CITY OF MIAMI, FLORIDA
Ad No. 40479