U.S. authorities are rushing approval to airlift intravenous fluids from overseas manufacturing plants to ease shortages caused by Hurricane Helen. The shortage has led hospitals to begin postponing surgeries as a way to ration supplies to the most vulnerable patients.
The current shortage comes as flooding hits western North Carolina, damaging the Baxter plant and currently closing it for cleaning. The plant produces about 60 percent of the U.S. fluid supply used for home dialysis and intravenous fluids for people who rely on IV nutrition. These include premature babies in intensive care and patients who rely on tube feedings to survive.
Now that Hurricane Milton is hitting Florida, the situation could become even more dire. On Tuesday, employees at B. Brown, which makes a quarter of the nation’s intravenous fluids, loaded medical bags onto trucks at the company’s Daytona Beach factory and drove north overnight to their desired safer location. I drove.
The Baxter plant in Marion, North Carolina, and the B. Brown plant in Daytona Beach, North Carolina, manufacture approximately 85 percent of the nation’s intravenous fluid supply. Shortage experts have long pointed to the risks of such overconcentration of critical supplies, citing the potential for exposure to disasters like the one now at hand. Supplies were tight even before the storm, reflecting a longstanding problem in which few companies were willing to produce critical but low-cost, low-margin medical products.
A spokeswoman for the B. Brown plant in Florida said the company was cooperating with federal authorities and that plant staff would be off work Wednesday and return on Friday once the hurricane passes.
This week, the company limited supply to hospital customers to 40% to 60% of its normal supply due to supply shortages caused by flooding at the Baxter plant. The American Hospital Association sent a letter to President Biden on Monday asking for help alleviating concerns about “significant shortages of these life-saving and life-sustaining products.”
The saline, dextrose and sterile water produced at the Baxter facility is used for countless applications in the medical field. These provide basic hydration before surgery or childbirth and can be mixed with nutrients and medications, including chemotherapy. These are widely used for life-sustaining intravenous fluids in premature infants. Some are important in treating sepsis, a life-threatening blood infection.
“If you come in with sepsis, especially septic shock, these 1 liter bags are the most immediate treatment, and sometimes you take two, if not three, or two in quick succession. “That’s the case,” the doctor said. Chris DeRienzo, American Hospital Association Chief Physician; “There are so many special people who are affected by the shortage, and what it really does have is an impact on the whole population.”
Doctors and patients said in interviews that patients who rely on Baxter infusions for home dialysis treatment and those who rely on IV nutrition to survive are especially suffering from the shortage.
Federal officials and some Baxter employees have been working nights and weekends to mitigate the impact of supply disruptions. The Food and Drug Administration is said to be on the verge of approving temporary imports of IV, dialysis and liquid nutrition products from several overseas locations.
In North Carolina, crews are working to rebuild a bridge adjacent to the Baxter site to remove and distribute trucks loaded with additional supplies not damaged by the storm.
Baxter said in a statement Wednesday that its overseas factories are ramping up production and that it expects FDA approval to export its products. The company said it would increase Wednesday’s supply from 40% of supply earlier this week to 60% of normal levels to account for expected deliveries. The company said in a statement that it plans to restart production in stages by the end of this year. Baxter said it has not released an estimate for when the plant will be fully operational.
Baxter CEO Jose Almeida said in a statement Wednesday that “we are dedicating human and financial resources to help us resume operations and ensure patients and healthcare providers have the products they need. I will spare no effort.”
For patients like Hannah Hale, 37, who lives in the Dallas area, help can’t come soon enough. Hale learned on Monday that she could not get enough concentrated glucose solution at a specialty pharmacy to continue administering the IV fluids she relies on.
She said Hale had been kept alive on IV fluids for eight years after undergoing extensive surgery for Crohn’s disease, a disease in which the immune system attacks the gastrointestinal tract.
“They wouldn’t throw me out like that,” she said, adding that calls to 14 other pharmacies turned up no backup sources. “I have no recourse.”
Texas Health, a large health system in North Texas, said it could not comment on patient-specific cases but had “aggressively implemented IV fluid conservation measures” due to fluid shortages caused by the storm.
The New York Times sent questions to Ms. Hale’s health care provider, who contacted her and advised her that mixing the non-perishable nutrients she had on hand with the saline solution would help and provide a makeshift solution. I was told that it was. She said the last bag of standard IV nutrition would only last until Wednesday.
The estimated 100,000 people who rely on intravenous fluids, including Baxter fluid, to receive dialysis at home have been hit even harder. These patients require special fluids to clean their blood when their kidneys are failing.
The North Carolina plant is one of the largest producers of infusions for home dialysis in the U.S., said William Poirier of the Kidney Care Association.
In the Chicago area, Northwestern Medicine doctors and nurses are working to boost fluid supplies for about 90 patients receiving dialysis at home. Dr. Vikram Agarwal, medical director of the home dialysis program, said they are unable to add new patients at this time.
“We’re doing triage. We’re trying to stratify risk,” he said. “If this shortage takes another week or two, there may be concerns.”
Approximately 400 agency workers are on the ground in the Southwest assisting communities reeling from Hurricane Helen, Health and Human Services Secretary Xavier Becerra said in a letter to health care providers Wednesday. said.
Becerra said the department has been working with Baxter to ensure the safety of the company’s employees and address supplies shortages since Hurricane Helen hit the region.
“My department is committed to doing everything we can to mitigate the effects of Hurricane Helen and prevent further disruption from Hurricane Milton,” the letter from Becerra said.
If federal officials’ plan comes to fruition, more resources could allay concerns.
Health and Human Services and FDA leaders have had extensive experience dealing with medical supply shortages in recent years. The coronavirus pandemic has exposed a severe lack of sufficient supplies, with nurses wearing garbage bags as protective gear and car companies manufacturing ventilators.
In 2023, a shortage of cheap chemotherapy drugs disrupted supplies from late spring to early summer, sparking a worldwide movement to replenish stocks and find new sources of supply. Just over a year ago, a tornado shattered part of the roof of a Pfizer factory in North Carolina, leading to further shortages of generic drugs.
High-stakes shuffling of critical supplies has become the new normal as increasingly powerful and unpredictable storms upend strained medical supply chains. The current IV shortage reminded many hospital workers of a similar power outage after Hurricane Maria in 2017, when the Baxter plant in Puerto Rico stopped making IV fluids.
And this episode is consistent with factors that experts have listed as increasing the risk of confusion for patients. Because the products are cheap, there is no incentive for most suppliers to produce competing products. The barrier to entry into this field is high given the sterility requirements. Product concentration also adds another risk factor, as 60% of the supply comes from a single location in the United States.
Tom Cotter, executive director of Healthcare Ready, a nonprofit founded after Hurricane Katrina, said it remains unclear whether lawmakers and other officials will learn from the series of crises.
“We haven’t seen a huge increase in government investment in resilience to strengthen supply chains,” Cotter said.
“Storms are reaching more intense areas than ever before,” he added. “There is a growing need to expand the scope of what appears to be vulnerable in the medical supply chain.”
