Don’t buy fake tourniquets: Use proven tourniquets, not toys.
A few weeks ago a student of our online Tactical Casualty Care course contacted us. The student’s county health department planned to issue teachers bleeding control kits for their classrooms. Our student had already purchased a pretty robust bleeding control kit for their classroom, researched the best, most proven equipment to put in their kit, and obtained proper training to be ready in a crisis. The student was shocked to receive counterfeit knock-offs of CAT tourniquets in the school’s kit.
The student’s concern came when the health department liaison informed teachers that the $17 bleeding control kits would contain two North American Rescue (NAR) CAT tourniquets. We teach in our classes that there are counterfeit and fake CAT tourniquets in circulation and the only way to be sure you’re getting the real thing is to buy it directly from the manufacturer. Tourniquets are a medical device and subject to FDA regulations. Beginning in 2010 the FDA recognized the problems with knock-offs and began requesting anyone who obtained a counterfeit device to destroy it, to ensure it would not end up back in the system. Although initially imported as toys for the airsoft community, they’re now making their way into legitimate medical kits and systems.
The counterfeit tourniquets have failed operationally in the United States.
In 2015 in New Hampshire, a fire service unwittingly was carrying such knock-offs on their rigs. When called upon to use them to stop a severely bleeding leg wound, the tourniquet failed. When contacted, NAR said, “no, that’s not one of ours. It’s a counterfeit.”
Back to our student/teacher, when the kits arrived, the teacher could tell without even opening the kit that one of the tourniquets was a fake. To be sure, the teacher sent it to Mike Shertz where he happened to be at the Special Operations Medical Association (SOMA) meeting with representatives from NAR. The kit contained one legitimate 7th generation CAT tourniquet in orange. The second tourniquet, black, was an obvious fake.
Teachers received a short, 30-minute training the teacher received on how to use their hemorrhage control kits. During the overview, a Health Services Representative from the Florida Department of Health reportedly told the teachers “We are at war. For whatever reason, we are at war.” Later during the same training, we were told he held up both tourniquets and said, “the black one [the fake one] is just as good as the orange one.” We disagree.
Where do the fake tourniquets come from?
There are at least three companies in China who are making fake tourniquets. They are not made to the military specifications, and we don’t know anything about the plastic quality or the stitch counts. There are quite a few ways to tell.
What are some signs a tourniquet is fake?
We showed the suspected counterfeit tourniquet to an official representative with NAR. They pointed out the numerous differences in this knock-off of the sixth generation CAT. The windlass has several issues: it is too small, the plastic is inferior to the CAT, and it bends easily. The time tape font was wrong. The ‘sonic weld’ that holds the tourniquet together was not actually a sonic weld. The plastic base plate had no markings on it, whereas a legitimate CAT has the NAR national stock number, licensing information, patent number, and manufacturing and lot number of the production. The windlass clip bent easily.
Fake tourniquets are not “better than nothing”
We passed along to the school district that the tourniquets were counterfeit and likely to fail. Their answer? We know. It’s better than nothing. We disagree. It’s a false sense of security depending on the equivalent of a dollar store toy instead of a life-saving device. If they believe themselves to be “at war,” why would they issue their personnel a toy instead of a proven tourniquet?
We agree with NAR: “It’s not anything new; it’s just dangerous.”
The only way to determine how widespread this problem is, is to gather data. Please help us analyze the scope of the problem.
Help us ensure schools are using the right equipment. Please complete the School Preparedness Survey.
An older, but still interesting pdf documenting the differences between CAT gen 3 and the knock-off E-cat.