A nutritional product being given to severely disabled patients is causing weight loss, bedsores and vomiting, according to their families as the health ministry blames “damaged stock”. 

Relatives of patients receiving Energie Shake products told Times of Malta the products are ineffective and causing health complications, with some families now spending more than €500 per month on alternatives. 

They say the products, which first started to be given to patients three months ago, are causing weight loss and leading to bedsores, which can develop when people are underweight due to increased pressure on the skin. Some also said their family members were vomiting after trying to drink from some batches of the product, which they suspected had gone off and described as having a consistency like expired milk. 

Despite reports that Mater Dei Hospital has stopped using Energie Shake products due to the same concerns, it is continuing to be distributed to patients through the ‘pharmacy of your choice’ (POYC) scheme, which provides free medicines to those with chronic conditions. 

The health ministry put the complaints down to “damaged stock”, which, it said, had been withdrawn in collaboration with the UK-based company that makes the product. Anaiah Healthcare said it had been contacted by the health ministry and would be supplying additional stock for free with all future orders.

Energie Shake approved by UK health authorities

Daniel Sammut said Energie Shake wasn’t working for his 26-year-old son, who has been in a wheelchair since a motorbike accident five years ago.

“It isn’t working well; it looks good  but, in practice, it isn’t working,” he said, stressing his son is dependent on the product, which he is fed enterally – through a tube directly into his stomach. 

“It’s shameful that people with severe disabilities and who are dependent on enteral feeding are being given inferior feeds and losing weight,” he said, adding his son had lost around 10kgs of weight since being put on to Energie Shake products three months ago.

Sammut, a medical doctor, said he had been told by staff at Mater Dei that the product was leading to weight loss because it wasn’t absorbable enough and that it had been recalled by the hospital despite continuing to be given out through POYC. 

He said he had tried doubling the number of feeds his son receives on the advice of a nutritionist but it hadn’t solved the problem. 

Sammut has since started an online petition asking the government to change the nutrition supplement provided through POYC, which, at the time of publication, had amassed over 300 signatures and a slew of comments slamming the product. 

Josephine Gatt’s 26-year-old son has severe cerebral palsy – an incurable condition affecting coordination and movement – epilepsy and is visually impaired and has been fed enterally for around 10 years. 

She said she first noticed he was losing weight when she realised his thighs were getting thinner and complained Energie Shake was noticeably waterier than the products they had been given in the past. 

“The consistency isn’t as thick; it’s very light, like water,” she said, adding her son hadn’t lost weight with other brands. “It’s not fair on us; this was issued by the health department.”

Gatt said one dietician from Mater Dei she had spoken to told her they had received “a lot” of complaints about the product.  

A parent who asked not to be named told Times of Malta her 27-year-old daughter with cerebral palsy was “losing a lot of weight” and, were it not for the fact she was still able to consume other foods due to being able to eat orally, she would be in trouble. “It’s so inferior – it’s thin, like skimmed milk. Sometimes, we have to throw it away without using it... they’re wasting our time by giving us an inferior product,” she said. 

The brother of a bedridden 31-year-old patient who also asked not to be named said weight loss caused by Energie Shake had led to his brother developing a four-centimetres-wide bedsore on his back, which had still not healed after almost two months.

He said his family had been forced to buy an alternative product, which cost €130 per week, adding the wound dressing and antibiotics to treat the bedsore were setting them back around €330 per month. 

He said his brother had been losing around a kilogram of weight per week while on Energie Shake, which he had put back on again at the same rate after starting an alternative product. 

Meanwhile, one man Times of Malta spoke to said his 66-year-old father had been admitted to intensive care after a bout of vomiting he attributed to the product caused him to ingest it into his lungs. 

On Friday, Opposition MP Mark Anthony Sammut described the issue as a "health crisis" after meeting two families affected by the product.

Company response

Energie Shake is manufactured by UK-based Anaiah Healthcare and, according to the company’s website, is designed for “special medical purposes for the dietary management of patients with or at risk of disease related malnutrition”.

When contacted, Anaiah Healthcare told Times of Malta they were aware of the complaints and were in contact with the health ministry.

“We have been contacted by the Ministry of Health in Malta, and we will be sending free stock for all future orders in case of any further issues,” said the company’s director, Ryan Rodrigues.

Stressing his company’s goal was to produce “cost-effective” products for patients, Rodrigues said it had clients in various countries and had not received similar complaints.

“We supply the NHS [national health service] in the UK and have clients in Scandinavia and the Middle East, and have not encountered these complaints before,” he said, adding Energie Shake had been approved by the UK health authorities.  

When asked about reports of some batches appearing to have expired, Rodrigues stressed that “if the product is not taken care of, it will deteriorate” and suggested that damage might have been caused to the packs when the shipment had been opened.

He said that while the three main European suppliers of similar nutritional products used plastic bottles, Anaiah Healthcare had chosen to package its products in paperboard, plastic and aluminium cartons for “environmental reasons”.

Alternative product ordered

Responding to questions, the health ministry put the complaints down to “damaged stock”, which, it said, had been withdrawn in collaboration with Anaiah Healthcare, which, it confirmed, would be replacing the items. However, a spokesperson for the ministry said that “no official reports regarding health issues were received in relation to this product”.

Stressing that “patient safety is the mainstay”, the spokesperson said a “precautionary quarantine” had been issued, with two batches of Energie Shake withdrawn from the market as a result.

“The department of health has also ordered an alternative product and delivery was also hastened,” he said, adding the health ministry had switched to Energie Shake “due to the new awarded tender as it fitted the clinical technical specifications”

He said a total of 2,506 patients on the POYC scheme were entitled to the product, which had been given to patients in all health entities across the country. 

The spokesperson did not confirm which product was currently being supplied by Mater Dei and did not respond to questions asking why Energie Shake was still being used by the POYC scheme if it had been withdrawn by the hospital.