Hospitals scramble as storms worsen IV fluid shortages
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Hospitals across the U.S. are postponing elective surgeries, giving some patients Gatorade and using other workarounds to conserve IV fluids in the face of a nationwide shortage that officials fear will intensify with the arrival of Hurricane Milton.
The big picture: Hurricane Helene swamped a Baxter International plant in North Carolina that supplies more than 60% of the nation's IV solution, and a second key facility operated by B. Braun in Daytona Beach, Florida, is in the path of the latest storm.
- 86% of health providers already are experiencing IV fluid shortages, according to purchasing organization Premier Inc., and almost 1 in 5 have already canceled elective surgeries and other procedures.
Driving the news: The Health and Human Services Department on Wednesday worked to move IV products out of the projected path of Milton out of concern that the storm could be "further disrupting an already fragile market," HHS Secretary Xavier Becerra wrote in a letter to providers.
- Officials also were approving airlifts of IV fluids from overseas manufacturing plants to address shortages stemming from the closure of the Baxter plant, the New York Times reported.
- The saline, dextrose and sterile water fluids have a wide variety of uses, from treating blood infections and administering chemotherapies to keeping patients hydrated, per the Times.
- Hospitals like Mass General Brigham are already withholding IV fluids in some cases and giving patients Gatorade or Pedialyte to stay hydrated.
- "We use in the area of hundreds of thousands of liters of these fluids across our entire system each month," chief preparedness and continuity officer Paul Biddinger told WGBH. "And so even little bits of conservation make a big difference in terms of of preserving our supply."
- The system is encouraging oral hydration with drinks like Gatorade when possible, and not preparing IV fluid bags unless health care teams are certain they'll need them.
Zoom in: The Food and Drug Administration and Baxter are identifying alternative IV, dialysis and nutrition products and the agency is also speeding up reviews of manufacturers' requests to extend the shelf life of products, Becerra wrote in the letter.
- HHS' Administration for Strategic Preparedness and Response is helping Baxter with infrastructure repairs to the North Carolina plant and helping the company to ramp up production at its other U.S. manufacturing sites.
- Federal officials said health care providers should conserve their sterile products, regardless of whether they're experiencing a supply disruption.
- Premier said smaller facilities with 25 or fewer beds are likelier to have had none of their IV orders filled. There's also acute concern about dialysis patients who get IV treatments and nutrition at home.
Catch up quick: IV fluids and other sterile injectable products were already experiencing tight supplies before Hurricane Helene hit, HHS said.
- B. Braun closed its Florida plant and its distribution center Wednesday morning. The company said in a news release that it worked with HHS to move inventory to a secure, temperature-controlled facility north of Florida.
- The company plans to move its product back to Daytona Beach once the storm passes.
- Meanwhile, Baxter has boosted manufacturing at its other locations across the country, and announced on Wednesday that it would increase the amount of high-demand IV fluids its U.S. customers can order.
- The company said it plans to restart production at its North Carolina facility in phases, with a goal of allowing customers to get 90% to 100% of their allocations by the end of the year.
What they're saying: "While we know the recovery from this historic storm will take time, we are grateful for the ongoing commitment to mitigate these supply chain disruptions and ensure access to care for patients," American Hospital Association president Rick Pollack said in a statement.
- AHA on Monday asked the federal government to take a number of actions in response to the Baxter plant's damage, including invoking the Defense Production Act for IV solutions. That would allow officials to require manufacturers to prioritize the production of the needed IV products.
Zoom out: Moody's said nonprofit health systems in Hurricane Milton's path have good liquidity and large physical presences, which could help them weather credit impacts from storm-related disruptions.
- But the storm's effect on local communities, including patients and staff, could cause operational disruptions, said Vanessa Chebli, associate lead analyst at Moody's.
Tina Reed contributed reporting.
